The Use of Preferred Items in a Word-Learning Task: Effects on On-Task Behaviour and Learning Outcomes of Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Keen, Deb; Pennell, Donna

2015-01-01

Identifying and using preferred items and activities to increase motivation and participation of children with autism spectrum disorder (ASD) has been an important and frequently used intervention strategy. Preferred objects, typically identified through a preference assessment, are most frequently used during instruction as reinforcers. These…

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study.

PubMed

Forcadell, Eduard; Torrents-Rodas, David; Vervliet, Bram; Leiva, David; Tortella-Feliu, Miquel; Fullana, Miquel A

2017-11-01

Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Social Tools and Rules for Teens (The START Program): Program Description and Preliminary Outcomes of an Experiential Socialization Intervention for Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Vernon, Ty W.; Miller, Amber R.; Ko, Jordan A.; Wu, Victoria L.

2016-01-01

Experiential learning is an essential process in the development of core social competencies. Unfortunately, adolescents with autism spectrum disorders often do not possess the prerequisite skillset and motivation to sustain the level of social immersion needed to benefit from this learning process. These persisting social vulnerabilities can…

Surfing for thinness: a pilot study of pro-eating disorder Web site usage in adolescents with eating disorders.

PubMed

Wilson, Jenny L; Peebles, Rebecka; Hardy, Kristina K; Litt, Iris F

2006-12-01

Pro-eating disorder Web sites are communities of individuals who engage in disordered eating and use the Internet to discuss their activities. Pro-recovery sites, which are less numerous, express a recovery-oriented perspective. This pilot study investigated the awareness and usage of pro-eating disorder Web sites among adolescents with eating disorders and their parents and explored associations with health and quality of life. This was a cross-sectional study of 698 families of patients (aged 10-22 years) diagnosed with an eating disorder at Stanford between 1997 and 2004. Anonymous surveys were mailed and offered in clinic. Survey content included questions about disease severity, health outcomes, Web site usage, and parental knowledge of eating disorder Web site usage. Surveys were returned by 182 individuals: 76 patients and 106 parents. Parents frequently (52.8%) were aware of pro-eating disorder sites, but an equal number did not know whether their child visited these sites, and only 27.6% had discussed them with their child. Most (62.5%) parents, however, did not know about pro-recovery sites. Forty-one percent of patients visited pro-recovery sites, 35.5% visited pro-eating disorder sites, 25.0% visited both, and 48.7% visited neither. While visiting pro-eating disorder sites, 96.0% reported learning new weight loss or purging techniques. However, 46.4% of pro-recovery site visitors also learned new techniques. Pro-eating disorder site users did not differ from nonusers in health outcomes but reported spending less time on school or schoolwork and had a longer duration of illness. Users of both pro-eating disorder and pro-recovery sites were hospitalized more than users of neither site. Pro-eating disorder site usage was prevalent among adolescents with eating disorders, yet parents had little knowledge of this. Although use of these sites was not associated with other health outcomes, usage may have a negative impact on quality of life and result in adolescents' learning about and adopting disordered eating behaviors.

Response to Nadler's Commentary on Arch and Craske's (2011) "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes"

ERIC Educational Resources Information Center

Arch, Joanna J.; Craske, Michelle G.

2012-01-01

Nadler (this issue), in his commentary of our article, "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes" (Arch & Craske, 2011), argues that we misrepresent the role of panic attacks within learning theory and overlook cognitive treatment targets. He presents several case…

Electroencephalographic Evidence of Abnormal Anticipatory Uncertainty Processing in Gambling Disorder Patients.

PubMed

Megías, Alberto; Navas, Juan F; Perandrés-Gómez, Ana; Maldonado, Antonio; Catena, Andrés; Perales, José C

2018-06-01

Putting money at stake produces anticipatory uncertainty, a process that has been linked to key features of gambling. Here we examined how learning and individual differences modulate the stimulus preceding negativity (SPN, an electroencephalographic signature of perceived uncertainty of valued outcomes) in gambling disorder patients (GDPs) and healthy controls (HCs), during a non-gambling contingency learning task. Twenty-four GDPs and 26 HCs performed a causal learning task under conditions of high and medium uncertainty (HU, MU; null and positive cue-outcome contingency, respectively). Participants were asked to predict the outcome trial-by-trial, and to regularly judge the strength of the cue-outcome contingency. A pre-outcome SPN was extracted from simultaneous electroencephalographic recordings for each participant, uncertainty level, and task block. The two groups similarly learnt to predict the occurrence of the outcome in the presence/absence of the cue. In HCs, SPN amplitude decreased as the outcome became predictable in the MU condition, a decrement that was absent in the HU condition, where the outcome remained unpredictable during the task. Most importantly, GDPs' SPN remained high and insensitive to task type and block. In GDPs, the SPN amplitude was linked to gambling preferences. When both groups were considered together, SPN amplitude was also related to impulsivity. GDPs thus showed an abnormal electrophysiological response to outcome uncertainty, not attributable to faulty contingency learning. Differences with controls were larger in frequent players of passive games, and smaller in players of more active games. Potential psychological mechanisms underlying this set of effects are discussed.

Social and Individual Aspects of Classroom Learning in Students with Autism Spectrum Disorder: An Action Research Pilot Study on Assessment

ERIC Educational Resources Information Center

Asberg, Jakob; Zander, Ulla; Zander, Eric; Sandberg, Annika Dahlgren

2012-01-01

The current paper reports on the outcome of an ongoing action research project at a school for higher-functioning students with Autism Spectrum Disorder (ASD) in Sweden. The overall aim of the study was to develop and evaluate a questionnaire that captures social and individual aspects of classroom learning suitable for use with students with ASD.…

Translational studies of goal-directed action as a framework for classifying deficits across psychiatric disorders

PubMed Central

Griffiths, Kristi R.; Morris, Richard W.; Balleine, Bernard W.

2014-01-01

The ability to learn contingencies between actions and outcomes in a dynamic environment is critical for flexible, adaptive behavior. Goal-directed actions adapt to changes in action-outcome contingencies as well as to changes in the reward-value of the outcome. When networks involved in reward processing and contingency learning are maladaptive, this fundamental ability can be lost, with detrimental consequences for decision-making. Impaired decision-making is a core feature in a number of psychiatric disorders, ranging from depression to schizophrenia. The argument can be developed, therefore, that seemingly disparate symptoms across psychiatric disorders can be explained by dysfunction within common decision-making circuitry. From this perspective, gaining a better understanding of the neural processes involved in goal-directed action, will allow a comparison of deficits observed across traditional diagnostic boundaries within a unified theoretical framework. This review describes the key processes and neural circuits involved in goal-directed decision-making using evidence from animal studies and human neuroimaging. Select studies are discussed to outline what we currently know about causal judgments regarding actions and their consequences, action-related reward evaluation, and, most importantly, how these processes are integrated in goal-directed learning and performance. Finally, we look at how adaptive decision-making is impaired across a range of psychiatric disorders and how deepening our understanding of this circuitry may offer insights into phenotypes and more targeted interventions. PMID:24904322

Auditory middle latency response in children with learning difficulties.

PubMed

Frizzo, Ana Claudia Figueiredo; Issac, Myriam Lima; Pontes-Fernandes, Angela Cristina; Menezes, Pedro de Lemos; Funayama, Carolina Araújo Rodrigues

2012-07-01

 This is an objective laboratory assessment of the central auditory systems of children with learning disabilities.  To examine and determine the properties of the components of the Auditory Middle Latency Response in a sample of children with learning disabilities.  This was a prospective, cross-sectional cohort study with quantitative, descriptive, and exploratory outcomes. We included 50 children aged 8-13 years of both genders with and without learning disorders. Those with disorders of known organic, environmental, or genetic causes were excluded.  The Na, Pa, and Nb waves were identified in all subjects. The ranges of the latency component values were as follows: Na = 9.8-32.3 ms, Pa = 19.0-51.4 ms, Nb = 30.0-64.3 ms (learning disorders group) and Na = 13.2-29.6 ms, Pa = 21.8-42.8 ms, Nb = 28.4-65.8 ms (healthy group). The values of the Na-Pa amplitude ranged from 0.3 to 6.8 ìV (learning disorders group) or 0.2-3.6 ìV (learning disorders group). Upon analysis, the functional characteristics of the groups were distinct: the left hemisphere Nb latency was longer in the study group than in the control group. Peculiarities of the electrophysiological measures were observed in the children with learning disorders. This study has provided information on the Auditory Middle Latency Response and can serve as a reference for other clinical and experimental studies in children with these disorders.

Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum.

PubMed

Fejzo, Marlena S; Magtira, Aromalyn; Schoenberg, Frederic Paik; Macgibbon, Kimber; Mullin, Patrick M

2015-06-01

The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (P<0.0005). Among characteristics of HG pregnancies, only early onset of symptoms (prior to 5 weeks gestation) was significantly linked to neurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Auditory middle latency response in children with learning difficulties

PubMed Central

Frizzo, Ana Claudia Figueiredo; Issac, Myriam Lima; Pontes-Fernandes, Angela Cristina; Menezes, Pedro de Lemos; Funayama, Carolina Araújo Rodrigues

2012-01-01

Summary Introduction: This is an objective laboratory assessment of the central auditory systems of children with learning disabilities. Aim: To examine and determine the properties of the components of the Auditory Middle Latency Response in a sample of children with learning disabilities. Methods: This was a prospective, cross-sectional cohort study with quantitative, descriptive, and exploratory outcomes. We included 50 children aged 8–13 years of both genders with and without learning disorders. Those with disorders of known organic, environmental, or genetic causes were excluded. Results and Conclusions: The Na, Pa, and Nb waves were identified in all subjects. The ranges of the latency component values were as follows: Na = 9.8–32.3 ms, Pa = 19.0–51.4 ms, Nb = 30.0–64.3 ms (learning disorders group) and Na = 13.2–29.6 ms, Pa = 21.8–42.8 ms, Nb = 28.4–65.8 ms (healthy group). The values of the Na-Pa amplitude ranged from 0.3 to 6.8 ìV (learning disorders group) or 0.2–3.6 ìV (learning disorders group). Upon analysis, the functional characteristics of the groups were distinct: the left hemisphere Nb latency was longer in the study group than in the control group. Peculiarities of the electrophysiological measures were observed in the children with learning disorders. This study has provided information on the Auditory Middle Latency Response and can serve as a reference for other clinical and experimental studies in children with these disorders. PMID:25991954

Neural Correlates of Reversal Learning in Severe Mood Dysregulation and Pediatric Bipolar Disorder

ERIC Educational Resources Information Center

Adleman, Nancy E.; Kayser, Reilly; Dickstein, Daniel; Blair, R. James R.; Pine, Daniel; Leibenluft, Ellen

2011-01-01

Objective: Outcome and family history data differentiate children with severe mood dysregulation (SMD), a syndrome characterized by chronic irritability, from children with "classic" episodic bipolar disorder (BD). Nevertheless, the presence of cognitive inflexibility in SMD and BD highlights the need to delineate neurophysiologic similarities and…

Attention-deficit hyperactivity disorder.

PubMed

Meek, D C

1990-09-01

The attention-deficit hyperactivity disorder is a common chronic disorder of childhood. No precise definition or approach to treatment is universally accepted; however, an extensive literature exists on which to base a rational approach to management. Symptomatic treatment with stimulant medication in selected patients is effective and safe, but not curative. Successful outcome depends on multimodality therapy, involving parents, teachers, and other professionals. Associated conditions, including learning disorders and emotional disturbance, must be identified and dealt with.

Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial.

PubMed

Kelly, J MacLaren; Jakubovski, Ewgeni; Bloch, Michael H

2015-03-01

Most patients with anxiety disorders receive treatment in primary care settings. Limited moderator data are available to inform clinicians of likely prognostic outcomes for individual patients. We identify baseline characteristics associated with outcome in adults seeking treatment for anxiety disorders. We conducted an exploratory moderator analysis from the Coordinated Anxiety Learning and Management (CALM) trial. In the CALM trial, 1,004 adults who met DSM-IV criteria for generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and/or posttraumatic stress disorder (PTSD) were randomized to usual care (UC) or a collaborative care intervention (ITV) of cognitive-behavioral therapy and/or pharmacotherapy between June 2006 and April 2008. Logistic regression was used to examine baseline characteristics associated with remission and response overall and by treatment condition. Receiver operating curve (ROC) analyses identified subgroups associated with similar likelihood of response and remission of global anxiety symptoms. Remission was defined as score < 6 on the 12-item Brief Symptom Inventory (BSI-12) anxiety and somatization subscales. Response was defined as at least 50% reduction on BSI-12, or meeting remission criteria. Randomization to ITV over UC was often the strongest predictor of outcome. Several baseline patient characteristics were associated with poor treatment outcome including comorbid depression, increased severity of underlying anxiety disorder(s) (P < .001), low socioeconomic status (perceived [P < .001] and actual [P < .05]), and limited social support (P < .001). Patient characteristics associated with particular benefit from ITV were being female (P < .05), increased depression (P < .01)/GAD severity (P < .05), and low socioeconomic status (P < .05). ROC analysis demonstrated prognostic subgroups with large differences in response likelihood. Further research should focus on the effectiveness of implementing the ITV intervention of CALM in community treatment centers where patients typically are of low socioeconomic status and may particularly benefit from ITV. ClinicalTrials.gov identifier: NCT00347269. © Copyright 2015 Physicians Postgraduate Press, Inc.

Intermediate Work Outcomes for Adolescents with High-Incidence Disabilities

ERIC Educational Resources Information Center

Rojewski, Jay W.; Lee, In Heok; Gregg, Noel

2014-01-01

A longitudinal sample from the Educational Longitudinal Study of 2002 was used to determine differences in work outcomes between (a) individuals with learning disabilities or emotional-behavior disorders and (b) individuals with or without disabilities. Twelve factors were arranged into individual, family, school-peer, and community categories.…

Teaching Reading Comprehension to Learners with Autism Spectrum Disorder: Predictors of Teacher Self-Efficacy and Outcome Expectancy

ERIC Educational Resources Information Center

Accardo, Amy L.; Finnegan, Elizabeth G.; Gulkus, Steven P.; Papay, Clare K.

2017-01-01

Learners with autism spectrum disorder (ASD) often exhibit difficulty in the area of reading comprehension. Research connecting the learning needs of individuals with ASD, existing effective practices, teacher training, and teacher perceptions of their own ability to teach reading comprehension is scarce. Quantitative survey methodology and…

Fast mapping semantic features: performance of adults with normal language, history of disorders of spoken and written language, and attention deficit hyperactivity disorder on a word-learning task.

PubMed

Alt, Mary; Gutmann, Michelle L

2009-01-01

This study was designed to test the word learning abilities of adults with typical language abilities, those with a history of disorders of spoken or written language (hDSWL), and hDSWL plus attention deficit hyperactivity disorder (+ADHD). Sixty-eight adults were required to associate a novel object with a novel label, and then recognize semantic features of the object and phonological features of the label. Participants were tested for overt ability (accuracy) and covert processing (reaction time). The +ADHD group was less accurate at mapping semantic features and slower to respond to lexical labels than both other groups. Different factors correlated with word learning performance for each group. Adults with language and attention deficits are more impaired at word learning than adults with language deficits only. Despite behavioral profiles like typical peers, adults with hDSWL may use different processing strategies than their peers. Readers will be able to: (1) recognize the influence of a dual disability (hDSWL and ADHD) on word learning outcomes; (2) identify factors that may contribute to word learning in adults in terms of (a) the nature of the words to be learned and (b) the language processing of the learner.

Emotion-based learning systems and the development of morality.

PubMed

Blair, R J R

2017-10-01

In this paper it is proposed that important components of moral development and moral judgment rely on two forms of emotional learning: stimulus-reinforcement and response-outcome learning. Data in support of this position will be primarily drawn from work with individuals with the developmental condition of psychopathy as well as fMRI studies with healthy individuals. Individuals with psychopathy show impairment on moral judgment tasks and a pronounced increased risk for instrumental antisocial behavior. It will be argued that these impairments are developmental consequences of impaired stimulus-aversive conditioning on the basis of distress cue reinforcers and response-outcome learning in individuals with this disorder. Copyright © 2017. Published by Elsevier B.V.

Attention to the Model's Face When Learning from Video Modeling Examples in Adolescents with and without Autism Spectrum Disorder

ERIC Educational Resources Information Center

van Wermeskerken, Margot; Grimmius, Bianca; van Gog, Tamara

2018-01-01

We investigated the effects of seeing the instructor's (i.e., the model's) face in video modeling examples on students' attention and their learning outcomes. Research with university students suggested that the model's face attracts students' attention away from what the model is doing, but this did not hamper learning. We aimed to investigate…

Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort.

PubMed

Hu, Danqing; Flick, Randall P; Zaccariello, Michael J; Colligan, Robert C; Katusic, Slavica K; Schroeder, Darrell R; Hanson, Andrew C; Buenvenida, Shonie L; Gleich, Stephen J; Wilder, Robert T; Sprung, Juraj; Warner, David O

2017-08-01

Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models. For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability. These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.

An effect of serotonergic stimulation on learning rates for rewards apparent after long intertrial intervals.

PubMed

Iigaya, Kiyohito; Fonseca, Madalena S; Murakami, Masayoshi; Mainen, Zachary F; Dayan, Peter

2018-06-26

Serotonin has widespread, but computationally obscure, modulatory effects on learning and cognition. Here, we studied the impact of optogenetic stimulation of dorsal raphe serotonin neurons in mice performing a non-stationary, reward-driven decision-making task. Animals showed two distinct choice strategies. Choices after short inter-trial-intervals (ITIs) depended only on the last trial outcome and followed a win-stay-lose-switch pattern. In contrast, choices after long ITIs reflected outcome history over multiple trials, as described by reinforcement learning models. We found that optogenetic stimulation during a trial significantly boosted the rate of learning that occurred due to the outcome of that trial, but these effects were only exhibited on choices after long ITIs. This suggests that serotonin neurons modulate reinforcement learning rates, and that this influence is masked by alternate, unaffected, decision mechanisms. These results provide insight into the role of serotonin in treating psychiatric disorders, particularly its modulation of neural plasticity and learning.

Schools' Mental Health Services and Young Children's Emotions, Behavior, and Learning

ERIC Educational Resources Information Center

Reback, Randall

2010-01-01

Recent empirical research has found that children's noncognitive skills play a critical role in their own success, young children's behavioral and psychological disorders can severely harm their future outcomes, and disruptive students harm the behavior and learning of their classmates. Yet relatively little is known about wide-scale interventions…

Acquisition of CS-US contingencies during Pavlovian fear conditioning and extinction in social anxiety disorder and posttraumatic stress disorder.

PubMed

Rabinak, Christine A; Mori, Shoko; Lyons, Maryssa; Milad, Mohammed R; Phan, K Luan

2017-01-01

Fear-based disorders, like social anxiety disorder (SAD) and posttraumatic stress disorder (PTSD), are characterized by an exaggerated fear response and avoidance to trigger cues, suggesting a transdiagnostic mechanism of psychopathology. Current theories suggest that abnormalities in conditioned fear is a primary contributor to the pathophysiology of these disorders. The primary goal of this study was to compare acquisition of conditioned stimulus (CS) and aversive unconditioned stimulus (US) contingencies during fear learning and extinction in individuals with SAD and PTSD. In a standard Pavlovian fear conditioning-extinction paradigm we measured subjective US expectancy ratings to different CSs in patients with SAD (n=16) compared to patients with PTSD (n=13) and healthy controls (n=15) RESULTS: Both patient groups (SAD, PTSD) acquired differential conditioning between a CS that predicted US (CS+) and a CS that never predicted the US (CS-), however, both groups reported an increased expectancy that the US would occur following the CS-. Additionally, the PTSD group overestimated that the US would occur in general. Neither patient group showed evidence of successful extinction of the CS+-US contingency nor differentiated their expectation of US occurrence between the CS+ and CS- during extinction learning. Group sample sizes were small and we did not include a trauma-exposed group without PTSD CONCLUSIONS: Both SAD and PTSD generalize expectations of an aversive outcome across CSs, even when a CS never signals an aversive outcome and PTSD may tend to over-expect threat. Fear learning and extinction abnormalities may be a core feature underlying shared symptoms across fear-based disorders. Copyright © 2016 Elsevier B.V. All rights reserved.

Evidence-Based Family Interventions for Adolescents and Young Adults With Bipolar Disorder.

PubMed

Miklowitz, David J

2016-01-01

An individual can develop bipolar disorder at any age, but emergence during adolescence and young adulthood can lead to a number of problematic behaviors and outcomes. Several drugs are available as first-line treatments, but even optimal pharmacotherapy rarely leads to complete remission and recovery. When added to pharmacologic treatment, certain targeted psychosocial treatments can improve outcomes for young patients with bipolar disorder. Because bipolar disorder affects family members as well as patients, and because adolescents and young adults often live with and are dependent on their parents, the patient's family should usually be included in treatment. Family-focused treatment and dialectical behavior therapy are promising methods of conducting family intervention. With effective treatment and the support of their families, young patients with bipolar disorder can learn to manage their disorder and become independent and healthy adults. © Copyright 2016 Physicians Postgraduate Press, Inc.

Developmental dyscalculia.

PubMed

Shalev, Ruth S

2004-10-01

Developmental dyscalculia is a specific learning disability affecting the normal acquisition of arithmetic skills. Genetic, neurobiologic, and epidemiologic evidence indicates that dyscalculia, like other learning disabilities, is a brain-based disorder. However, poor teaching and environmental deprivation have also been implicated in its etiology. Because the neural network of both hemispheres comprises the substrate of normal arithmetic skills, dyscalculia can result from dysfunction of either hemisphere, although the left parietotemporal area is of particular significance. The prevalence of developmental dyscalculia is 5 to 6% in the school-aged population and is as common in girls as in boys. Dyscalculia can occur as a consequence of prematurity and low birthweight and is frequently encountered in a variety of neurologic disorders, such as attention-deficit hyperactivity disorder (ADHD), developmental language disorder, epilepsy, and fragile X syndrome. Developmental dyscalculia has proven to be a persisting learning disability, at least for the short term, in about half of affected preteen pupils. Educational interventions for dyscalculia range from rote learning of arithmetic facts to developing strategies for solving arithmetic exercises. The long-term prognosis of dyscalculia and the role of remediation in its outcome are yet to be determined.

Feedback-based probabilistic category learning is selectively impaired in attention/hyperactivity deficit disorder.

PubMed

Gabay, Yafit; Goldfarb, Liat

2017-07-01

Although Attention-Deficit Hyperactivity Disorder (ADHD) is closely linked to executive function deficits, it has recently been attributed to procedural learning impairments that are quite distinct from the former. These observations challenge the ability of the executive function framework solely to account for the diverse range of symptoms observed in ADHD. A recent neurocomputational model emphasizes the role of striatal dopamine (DA) in explaining ADHD's broad range of deficits, but the link between this model and procedural learning impairments remains unclear. Significantly, feedback-based procedural learning is hypothesized to be disrupted in ADHD because of the involvement of striatal DA in this type of learning. In order to test this assumption, we employed two variants of a probabilistic category learning task known from the neuropsychological literature. Feedback-based (FB) and paired associate-based (PA) probabilistic category learning were employed in a non-medicated sample of ADHD participants and neurotypical participants. In the FB task, participants learned associations between cues and outcomes initially by guessing and subsequently through feedback indicating the correctness of the response. In the PA learning task, participants viewed the cue and its associated outcome simultaneously without receiving an overt response or corrective feedback. In both tasks, participants were trained across 150 trials. Learning was assessed in a subsequent test without a presentation of the outcome or corrective feedback. Results revealed an interesting disassociation in which ADHD participants performed as well as control participants in the PA task, but were impaired compared with the controls in the FB task. The learning curve during FB training differed between the two groups. Taken together, these results suggest that the ability to incrementally learn by feedback is selectively disrupted in ADHD participants. These results are discussed in relation to both the ADHD dopaminergic dysfunction model and recent findings implicating procedural learning impairments in those with ADHD. Copyright © 2017 Elsevier Inc. All rights reserved.

Nociceptin and the nociceptin receptor in learning and memory.

PubMed

Andero, Raül

2015-10-01

There are many processes in which the neuropeptide nociceptin/orphanin FQ (N/OFQ or nociceptin) is involved in the brain. The role of nociceptin in learning and memory holds promise in modulating these processes in health and disease in the human brain. This review summarizes the body of research focused on N/OFQ and its specific receptor, the nociceptin receptor (NOP receptor), in learning and memory, and its potential mechanisms of action, in which acetylcholine, NMDA receptor, and noradrenaline may be critical. Finally, the association between NOP receptor and posttraumatic stress disorder (PTSD), a psychiatric disorder with altered fear learning, is examined as one of the potential outcomes resulting from pathological consequences of dysregulation of N/OFQ-NOP receptor in the brain. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhancing Exposure Therapy for Anxiety Disorders, Obsessive Compulsive Disorder, and Posttraumatic Stress Disorder

PubMed Central

McGuire, Joseph F.; Lewin, Adam B.; Storch, Eric A.

2014-01-01

Translating findings from basic science, several compounds have been identified that may enhance therapeutic outcomes and/or expedite treatment gains when administered alongside exposure-based treatments. Four of these compounds (referred to as cognitive enhancers) have been evaluated in the context of randomized controlled trials for anxiety disorders (e.g., specific phobias, panic disorder, social anxiety disorder), obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). These cognitive enhancers include D-cycloserine, yohimbine hydrochloride, glucocorticoids and cortisol, and brain derived neurotrophic factor. There is consistent evidence that cognitive enhancers can enhance therapeutic outcomes and/or expedite treatment gains across anxiety disorders, OCD, and PTSD. Emerging evidence has highlighted the importance of within-session fear habituation and between-session fear learning, which can either enhance fear extinction or reconsolidate of fear responses. Although findings from these trials are promising, there are several considerations that warrant further evaluation prior to wide-spread use of cognitive enhancers in exposure-based treatments. Consistent trial design and large sample sizes are important in future studies of cognitive enhancers. PMID:24972729

Can you spell dyslexia without SLI? Comparing the cognitive profiles of dyslexia and specific language impairment and their roles in learning.

PubMed

Alloway, Tracy Packiam; Tewolde, Furtuna; Skipper, Dakota; Hijar, David

2017-06-01

The aim of the present study is to explore whether those with Specific Language Impairment (SLI) and dyslexia display distinct or overlapping cognitive profiles with respect to learning outcomes. In particular, we were interested in two key cognitive skills associated with academic performance - working memory and IQ. We recruited three groups of children - those with SLI, those with dyslexia, and a control group. All children were given standardized tests of working memory, IQ (vocabulary and matrix), spelling, and math. The pattern of results suggests that both children with dyslexia and SLI are characterized with poorer verbal working memory and IQ compared to controls, but preserved nonverbal cognitive skills. It appears that that these two disorder groups cannot be distinguished by the severity of their cognitive deficits. However, there was a differential pattern with respect to learning outcomes, where the children with dyslexia rely more on visual skills in spelling, while those with SLI use their relative strengths in vocabulary. These findings can have important implications for how intervention is tailored in the classroom, as disorder-specific support could yield important gains in learning. Copyright © 2017. Published by Elsevier Ltd.

Learning and Recall of Medical Treatment-Related Information in Older Adults Using the Differential Outcomes Procedure

PubMed Central

Plaza, Victoria; Molina, Michael; Fuentes, Luis J.; Estévez, Angeles F.

2018-01-01

It has recently been reported that the differential outcomes procedure (DOP) might be one of the therapeutical techniques focused at promoting autonomy in the elderly to deal with their medical issues. Molina et al. (2015) found that a group of healthy young adults improved their learning and long-term retention of six disorder/pill associations when each relationship to be learned was associated with a particular reinforcer (the differential outcomes condition) compared to when they were randomly administered (the non-differential outcomes condition). In the present study, we extend these findings to older adults who usually show difficulties to remember to take their medications as prescribed. Participants were asked to learn the association between three pills and the specific time at the day when they had to take each medication. Two memory tests were also performed 1 h and 1 week after completing the training phase. Results showed a faster learning of the task and long-term retention of the previously learned associations (pill/time of day) when differential outcomes were used. Furthermore, the older adults’ performance in the learning and memory phases did not differ from that of the younger adults in the DOP condition. These findings demonstrate that this procedure can help elderly people to ameliorate not only their learning, but also their long-term memory difficulties, suggesting the potential for the DOP to promote adherence to treatment in this population. PMID:29491846

Assessing learning outcomes and cost effectiveness of an online sleep curriculum for medical students.

PubMed

Bandla, Hari; Franco, Rose A; Simpson, Deborah; Brennan, Kimberly; McKanry, Jennifer; Bragg, Dawn

2012-08-15

Sleep disorders are highly prevalent across all age groups but often remain undiagnosed and untreated, resulting in significant health consequences. To overcome an inadequacy of available curricula and learner and instructor time constraints, this study sought to determine if an online sleep medicine curriculum would achieve equivalent learner outcomes when compared with traditional, classroom-based, face-to-face instruction at equivalent costs. Medical students rotating on a required clinical clerkship received instruction in 4 core clinical sleep-medicine competency domains in 1 of 2 delivery formats: a single 2.5-hour face-to-face workshop or 4 asynchronous e-learning modules. Immediate learning outcomes were assessed in a subsequent clerkship using a multiple-choice examination and standardized patient station, with long-term outcomes assessed through analysis of students' patient write-ups for inclusion of sleep complaints and diagnoses before and after the intervention. Instructional costs by delivery format were tracked. Descriptive and inferential statistical analyses compared learning outcomes and costs by instructional delivery method (face-to-face versus e-learning). Face-to-face learners, compared with online learners, were more satisfied with instruction. Learning outcomes (i.e., multiple-choice examination, standardized patient encounter, patient write-up), as measured by short-term and long-term assessments, were roughly equivalent. Design, delivery, and learner-assessment costs by format were equivalent at the end of 1 year, due to higher ongoing teaching costs associated with face-to-face learning offsetting online development and delivery costs. Because short-term and long-term learner performance outcomes were roughly equivalent, based on delivery method, the cost effectiveness of online learning is an economically and educationally viable instruction platform for clinical clerkships.

Protective resources and long-term recovery from alcohol use disorders.

PubMed

Moos, Rudolf H; Moos, Bernice S

2007-01-05

This study examined indices of personal and social resources drawn from social learning, behavioral economics, and social control theories as predictors of medium- and long-term alcohol use disorder outcomes. Individuals (N = 461) who initiated help-seeking for alcohol-related problems were surveyed at baseline and 1, 3, 8, and 16 years later. At baseline and each follow-up, participants provided information about their personal and social resources and alcohol-related and psychosocial functioning. In general, protective resources associated with social learning (self-efficacy and approach coping), behavioral economics (health and financial resources and resources associated with Alcoholics Anonymous), and social control theory (bonding with family members, friends, and coworkers) predicted better alcohol-related and psychosocial outcomes. A summary index of protective resources associated with all three theories significantly predicted remission. Protective resources strengthened the positive influence of treatment on short-term remission and partially mediated the association between treatment and remission. Application of social learning, behavior economic, and social control theories may help to identify predictors of remission and thus to allocate treatment more efficiently.

Brain mapping in cognitive disorders: a multidisciplinary approach to learning the tools and applications of functional neuroimaging

PubMed Central

Kelley, Daniel J; Johnson, Sterling C

2007-01-01

Background With rapid advances in functional imaging methods, human studies that feature functional neuroimaging techniques are increasing exponentially and have opened a vast arena of new possibilities for understanding brain function and improving the care of patients with cognitive disorders in the clinical setting. There is a growing need for medical centers to offer clinically relevant functional neuroimaging courses that emphasize the multifaceted and multidisciplinary nature of this field. In this paper, we describe the implementation of a functional neuroimaging course focusing on cognitive disorders that might serve as a model for other medical centers. We identify key components of an active learning course design that impact student learning gains in methods and issues pertaining to functional neuroimaging that deserve consideration when optimizing the medical neuroimaging curriculum. Methods Learning gains associated with the course were assessed using polychoric correlation analysis of responses to the SALG (Student Assessment of Learning Gains) instrument. Results Student gains in the functional neuroimaging of cognition as assessed by the SALG instrument were strongly associated with several aspects of the course design. Conclusion Our implementation of a multidisciplinary and active learning functional neuroimaging course produced positive learning outcomes. Inquiry-based learning activities and an online learning environment contributed positively to reported gains. This functional neuroimaging course design may serve as a useful model for other medical centers. PMID:17953758

Decision Making: from Neuroscience to Psychiatry

PubMed Central

Lee, Daeyeol

2013-01-01

Adaptive behaviors increase the likelihood of survival and reproduction and improve the quality of life. However, it is often difficult to identify optimal behaviors in real life due to the complexity of the decision maker’s environment and social dynamics. As a result, although many different brain areas and circuits are involved in decision making, evolutionary and learning solutions adopted by individual decision makers sometimes produce suboptimal outcomes. Although these problems are exacerbated in numerous neurological and psychiatric disorders, their underlying neurobiological causes remain incompletely understood. In this review, theoretical frameworks in economics and machine learning and their applications in recent behavioral and neurobiological studies are summarized. Examples of such applications in clinical domains are also discussed for substance abuse, Parkinson’s disease, attention-deficit/hyperactivity disorder, schizophrenia, mood disorders, and autism. Findings from these studies have begun to lay the foundations necessary to improve diagnostics and treatment for various neurological and psychiatric disorders. PMID:23622061

Disadvantageous decision-making in borderline personality disorder: Partial support from a meta-analytic review.

PubMed

Paret, Christian; Jennen-Steinmetz, Christine; Schmahl, Christian

2017-01-01

To achieve long-term goals, organisms evaluate outcomes and expected consequences of their behaviors. Unfavorable decisions maintain many symptoms of borderline personality disorder (BPD); therefore, a better understanding of the mechanisms underlying decision-making in BPD is needed. In this review, the current literature comparing decision-making in patients with BPD versus healthy controls is analyzed. Twenty-eight empirical studies were identified through a structured literature search. The effect sizes from studies applying comparable experimental tasks were analyzed. It was found that (1) BPD patients discounted delayed rewards more strongly; (2) reversal learning was not significantly altered in BPD; and (3) BPD patients achieved lower net gains in the Iowa Gambling Task (IGT). Current psychotropic medication, sex and differences in age between the patient and control group moderated the IGT outcome. Altered decision-making in a variety of other tasks was supported by a qualitative review. In summary, current evidence supports the altered valuation of outcomes in BPD. A multifaceted influence on decision-making and adaptive learning is reflected in this literature. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impaired cognitive plasticity and goal-directed control in adolescent obsessive-compulsive disorder.

PubMed

Gottwald, Julia; de Wit, Sanne; Apergis-Schoute, Annemieke M; Morein-Zamir, Sharon; Kaser, Muzaffer; Cormack, Francesca; Sule, Akeem; Limmer, Winifred; Morris, Anna Conway; Robbins, Trevor W; Sahakian, Barbara J

2018-01-22

Youths with obsessive-compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study. A total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control. Adolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control. This study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.

Prediction of Autism at 3 Years from Behavioural and Developmental Measures in High-Risk Infants: A Longitudinal Cross-Domain Classifier Analysis

ERIC Educational Resources Information Center

Bussu, G.; Jones, E. J. H.; Charman, T.; Johnson, M. H.; Buitelaar, J. K.; Baron-Cohen, S.; Bedford, R.; Bolton, P.; Blasi, A.; Chandler, S.; Cheung, C.; Davies, K.; Elsabbagh, M.; Fernandes, J.; Gammer, I.; Garwood, H.; Gliga, T.; Guiraud, J.; Hudry, K.; Liew, M.; Lloyd-Fox, S.; Maris, H.; O'Hara, L.; Pasco, G.; Pickles, A.; Ribeiro, H.; Salomone, E.; Tucker, L.; Volein, A.

2018-01-01

We integrated multiple behavioural and developmental measures from multiple time-points using machine learning to improve early prediction of individual Autism Spectrum Disorder (ASD) outcome. We examined Mullen Scales of Early Learning, Vineland Adaptive Behavior Scales, and early ASD symptoms between 8 and 36 months in high-risk siblings (HR; n…

Modifications to the Trauma Recovery and Empowerment Model (TREM) for Substance-Abusing Women with Histories of Violence: Outcomes and Lessons Learned at a Colorado Substance Abuse Treatment Center

ERIC Educational Resources Information Center

Toussaint, Danielle W.; VanDeMark, Nancy R.; Bornemann, Angela; Graeber, Carla J.

2007-01-01

A growing body of literature demonstrates the co-occurrence of posttraumatic stress disorder and substance use disorder for females seeking substance abuse treatment. Nonetheless, relatively few trauma-specific treatments have been implemented or evaluated with this population. In this quasi-experimental study (N = 170), the Trauma Recovery and…

Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study.

PubMed

Van den Heuvel, S C G H; Goossens, P J J; Terlouw, C; Van Achterberg, T; Schoonhoven, L

2015-12-01

Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face-to-face, in-depth interviews, guided by a topic list, along service users with BD I or II (n = 16) in three specialised community care clinics across the Netherlands. Interviews were digitally recorded and transcribed verbatim prior to analysis in Atlas.ti 7. Unlike existing studies, which suggest that individual abilities of service users determine outcomes in self-management of BD, the current study found that self-management of BD is a learning process that takes place in a collaborative network. We identified five categories: acknowledgment of having BD, processing the information load, illness management, reflecting on living with BD, and self-management of BD. The success of self-management depends on the acknowledgment of individual limitations in learning to cope with BD and willingness to use a social network as a back-up instead. Especially, the dormant fear of a recurrent episode is a hampering factor in this learning process. © 2015 John Wiley & Sons Ltd.

Sense of agency, associative learning, and schizotypy

PubMed Central

Moore, James W.; Dickinson, Anthony; Fletcher, Paul C.

2011-01-01

Despite the fact that the role of learning is recognised in empirical and theoretical work on sense of agency (SoA), the nature of this learning has, rather surprisingly, received little attention. In the present study we consider the contribution of associative mechanisms to SoA. SoA can be measured quantitatively as a temporal linkage between voluntary actions and their external effects. Using an outcome blocking procedure, it was shown that training action–outcome associations under conditions of increased surprise augmented this temporal linkage. Moreover, these effects of surprise were correlated with schizotypy scores, suggesting that individual differences in higher level experiences are related to associative learning and to its impact on SoA. These results are discussed in terms of models of SoA, and our understanding of disrupted SoA in certain disorders. PMID:21295497

Adult Outcome of ADHD: An Overview of Results From the MGH Longitudinal Family Studies of Pediatrically and Psychiatrically Referred Youth With and Without ADHD of Both Sexes.

PubMed

Uchida, Mai; Spencer, Thomas J; Faraone, Stephen V; Biederman, Joseph

2018-04-01

We aimed to provide an overview of the Massachusetts General Hospital (MGH) Longitudinal Studies of ADHD. We evaluated and followed samples of boys and girls with and without ADHD ascertained from psychiatric and pediatric sources and their families. These studies documented that ADHD in both sexes is associated with high levels of persistence into adulthood, high levels of familiality with ADHD and other psychiatric disorders, a wide range of comorbid psychiatric and cognitive disorders including mood, anxiety, and substance use disorders, learning disabilities, executive function deficits, emotional dysregulation, and autistic traits as well as functional impairments. The MGH studies suggested that stimulant treatment decreased risks of developing comorbid psychiatric disorders, substance use disorders, and functional outcomes. The MGH studies documented the neural basis of persistence of ADHD using neuroimaging. The MGH studies provided various insights on symptoms, course, functions, comorbidities, and neuroscience of ADHD.

Elucidating the Links Between Endocrine Disruptors and Neurodevelopment

PubMed Central

Blawas, Ashley M.; Gray, Kimberly; Heindel, Jerrold J.; Lawler, Cindy P.

2015-01-01

Recent data indicate that approximately 12% of children in the United States are affected by neurodevelopmental disorders, including attention deficit hyperactivity disorder, learning disorders, intellectual disabilities, and autism spectrum disorders. Accumulating evidence indicates a multifactorial etiology for these disorders, with social, physical, genetic susceptibility, nutritional factors, and chemical toxicants acting together to influence risk. Exposure to endocrine-disrupting chemicals during the early stages of life can disrupt normal patterns of development and thus alter brain function and disease susceptibility later in life. This article highlights research efforts and pinpoints approaches that could shed light on the possible associations between environmental chemicals that act on the endocrine system and compromised neurodevelopmental outcomes. PMID:25714811

Who Gets the Most Out of Cognitive-Behavioral Therapy for Anxiety Disorders?

PubMed Central

Glenn, Daniel; Golinelli, Daniela; Rose, Raphael D.; Roy-Byrne, Peter; Stein, Murray B.; Sullivan, Greer; Bystritksy, Alexander; Sherbourne, Cathy; Craske, Michelle G.

2013-01-01

Objective The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders. Method Measures of high versus low treatment dose, and high versus low patient engagement in CBT were compared as predictors of 12 and 18 month outcomes for patients being treated for anxiety disorders with CBT (with or without concurrent pharmacotherapy) in primary care settings as part of a randomized controlled effectiveness trial of the Coordinated Anxiety Learning and Management (CALM) intervention. Measures of dose (attendance, exposure completion) and engagement in CBT (homework adherence, commitment) were collected throughout treatment, and blinded follow-up phone assessments of outcome measures (12-item Brief Symptom Inventory, Patient Health Questionnaire 8, Sheehan Disability Scale) were completed at 12 and 18 months. Propensity score weighting controlled for baseline differences in demographics and symptom severity between patients with high and low dose and engagement. These analyses included the 439 patients that selected CBT as treatment modality. Results Completing exposures, high attendance, and being more homework adherent predicted better outcomes across all measures at 12 and 18 months, and high CBT commitment predicted better outcomes on all measures at 18 months. Conclusions This study found that higher treatment dose and patient engagement in CBT for anxiety disorders were stable and robust predictors of greater reductions in anxiety symptoms, depression symptoms, and functional disability. PMID:23750465

Improving outcomes for patients with medication-resistant anxiety: effects of collaborative care with cognitive behavioral therapy.

PubMed

Campbell-Sills, Laura; Roy-Byrne, Peter P; Craske, Michelle G; Bystritsky, Alexander; Sullivan, Greer; Stein, Murray B

2016-12-01

Many patients with anxiety disorders remain symptomatic after receiving evidence-based treatment, yet research on treatment-resistant anxiety is limited. We evaluated effects of cognitive behavioral therapy (CBT) on outcomes of patients with medication-resistant anxiety disorders using data from the Coordinated Anxiety Learning and Management (CALM) trial. Primary care patients who met study entry criteria (including DSM-IV diagnosis of generalized anxiety disorder, panic disorder, posttraumatic stress disorder, or social anxiety disorder) despite ongoing pharmacotherapy of appropriate type, dose, and duration were classified as medication resistant (n = 227). Logistic regression was used to estimate effects of CALM's CBT program (CALM-CBT; chosen by 104 of 117 medication-resistant patients randomized to CALM) versus usual care (UC; n = 110) on response [≥ 50% reduction of 12-item Brief Symptom Inventory (BSI-12) anxiety and somatic symptom score] and remission (BSI-12 < 6) at 6, 12, and 18 months. Within-group analyses examined outcomes by treatment choice (CBT vs. CBT plus medication management) and CBT dose. Approximately 58% of medication-resistant CALM-CBT patients responded and 46% remitted during the study. Relative to UC, CALM-CBT was associated with greater response at 6 months (AOR = 3.78, 95% CI 2.02-7.07) and 12 months (AOR = 2.49, 95% CI 1.36-4.58) and remission at 6, 12, and 18 months (AORs = 2.44 to 3.18). Patients in CBT plus medication management fared no better than those in CBT only. Some evidence suggested higher CBT dose produced better outcomes. CBT can improve outcomes for patients whose anxiety symptoms are resistant to standard pharmacotherapy. © 2016 Wiley Periodicals, Inc.

Polyunsaturated fatty acids (PUFAs) for children with specific learning disorders.

PubMed

Tan, May Loong; Ho, Jacqueline J; Teh, Keng Hwang

2012-12-12

About 5% of schoolchildren have a specific learning disorder, defined as an unexpected failure to acquire adequate abilities in reading, writing or mathematic skills not as a result of reduced intellectual ability, inadequate teaching or social deprivation. Of these, 80% are reading disorders. Polyunsaturated fatty acids (PUFAs), in particular omega-3 and omega-6 fatty acids, which are found abundantly in the brain and retina are important for learning. Some children with specific learning disorders have been found to be deficient in these PUFAs, and it is argued that supplementation of PUFAs may help these children improve their learning abilities. To assess the effects of polyunsaturated fatty acids (PUFAs) supplementation for children with specific learning disorders, on learning outcomes. We searched the following databases in April 2012: CENTRAL (2012, Issue 4), MEDLINE (1948 to April Week 2 2012), EMBASE (1980 to 2012 Week 16), PsycINFO (1806 to April 2012), ERIC (1966 to April 2012), Science Citation Index (1970 to 20 April 2012), Social Science Citation Index (1970 to 20 April 2012), Conference Proceedings Citation Index-Science (1970 to 20 April 2012), Conference Proceedings Citation Index-Social Sciences and Humanites (1970 to 20 April 2012), Cochrane Database of Systematic Reviews (2012, Issue 4), DARE (2012, Issue 2) , ZETOC (24 April 2012) and WorldCat (24 April 2012). We searched the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov on 24 April 2012. We also searched the reference lists of relevant articles identified by the searches. Randomised or quasi-randomised controlled trials comparing polyunsaturated fatty acids (PUFAs) with placebo or no treatment in children aged below 18 years with specific learning disabilities diagnosed using DSM-IV, ICD-10 or equivalent criteria. We intended to include participants with co-existing developmental disorders such as attention deficit hyperactivity disorder (ADHD) or autism. Two authors (ML and KH) independently screened the titles and abstracts of the search results and eliminated all studies that did not meet the inclusion criteria. Authors were contacted for missing information and clarifications when needed. We did not find any studies suitable for inclusion in the review. One study is awaiting classification as we were unable to get any information from the study author. There is insufficient evidence to draw any conclusion about the use of PUFAs for children with specific learning disorders. There is a need for well designed randomised studies to support or refute the use of PUFAs in this group of children.

Bisphenol A, phthalates and lead and learning and behavioral problems in Canadian children 6-11 years of age: CHMS 2007-2009.

PubMed

Arbuckle, Tye E; Davis, Karelyn; Boylan, Khrista; Fisher, Mandy; Fu, Jingshan

2016-05-01

Childhood developmental disorders and related problems such as learning disabilities and attention deficit hyperactivity disorder (ADHD) account for a growing burden on the family, education and health care systems. Exposure to environmental chemicals such as bisphenol A (BPA) and phthalates may play a role in the development of child behavioral problems. Using cross-sectional data from Cycle 1 of the Canadian Health Measures Survey (CHMS), we examined the potential association between urinary concentrations of BPA and various phthalate metabolites and child learning and behavioral problems, considering important covariates such as gender, blood lead and environmental tobacco smoke (ETS). The Strengths and Difficulties Questionnaire (SDQ) outcomes of interest were emotional symptoms, hyperactivity/inattention, and a total difficulties score with borderline and abnormal scores grouped together and compared with children with normal scores. Other outcomes studied included any reported learning disability, a subset of learning disabilities reported as ADD/ADHD (attention deficit disorder) and use of psychotropic medications in the past month. Among children ages 6-11 years, the prevalences of any learning disability, ADD, and ADHD were 8.7%, 1.5% and 2.8%, respectively. Estimated prevalences for SDQ hyperactivity/inattention, emotional symptoms and total difficulties scores were 16.9%, 15.0%, and 13.0%, respectively. Child's urinary BPA was associated with taking psychotropic medications (OR 1.59; 95% CI 1.05-2.40). Urinary MBzP concentration was significantly associated with emotional symptoms in girls (OR 1.38 95% CI 1.09-1.75) but not in boys (OR 1.05 95% CI 0.82-1.36).) Blood lead was significantly associated with several of the outcomes examined, with a significant interaction observed between prenatal smoking and blood lead for the total difficulties score (OR=10.57; 95% CI 2.81-39.69 vs. OR=1.98; 95% CI 1.41-2.79 if mother did not smoke during pregnancy). Although limited by the cross-sectional nature of the study which precludes examining causation, the results suggest that although some indicators of child behavior were significantly associated with their urinary BPA and phthalate concentrations, the major chemical associated with adverse behavioral indicators was lead. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

The Postschool Outcomes of Students with Mild Intellectual Disability: Does It Get Better with Time?

ERIC Educational Resources Information Center

Bouck, E. C.

2014-01-01

Background: Although students with mild intellectual disability (MID) present unique educational needs and considerations, in research and in practice, they are sometimes aggregated with students with learning disabilities and emotional disorders and considered mild disabilities or aggregated with students with moderate/severe intellectual…

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes.

PubMed

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes

PubMed Central

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children’s developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation. PMID:29388595

Disorders of Sex Development (DSD): Networking and Standardization Considerations.

PubMed

Sandberg, D E; Callens, N; Wisniewski, A B

2015-05-01

Syndromes resulting in Disorders of Sex Development (DSD) are individually rare. Historically, this fact has hindered both clinical research and the delivery of evidence-based care. Recognizing the need for advancement, members of European and North American medical societies produced policy statements, notably the Consensus Statement on Management of Intersex Disorders, which recognize that optimal healthcare in DSD requires multidisciplinary teams in conjunction with networking of treatment centers and continued development of patient registries. This paper summarizes efforts in Europe and the U.S. toward creating networks focused on expanding discovery and improving healthcare and quality of life outcomes in DSD. The objectives and function of registry-based networks (EuroDSD/I-DSD), learning collaboratives (DSD-net), clinical outcomes research (DSD-Life), and networking hybrids (DSD-TRN) are reviewed. Opportunities for, and barriers to standardization in research and care are highlighted in light of practical considerations, for example, limitations in reliably classifying anatomic phenotypes and gaps in behavioral health staffing resources. The role of patient-reported outcomes is considered, with emphasis on integrating patient perspectives, given findings of limited agreement in outcome ratings by healthcare providers and patients. Finally, the characteristics of clinical centers likely to deliver the highest quality outcomes are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Incorporating multiple secondary targets into learning trials for individuals with autism spectrum disorder.

PubMed

Nottingham, Casey L; Vladescu, Jason C; Kodak, Tiffany; Kisamore, April N

2017-07-01

The current study examined the outcome of presenting multiple secondary targets in learning trials for individuals with autism spectrum disorder. We compared conditions in which (a) a secondary target was presented in the antecedent and consequence of trials, (b) two secondary targets were presented in the consequence of trials, (c) one secondary target was presented in the consequence of each trial, and (d) no additional targets were presented trials. The participants acquired the majority of secondary targets. Presenting one or multiple secondary targets per trial, regardless of the location of these secondary targets, increased the efficiency of instruction in comparison to a condition with no secondary target. © 2017 Society for the Experimental Analysis of Behavior.

Reliability and Validity of the HoNOS-LD and HoNOS in a Sample of Individuals with Mild to Borderline Intellectual Disability and Severe Emotional and Behavior Disorders

ERIC Educational Resources Information Center

Tenneij, Nienke; Didden, Robert; Veltkamp, Eline; Koot, Hans M.

2009-01-01

In this study, psychometric properties of the Health of the Nation Outcome scales (HoNOS) and Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) were investigated in a sample (n = 79) of (young) adults with mild to borderline intellectual disability (ID) and severe behavior and mental health problems who were…

Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement.

PubMed

Glenn, Daniel; Golinelli, Daniela; Rose, Raphael D; Roy-Byrne, Peter; Stein, Murray B; Sullivan, Greer; Bystritksy, Alexander; Sherbourne, Cathy; Craske, Michelle G

2013-08-01

The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders. Measures of high versus low treatment dose and high versus low patient engagement in CBT were compared as predictors of 12- and 18-month outcomes for patients being treated for anxiety disorders with CBT (with or without concurrent pharmacotherapy) in primary care settings as part of a randomized controlled effectiveness trial of the Coordinated Anxiety Learning and Management (CALM) intervention. Measures of dose (attendance, exposure completion) and engagement in CBT (homework adherence, commitment) were collected throughout treatment, and blinded follow-up phone assessments of outcome measures (12-item Brief Symptom Inventory, Patient Health Questionnaire 8, Sheehan Disability Scale) were completed at 12 and 18 months. Propensity score weighting controlled for baseline differences in demographics and symptom severity between patients with high and low dose and engagement. These analyses included the 439 patients who selected CBT as treatment modality. Completing exposures, having high attendance, and being more adherent to completing homework predicted better outcomes across all measures at 12 and 18 months, and high CBT commitment predicted better outcomes on all measures at 18 months. This study found that higher treatment dose and patient engagement in CBT for anxiety disorders were stable and robust predictors of greater reductions in anxiety symptoms, depression symptoms, and functional disability. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Mental health outcomes in HIV and childhood maltreatment: a systematic review

PubMed Central

2012-01-01

Background High rates of childhood maltreatment have been documented in HIV-positive men and women. In addition, mental disorders are highly prevalent in both HIV-infected individuals and victims of childhood maltreatment. However, there is a paucity of research investigating the mental health outcomes associated with childhood maltreatment in the context of HIV infection. The present systematic review assessed mental health outcomes in HIV-positive individuals who were victims of childhood maltreatment. Methods A systematic search of all retrospective, prospective, or clinical trial studies assessing mental health outcomes associated with HIV and childhood maltreatment. The following online databases were searched on 25–31 August 2010: PubMed, Social Science Citation Index, and the Cochrane Library (the Cochrane Central Register of Controlled Trials and the Cochrane Developmental, Psychosocial and Learning Problems, HIV/AIDS, and Depression, Anxiety and Neurosis registers). Results We identified 34 studies suitable for inclusion. A total of 14,935 participants were included in these studies. A variety of mixed mental health outcomes were reported. The most commonly reported psychiatric disorders among HIV-positive individuals with a history of childhood maltreatment included: substance abuse, major depressive disorder, and posttraumatic stress disorder. An association between childhood maltreatment and poor adherence to antiretroviral regimens was also reported in some studies. Conclusion A broad range of adult psychopathology has been reported in studies of HIV-infected individuals with a history of childhood maltreatment. However, a direct causal link cannot be well established. Longer term assessment will better delineate the nature, severity, and temporal relationship of childhood maltreatment to mental health outcomes. PMID:22742536

A comparison study of early non-psychotic deviant behavior in Afrikaner and US patients with schizophrenia or schizoaffective disorder

PubMed Central

Sobin, Christina; Roos, J. Louw; Pretorius, Herman; Lundy, Laura S.; Karayiorgou, Maria

2009-01-01

In a previous study early non-psychotic deviant behaviors in US adult schizophrenic patients recruited for a large-scale genetic study were examined (Psychiatry Research, 101, 101). Early deviance characterized a distinct subgroup of patients at rates that were consistent with earlier reports. In addition, specific early non-psychotic deviant behaviors were meaningfully associated with later disease outcomes. In the present study, we examined the demographic, syndrome course, symptom and early deviant behavior history of 109 Afrikaner probands who met criteria for DSM schizophrenia or schizoaffective disorder, and compared them to 109 age- and gender-matched US probands. Consistent with past findings, 68% of Afrikaner probands, as compared to 67% of age- and gender-matched US probands, reported one or more forms of early non-psychotic deviance, including poor socialization, extreme fears/chronic sadness, and/or attention/learning impairment. The remaining 32 and 33% of probands, respectively, were without behavioral deviance until the onset of schizophrenia or schizoaffective disorder. The frequency and distribution of individual deviant behaviors were strikingly consistent between the samples. However, logistic regression analyses revealed different patterns of associations between the early deviant behaviors manifested and disease outcome. Afrikaner participants with early fears/chronic sadness were 3 times more likely to attempt suicide, while among US participants, this form of early deviance conferred 3.5 times more risk for later schizoaffective disorder, and 3 times greater likelihood of later sensory (tactile and/or olfactory) hallucinations. Afrikaner participants with attention/learning impairment were 2.5 times more likely to experience later auditory hallucinations, while US participants with these early difficulties were 3 times more likely to experience thought disorder. We concluded that early non-psychotic childhood deviance in this independently collected Afrikaner population distinguished a distinct subtype of patients and that the forms of early deviance manifested were meaningfully linked to later disease outcome. Possible reasons for the association pattern differences in these two populations are considered. PMID:12606014

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

PubMed

DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

2013-06-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors

PubMed Central

DeBate, Rita D.; Severson, Herbert H.; Cragun, Deborah L.; Gau, Jeff M.; Merrell, Laura K.; Bleck, Jennifer R.; Christiansen, Steve; Koerber, Anne; Tomar, Scott L.; McCormack Brown, Kelli R.; Tedesco, Lisa A.; Hendricson, William

2013-01-01

Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51–0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed. PMID:23564725

A neurocomputational account of reward and novelty processing and effects of psychostimulants in attention deficit hyperactivity disorder.

PubMed

Sethi, Arjun; Voon, Valerie; Critchley, Hugo D; Cercignani, Mara; Harrison, Neil A

2018-05-01

Computational models of reinforcement learning have helped dissect discrete components of reward-related function and characterize neurocognitive deficits in psychiatric illnesses. Stimulus novelty biases decision-making, even when unrelated to choice outcome, acting as if possessing intrinsic reward value to guide decisions toward uncertain options. Heightened novelty seeking is characteristic of attention deficit hyperactivity disorder, yet how this influences reward-related decision-making is computationally encoded, or is altered by stimulant medication, is currently uncertain. Here we used an established reinforcement-learning task to model effects of novelty on reward-related behaviour during functional MRI in 30 adults with attention deficit hyperactivity disorder and 30 age-, sex- and IQ-matched control subjects. Each participant was tested on two separate occasions, once ON and once OFF stimulant medication. OFF medication, patients with attention deficit hyperactivity disorder showed significantly impaired task performance (P = 0.027), and greater selection of novel options (P = 0.004). Moreover, persistence in selecting novel options predicted impaired task performance (P = 0.025). These behavioural deficits were accompanied by a significantly lower learning rate (P = 0.011) and heightened novelty signalling within the substantia nigra/ventral tegmental area (family-wise error corrected P < 0.05). Compared to effects in controls, stimulant medication improved attention deficit hyperactivity disorder participants' overall task performance (P = 0.011), increased reward-learning rates (P = 0.046) and enhanced their ability to differentiate optimal from non-optimal novel choices (P = 0.032). It also reduced substantia nigra/ventral tegmental area responses to novelty. Preliminary cross-sectional evidence additionally suggested an association between long-term stimulant treatment and a reduction in the rewarding value of novelty. These data suggest that aberrant substantia nigra/ventral tegmental area novelty processing plays an important role in the suboptimal reward-related decision-making characteristic of attention deficit hyperactivity disorder. Compared to effects in controls, abnormalities in novelty processing and reward-related learning were improved by stimulant medication, suggesting that they may be disorder-specific targets for the pharmacological management of attention deficit hyperactivity disorder symptoms.

Disrupted reinforcement signaling in the orbitofrontal cortex and caudate in youths with conduct disorder or oppositional defiant disorder and a high level of psychopathic traits.

PubMed

Finger, Elizabeth C; Marsh, Abigail A; Blair, Karina S; Reid, Marguerite E; Sims, Courtney; Ng, Pamela; Pine, Daniel S; Blair, R James R

2011-02-01

Dysfunction in the amygdala and orbitofrontal cortex has been reported in youths and adults with psychopathic traits. The specific nature of the functional irregularities within these structures remains poorly understood. The authors used a passive avoidance task to examine the responsiveness of these systems to early stimulus-reinforcement exposure, when prediction errors are greatest and learning maximized, and to reward in youths with psychopathic traits and comparison youths. While performing the passive avoidance learning task, 15 youths with conduct disorder or oppositional defiant disorder plus a high level of psychopathic traits and 15 healthy subjects completed a 3.0-T fMRI scan. Relative to the comparison youths, the youths with a disruptive behavior disorder plus psychopathic traits showed less orbitofrontal responsiveness both to early stimulus-reinforcement exposure and to rewards, as well as less caudate response to early stimulus-reinforcement exposure. There were no group differences in amygdala responsiveness to these two task measures, but amygdala responsiveness throughout the task was lower in the youths with psychopathic traits. Compromised sensitivity to early reinforcement information in the orbitofrontal cortex and caudate and to reward outcome information in the orbitofrontal cortex of youths with conduct disorder or oppositional defiant disorder plus psychopathic traits suggests that the integrated functioning of the amygdala, caudate, and orbitofrontal cortex may be disrupted. This provides a functional neural basis for why such youths are more likely to repeat disadvantageous decisions. New treatment possibilities are raised, as pharmacologic modulations of serotonin and dopamine can affect this form of learning.

Associative Learning Through Acquired Salience

PubMed Central

Treviño, Mario

2016-01-01

Most associative learning studies describe the salience of stimuli as a fixed learning-rate parameter. Presumptive saliency signals, however, have also been linked to motivational and attentional processes. An interesting possibility, therefore, is that discriminative stimuli could also acquire salience as they become powerful predictors of outcomes. To explore this idea, we first characterized and extracted the learning curves from mice trained with discriminative images offering varying degrees of structural similarity. Next, we fitted a linear model of associative learning coupled to a series of mathematical representations for stimulus salience. We found that the best prediction, from the set of tested models, was one in which the visual salience depended on stimulus similarity and a non-linear function of the associative strength. Therefore, these analytic results support the idea that the net salience of a stimulus depends both on the items' effective salience and the motivational state of the subject that learns about it. Moreover, this dual salience model can explain why learning about a stimulus not only depends on the effective salience during acquisition but also on the specific learning trajectory that was used to reach this state. Our mathematical description could be instrumental for understanding aberrant salience acquisition under stressful situations and in neuropsychiatric disorders like schizophrenia, obsessive-compulsive disorder, and addiction. PMID:26793078

Associative Learning Through Acquired Salience.

PubMed

Treviño, Mario

2015-01-01

Most associative learning studies describe the salience of stimuli as a fixed learning-rate parameter. Presumptive saliency signals, however, have also been linked to motivational and attentional processes. An interesting possibility, therefore, is that discriminative stimuli could also acquire salience as they become powerful predictors of outcomes. To explore this idea, we first characterized and extracted the learning curves from mice trained with discriminative images offering varying degrees of structural similarity. Next, we fitted a linear model of associative learning coupled to a series of mathematical representations for stimulus salience. We found that the best prediction, from the set of tested models, was one in which the visual salience depended on stimulus similarity and a non-linear function of the associative strength. Therefore, these analytic results support the idea that the net salience of a stimulus depends both on the items' effective salience and the motivational state of the subject that learns about it. Moreover, this dual salience model can explain why learning about a stimulus not only depends on the effective salience during acquisition but also on the specific learning trajectory that was used to reach this state. Our mathematical description could be instrumental for understanding aberrant salience acquisition under stressful situations and in neuropsychiatric disorders like schizophrenia, obsessive-compulsive disorder, and addiction.

How Does the Neighborhood "Come through the Door?" Concentrated Disadvantage, Residential Instability, and the Home Environment for Preschoolers.

PubMed

May, Emily M; Azar, Sandra T; Matthews, Stephen A

2018-03-01

Living in a disadvantaged neighborhood is associated with heightened risk for poor school readiness and health outcomes in early childhood, and the home environment is thought to be a primary mechanism by which neighborhood context impacts preschoolers. This study examined the effects of neighborhood concentrated disadvantage and neighborhood residential instability on the home physical environment and home learning environment for preschoolers in economically disadvantaged families (N = 187). Using structural equation modeling, mothers' perceived neighborhood disorder and depressive symptoms were examined as mechanisms by which neighborhood context "comes through the door." Mothers' neighborhood social embeddedness was also explored as a protective factor. Results showed that concentrated disadvantage was negatively associated with the quality of the home physical environment, and residential instability was negatively associated with the quality of the home learning environment. Concentrated disadvantage had an indirect effect on the home learning environment through mothers' perceived neighborhood disorder and depressive symptoms. The effects of concentrated disadvantage on the home environment were buffered by mothers' neighborhood social embeddedness. Study findings advance understanding of socioeconomic- and place-based disparities in developmental outcomes and identify potential targets for interventions aimed at lessening effects of neighborhood disadvantage on families with young children. © Society for Community Research and Action 2018.

Reversal Learning Task in Children with Autism Spectrum Disorder: A Robot-Based Approach.

PubMed

Costescu, Cristina A; Vanderborght, Bram; David, Daniel O

2015-11-01

Children with autism spectrum disorder (ASD) engage in highly perseverative and inflexible behaviours. Technological tools, such as robots, received increased attention as social reinforces and/or assisting tools for improving the performance of children with ASD. The aim of our study is to investigate the role of the robotic toy Keepon in a cognitive flexibility task performed by children with ASD and typically developing (TD) children. The number of participants included in this study is 81 children: 40 TD children and 41 children with ASD. Each participant had to go through two conditions: robot interaction and human interaction in which they had performed the reversal learning task. Our primary outcomes are the number of errors from acquisition phase and from reversal phase of the task; as secondary outcomes we have measured attentional engagement and positive affect. The results of this study showed that children with ASD are more engaged in the task and they seem to enjoy more the task when interacting with the robot compared with the interaction with the adult. On the other hand their cognitive flexibility performance is, in general, similar in the robot and the human conditions with the exception of the learning phase where the robot can interfere with the performance. Implication for future research and practice are discussed.

The role of negative urgency and expectancies in problem drinking and disordered eating: testing a model of comorbidity in pathological and at-risk samples.

PubMed

Fischer, Sarah; Settles, Regan; Collins, Brittany; Gunn, Rachel; Smith, Gregory T

2012-03-01

The aim of this study was to test hypotheses derived from a model that explains both the comorbidity of problem drinking and eating disorder symptoms and the difference in risk process between the two disorders. In Study One, the authors examined four personality constructs typically associated with rash action (sensation seeking, lack of planning, lack of persistence, and negative urgency) and disorder-specific expectancies in samples of women with eating disorders, substance dependence disorders, comorbid conditions, and no symptoms (N = 104). Negative urgency, the tendency to act rashly when distressed, differentiated the disordered groups from the control group. In contrast, learned expectancies differentiated among clinical groups. Women with eating disorders endorsed high levels of eating and dieting expectancies and women with substance use disorders endorsed high levels of alcohol expectancies, while comorbid women endorsed high levels of both. In Study Two, this pattern of findings was replicated in a sample of fifth grade girls (N = 905). Girls who had engaged in binge eating, alcohol use, or both had higher levels of negative urgency than asymptomatic girls, and the pattern of outcome expectancy endorsement was disorder specific. Negative urgency may represent a general, personality influence on both eating disordered behaviors and symptoms of alcohol dependence, which, when combined with learned, behavior-specific expectancies, leads to specific addictive behavior patterns. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Acquired Aplastic Anemia: What Have We Learned and What Is in the Horizon?

PubMed

Savaşan, Süreyya

2018-06-01

Acquired aplastic anemia (aAA) characterized by peripheral pancytopenia and bone marrow aplasia is a rare and serious disorder. Differential diagnosis includes constitutional bone marrow failure syndromes and myelodysplastic disorders. Autoimmune reaction to altered hematopoietic stem cells highlights the underlying mechanism. Matched related donor allogeneic hematopoietic stem cell transplantation is the ideal pediatric treatment; alternative approaches include immunosuppressive therapy and use of eltrombopag. Progression to clonal disorders can occur. Recently, alternative donor hematopoietic stem cell transplantation outcomes have significantly improved. Despite advances, aAA continues to be a challenge for hematologists. Copyright © 2018 Elsevier Inc. All rights reserved.

A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

PubMed Central

2014-01-01

Background Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. Despite the fact that SSTs are often applied in clinical practice, the evidence for the effectiveness of these trainings for children with ASD is inconclusive. Moreover, long term outcome and generalization of learned skills are little evaluated. Additionally, there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life. Method/Design In a randomized controlled trial (RCT) with three conditions, 120 participants with ASD at the end of primary school (10–12 years of calendar age) have been randomized to SST, SST-PTI (SST with Parent & Teacher Involvement), or care-as-usual. The SST consists of 18 group sessions of 1.5 hours for the children. In the SST-PTI condition, parents additionally participate in 8 parent sessions and parents and teachers are actively involved in homework assignments. Assessment takes place at three moments: before and immediately after the intervention period and at 6 months follow-up. Primary outcome is socialization, as an aspect of adaptive functioning. Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective. Additionally, possible predictors of treatment outcome will be assessed. Discussion The current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range (10–12 years). Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of generalization of learned skills to daily life, and the evaluation of efficacy in the longer term by follow-up measures at 6 months after the end of training. Trial registration NTR2405 PMID:24989854

A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

PubMed

Dekker, Vera; Nauta, Maaike H; Mulder, Erik J; Timmerman, Marieke E; de Bildt, Annelies

2014-07-02

Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. Despite the fact that SSTs are often applied in clinical practice, the evidence for the effectiveness of these trainings for children with ASD is inconclusive. Moreover, long term outcome and generalization of learned skills are little evaluated. Additionally, there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life. In a randomized controlled trial (RCT) with three conditions, 120 participants with ASD at the end of primary school (10-12 years of calendar age) have been randomized to SST, SST-PTI (SST with Parent & Teacher Involvement), or care-as-usual. The SST consists of 18 group sessions of 1.5 hours for the children. In the SST-PTI condition, parents additionally participate in 8 parent sessions and parents and teachers are actively involved in homework assignments. Assessment takes place at three moments: before and immediately after the intervention period and at 6 months follow-up. Primary outcome is socialization, as an aspect of adaptive functioning. Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective. Additionally, possible predictors of treatment outcome will be assessed. The current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range (10-12 years). Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of generalization of learned skills to daily life, and the evaluation of efficacy in the longer term by follow-up measures at 6 months after the end of training. NTR2405.

The Effects of Mnemonic Interventions on Academic Outcomes for Youth with Disabilities: A Systematic Review

ERIC Educational Resources Information Center

Wolgemuth, Jennifer R.; Cobb, R. Brian; Alwell, Morgen

2008-01-01

The relationship between mnemonic instruction and academic performance for secondary-school-age youth with disabilities was explored in this systematic review. A total of 20 studies intervening with 669 youth with learning disabilities, emotional and behavioral disorders, and mild developmental disabilities were reviewed. The findings of this…

School Discipline Disproportionality: American Indian Students in Special Education

ERIC Educational Resources Information Center

Whitford, Denise K.

2017-01-01

American Indian students are disproportionately represented in school discipline referrals (ODRs) and administrative outcomes across general school populations (Brown and DiTillio in "J Educ Learn" 2(4):47-59, 2013; Whitford and Levine-Donnerstein in "Behav Disord" 39(2), 2014). The purpose of this study was to examine the ODRs…

Endurance of Multiplication Fact Fluency for Students with Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Brady, Kelly K.; Kubina, Richard M., Jr.

2010-01-01

This study examines the relationship between a critical learning outcome of behavioral fluency and endurance, by comparing the effects of two practice procedures on multiplication facts two through nine. The first procedure, called whole time practice trial, consisted of an uninterrupted 1 minute practice time. The second procedure, endurance…

Modeling Avoidance in Mood and Anxiety Disorders Using Reinforcement Learning.

PubMed

Mkrtchian, Anahit; Aylward, Jessica; Dayan, Peter; Roiser, Jonathan P; Robinson, Oliver J

2017-10-01

Serious and debilitating symptoms of anxiety are the most common mental health problem worldwide, accounting for around 5% of all adult years lived with disability in the developed world. Avoidance behavior-avoiding social situations for fear of embarrassment, for instance-is a core feature of such anxiety. However, as for many other psychiatric symptoms the biological mechanisms underlying avoidance remain unclear. Reinforcement learning models provide formal and testable characterizations of the mechanisms of decision making; here, we examine avoidance in these terms. A total of 101 healthy participants and individuals with mood and anxiety disorders completed an approach-avoidance go/no-go task under stress induced by threat of unpredictable shock. We show an increased reliance in the mood and anxiety group on a parameter of our reinforcement learning model that characterizes a prepotent (pavlovian) bias to withhold responding in the face of negative outcomes. This was particularly the case when the mood and anxiety group was under stress. This formal description of avoidance within the reinforcement learning framework provides a new means of linking clinical symptoms with biophysically plausible models of neural circuitry and, as such, takes us closer to a mechanistic understanding of mood and anxiety disorders. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder

PubMed Central

Linstead, E; Dixon, D R; Hong, E; Burns, C O; French, R; Novack, M N; Granpeesheh, D

2017-01-01

Applied behavior analysis (ABA) is considered an effective treatment for individuals with autism spectrum disorder (ASD), and many researchers have further investigated factors associated with treatment outcomes. However, few studies have focused on whether treatment intensity and duration have differential influences on separate skills. The aim of the current study was to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. Separate multiple linear regression analyses were used to evaluate these relationships. Participants included 1468 children with ASD, ages 18 months to 12 years old, M=7.57 years, s.d.=2.37, who were receiving individualized ABA services. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all eight treatment domains. The academic and language domains showed the strongest response, with effect sizes of 1.68 and 1.85 for treatment intensity and 4.70 and 9.02 for treatment duration, respectively. These findings are consistent with previous research that total dosage of treatment positively influences outcomes. The current study also expands on extant literature by providing a better understanding of the differential impact that these treatment variables have across various treatment domains. PMID:28925999

Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

PubMed Central

Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

2016-01-01

Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

Medial-Frontal Stimulation Enhances Learning in Schizophrenia by Restoring Prediction Error Signaling.

PubMed

Reinhart, Robert M G; Zhu, Julia; Park, Sohee; Woodman, Geoffrey F

2015-09-02

Posterror learning, associated with medial-frontal cortical recruitment in healthy subjects, is compromised in neuropsychiatric disorders. Here we report novel evidence for the mechanisms underlying learning dysfunctions in schizophrenia. We show that, by noninvasively passing direct current through human medial-frontal cortex, we could enhance the event-related potential related to learning from mistakes (i.e., the error-related negativity), a putative index of prediction error signaling in the brain. Following this causal manipulation of brain activity, the patients learned a new task at a rate that was indistinguishable from healthy individuals. Moreover, the severity of delusions interacted with the efficacy of the stimulation to improve learning. Our results demonstrate a causal link between disrupted prediction error signaling and inefficient learning in schizophrenia. These findings also demonstrate the feasibility of nonpharmacological interventions to address cognitive deficits in neuropsychiatric disorders. When there is a difference between what we expect to happen and what we actually experience, our brains generate a prediction error signal, so that we can map stimuli to responses and predict outcomes accurately. Theories of schizophrenia implicate abnormal prediction error signaling in the cognitive deficits of the disorder. Here, we combine noninvasive brain stimulation with large-scale electrophysiological recordings to establish a causal link between faulty prediction error signaling and learning deficits in schizophrenia. We show that it is possible to improve learning rate, as well as the neural signature of prediction error signaling, in patients to a level quantitatively indistinguishable from that of healthy subjects. The results provide mechanistic insight into schizophrenia pathophysiology and suggest a future therapy for this condition. Copyright © 2015 the authors 0270-6474/15/3512232-09$15.00/0.

Effects of an employer-based intervention on employment outcomes for youth with significant support needs due to autism.

PubMed

Wehman, Paul; Schall, Carol M; McDonough, Jennifer; Graham, Carolyn; Brooke, Valerie; Riehle, J Erin; Brooke, Alissa; Ham, Whitney; Lau, Stephanie; Allen, Jaclyn; Avellone, Lauren

2017-04-01

The purpose of this study was to develop and investigate an employer-based 9-month intervention for high school youth with autism spectrum disorder to learn job skills and acquire employment. The intervention modified a program titled Project SEARCH and incorporated the use of applied behavior analysis to develop Project SEARCH plus Autism Spectrum Disorder Supports. A randomized clinical trial compared the implementation of Project SEARCH plus Autism Spectrum Disorder Supports with high school special education services as usual. Participants were 49 high-school-aged individuals between the ages of 18 and 21 years diagnosed with an autism spectrum disorder and eligible for supported employment. Students also had to demonstrate independent self-care. At 3 months post-graduation, 90% of the treatment group acquired competitive, part-time employment earning US$9.53-US$10.66 per hour. Furthermore, 87% of those individuals maintained employment at 12 months post-graduation. The control group's employment outcomes were 6% acquiring employment by 3 months post-graduation and 12% acquiring employment by 12 months post-graduation. The positive employment outcomes generated by the treatment group provide evidence that youth with autism spectrum disorder can gain and maintain competitive employment. Additionally, there is evidence that they are able to advance within that time toward more weekly hours worked, while they also displayed increasing independence in the work setting.

Medial prefrontal cortex as an action-outcome predictor.

PubMed

Alexander, William H; Brown, Joshua W

2011-09-18

The medial prefrontal cortex (mPFC) and especially anterior cingulate cortex is central to higher cognitive function and many clinical disorders, yet its basic function remains in dispute. Various competing theories of mPFC have treated effects of errors, conflict, error likelihood, volatility and reward, using findings from neuroimaging and neurophysiology in humans and monkeys. No single theory has been able to reconcile and account for the variety of findings. Here we show that a simple model based on standard learning rules can simulate and unify an unprecedented range of known effects in mPFC. The model reinterprets many known effects and suggests a new view of mPFC, as a region concerned with learning and predicting the likely outcomes of actions, whether good or bad. Cognitive control at the neural level is then seen as a result of evaluating the probable and actual outcomes of one's actions. © 2011 Nature America, Inc. All rights reserved.

Medial prefrontal cortex as an action-outcome predictor

PubMed Central

Alexander, William H.; Brown, Joshua W.

2011-01-01

The medial prefrontal cortex (mPFC) and especially anterior cingulate cortex (ACC) is central to higher cognitive function and numerous clinical disorders, yet its basic function remains in dispute. Various competing theories of mPFC have treated effects of errors, conflict, error likelihood, volatility, and reward, based on findings from neuroimaging and neurophysiology in humans and monkeys. To date, no single theory has been able to reconcile and account for the variety of findings. Here we show that a simple model based on standard learning rules can simulate and unify an unprecedented range of known effects in mPFC. The model reinterprets many known effects and suggests a new view of mPFC, as a region concerned with learning and predicting the likely outcomes of actions, whether good or bad. Cognitive control at the neural level is then seen as a result of evaluating the probable and actual outcomes of one's actions. PMID:21926982

Cognitive and Guided Mastery Therapies for Panic Disorder with Agoraphobia: 18-Year Long-Term Outcome and Predictors of Long-Term Change.

PubMed

Hoffart, Asle; Hedley, Liv M; Svanøe, Karol; Sexton, Harold

2016-01-01

In this study, we wished to compare the long-term outcome of (medication-free) panic disorder with agoraphobia patients randomized to cognitive or guided mastery therapy. Thirty-one (67.4%) of 46 patients who had completed treatment were followed up about 18 years after end of treatment. In the combined sample and using intent-to-follow-up analyses, there were large within-group effect sizes of -1.79 and -1.63 on the primary interview-based and self-report outcome measures of avoidance of situations when alone, and 56.5% no longer had a panic disorder and/or agoraphobia diagnosis. No outcome differences between the two treatments emerged. Guided mastery was associated with greater beneficial changes in catastrophic beliefs and self-efficacy. For two of five outcome measures, more reduction in panic-related beliefs about physical and mental catastrophes from pre- to post-treatment predicted lower level of anxiety from post-treatment to 18-year follow-up when the effect of treatment changes in (a) self-efficacy and (b) anxiety was controlled. However, for one of the outcome measures, this effect attenuated with time. Copyright © 2014 John Wiley & Sons, Ltd. The results suggest that the very-long-term outcome of both cognitive therapy and guided mastery therapy for agoraphobia is positive. The results support the role of catastrophic beliefs as mediator of change. The pattern of results suggests that learning processes other than catastrophic beliefs may be important for long-term outcome as well. Copyright © 2014 John Wiley & Sons, Ltd.

Trajectories of change across outcomes in intensive treatment for adolescent panic disorder and agoraphobia.

PubMed

Gallo, Kaitlin P; Cooper-Vince, Christine E; Hardway, Christina L; Pincus, Donna B; Comer, Jonathan S

2014-01-01

Much remains to be learned about typical and individual growth trajectories across treatment for adolescent panic disorder with and without agoraphobia and about critical treatment points associated with key changes. The present study examined the rate and shape of change across an 8-day intensive cognitive behavioral therapy for adolescent panic disorder with and without agoraphobia (N = 56). Participants ranged in age from 12 to 17 (M = 15.14, SD = 1.70; 58.9% female, 78.6% Caucasian). Multilevel modeling evaluated within-treatment linear and nonlinear changes across three treatment outcomes: panic severity, fear, and avoidance. Overall panic severity showed linear change, decreasing throughout treatment. In contrast, fear and avoidance ratings both showed cubic change, peaking slightly at the first session of treatment, starting to decrease at the second session of treatment, and with large gains continuing then plateauing at the fourth session. Findings are considered with regard to the extent to which they may elucidate critical treatment components and sessions for adolescents with panic disorder with and without agoraphobia.

Friendship: Operationalizing the Intangible to Improve Friendship-Based Outcomes for Individuals With Autism Spectrum Disorder.

PubMed

Finke, Erinn H

2016-11-01

Individuals with autism spectrum disorder (ASD) have social deficits that affect making and maintaining friends. Many empirically tested methods to address these social deficits are available, yet difficulties related to the establishment and maintenance of authentic friendships persist. This viewpoint article (a) briefly reviews the current state of the science relative to social and friendship skills training for individuals with ASD, (b) considers the potential links (or lack thereof) between current social and friendship skill interventions for individuals with ASD and outcomes related to making and maintaining friends, (c) examines how friendship-related outcomes might be maximized, and (d) proposes a framework for intervention planning that may promote these valued outcomes. There are several key concepts to consider in planning intervention targeting friendship as an outcome. These concepts include (a) equal status, (b) mutually motivating and authentic opportunities for interaction, and (c) frequent opportunities for interaction. There are many aspects about friendship development that cannot be controlled or contrived. Much is still to be learned about the achievement of better friendships for individuals with ASD. Reconceptualizing the way we design intervention may promote better outcomes for individuals on the autism spectrum.

Lessons learned: a pilot study on occupational therapy effectiveness for children with sensory modulation disorder.

PubMed

Miller, Lucy Jane; Schoen, Sarah A; James, Katherine; Schaaf, Roseann C

2007-01-01

The purpose of this pilot study was to prepare for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) with children who have sensory processing disorders (SPD). A one-group pretest, posttest design with 30 children was completed with a subset of children with SPD, those with sensory modulation disorder. Lessons learned relate to (a) identifying a homogeneous sample with quantifiable inclusion criteria, (b) developing an intervention manual for study replication and a fidelity to treatment measure, (c) determining which outcomes are sensitive to change and relate to parents' priorities, and (d) clarifying rigorous methodologies (e.g., blinded examiners, randomization, power). A comprehensive program of research is needed, including multiple pilot studies to develop enough knowledge that high-quality effectiveness research in occupational therapy can be completed. Previous effectiveness studies in OT-SI have been single projects not based on a unified long-term program of research.

Neurocognitive performance in unmedicated patients with hoarding disorder.

PubMed

Sumner, Jennifer M; Noack, Carolyn G; Filoteo, J Vincent; Maddox, W Todd; Saxena, Sanjaya

2016-02-01

Hoarding disorder (HD) is an often incapacitating psychiatric illness associated with a wide range of neurocognitive abnormalities. Some prior neuropsychological studies have found executive dysfunction in HD, but no clear pattern has emerged. One potential reason for discrepant results in previous studies might be the inclusion of patients on psychotropic and other medications that can affect neurocognitive performance. Therefore, we examined neurocognitive functioning in medication-free HD patients. We also added a novel investigation of implicit learning, which has been found to be abnormal in obsessive-compulsive disorder (OCD) and related disorders. Twenty-six participants meeting the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) diagnostic criteria for HD and 23 normal controls were administered a battery of neuropsychological tests and symptom rating scales. All participants were free of psychotropic medications for at least 6 weeks prior to the study. HD participants showed no significant differences from normal controls on measures of verbal memory, attention, or executive functioning, including response inhibition, planning, organization, and decision making. However, HD participants demonstrated a trend toward less implicit learning and greater use of explicit learning strategies during perceptual categorization compared to normal controls. HD participants who used an implicit strategy performed significantly worse than controls who used an implicit strategy. Hoarding symptom severity was not associated with neurocognitive performance. HD patients may have a tendency to use explicit rather than implicit learning strategies for perceptual categorization but perform as well as normal controls on many other neurocognitive measures. Future studies should assess unmedicated participants and examine test strategies, not just outcomes. PsycINFO Database Record (c) 2016 APA, all rights reserved.

Impact of the Personal Strengths Program on Self-Determination Levels of College Students with LD and/or ADHD

ERIC Educational Resources Information Center

Farmer, Jennie L.; Allsopp, David H.; Ferron, John M.

2015-01-01

This study investigates the impact of The Personal Strengths Program (PSP) on seven college students with learning disabilities and/or attention deficit hyperactivity disorder (LD/ADHD) using a multiple baseline design. Students with LD/ADHD experience increased challenges in school settings and decreased post-secondary outcomes when compared with…

Staying well with bipolar disorder: A qualitative analysis of five-year follow-up interviews with young people.

PubMed

Crowe, M; Inder, M

2018-05-01

WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Bipolar disorder is a long-term condition which causes ongoing disruptions to the individual's life. Current evidence suggests that a combination of medication in combination with psychotherapy is more effective than medication alone. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There are few published reports of the effects of interventions (pharmacological or psychotherapeutic) for treatment in bipolar disorder. While both psychotherapies provided a framework for understanding bipolar disorder each had specific strategies that participants identified as effective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Because bipolar disorder is a long-term condition, its treatment needs to incorporate psychotherapeutic approaches that address the unique nature of its impact on each individual and provide individualized strategies for managing the disorder. Both Interpersonal and Social Rhythm Therapy and Specialist Supportive Care provide strategies that promote personal recovery. Introduction The primary outcomes from this study of psychotherapy for young people with bipolar disorder identified that most participants had continued to remain well. Given that up to 80% of people relapse within 2 years, it was important to establish how these participants described the process of staying well. Aim To examine how participants in a psychotherapy for young people with bipolar disorder study at 5-year follow-up described their experiences of the intervention and its impact on living with the disorder. Methods This qualitative study was conducted 5 years after participants had completed a psychotherapy intervention in a randomized controlled trial for young people with bipolar disorder. Thirty people were recruited into this qualitative study and interviewed regarding their experiences. The data were analysed using an inductive thematic analysis. Findings Three themes were identified from the data: self-awareness in the context of bipolar disorder; understanding my bipolar disorder; and learning to stay well with bipolar disorder. Conclusions Mental health nurses can promote the factors that participants found helpful in learning to stay well self-awareness, understanding the unique characteristics of their disorder, learning to take care of the self and stabilization of social rhythms. © 2018 John Wiley & Sons Ltd.

Study of positive and negative feedback sensitivity in psychosis using the Wisconsin Card Sorting Test.

PubMed

Farreny, Aida; Del Rey-Mejías, Ángel; Escartin, Gemma; Usall, Judith; Tous, Núria; Haro, Josep Maria; Ochoa, Susana

2016-07-01

Schizophrenia involves marked motivational and learning deficits that may reflect abnormalities in reward processing. The purpose of this study was to examine positive and negative feedback sensitivity in schizophrenia using computational modeling derived from the Wisconsin Card Sorting Test (WCST). We also aimed to explore feedback sensitivity in a sample with bipolar disorder. Eighty-three individuals with schizophrenia and 27 with bipolar disorder were included. Demographic, clinical and cognitive outcomes, together with the WCST, were considered in both samples. Computational modeling was performed using the R syntax to calculate 3 parameters based on trial-by-trial execution on the WCST: reward sensitivity (R), punishment sensitivity (P), and choice consistency (D). The associations between outcome variables and the parameters were investigated. Positive and negative sensitivity showed deficits, but P parameter was clearly diminished in schizophrenia. Cognitive variables, age, and symptoms were associated with R, P, and D parameters in schizophrenia. The sample with bipolar disorder would show cognitive deficits and feedback abnormalities to a lesser extent than individuals with schizophrenia. Negative feedback sensitivity demonstrated greater deficit in both samples. Idiosyncratic cognitive requirements in the WCST might introduce confusion when supposing model-free reinforcement learning. Negative symptoms of schizophrenia were related to lower feedback sensitivity and less goal-directed patterns of choice. Copyright © 2016 Elsevier Inc. All rights reserved.

Randomized trial of two e-learning programs for oral health students on secondary prevention of eating disorders.

PubMed

DeBate, Rita D; Severson, Herbert H; Cragun, Deborah; Bleck, Jennifer; Gau, Jeff; Merrell, Laura; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William; Taris, Mark

2014-01-01

The purpose of this study was to test whether an interactive, web-based training program is more effective than an existing, flat-text, e-learning program at improving oral health students' knowledge, motivation, and self-efficacy to address signs of disordered eating behaviors with patients. Eighteen oral health classes of dental and dental hygiene students were randomized to either the Intervention (interactive program; n=259) or Alternative (existing program; n=58) conditions. Hierarchical linear modeling assessed for posttest differences between groups while controlling for baseline measures. Improvement among Intervention participants was superior to those who completed the Alternative program for three of the six outcomes: benefits/barriers, self-efficacy, and skills-based knowledge (effect sizes ranging from 0.43 to 0.87). This study thus suggests that interactive training programs may be better than flat-text e-learning programs for improving the skills-based knowledge and self-efficacy necessary for behavior change.

Effects of co-occurring depression on treatment for anxiety disorders: analysis of outcomes from a large primary care effectiveness trial.

PubMed

Campbell-Sills, Laura; Sherbourne, Cathy D; Roy-Byrne, Peter; Craske, Michelle G; Sullivan, Greer; Bystritsky, Alexander; Lang, Ariel J; Chavira, Denise A; Rose, Raphael D; Shaw Welch, Stacy; Stein, Murray B

2012-12-01

Co-occurring depression is common in patients seeking treatment for anxiety; however, the literature on the effects of depression on anxiety treatment outcomes is inconclusive. The current study evaluated prescriptive and prognostic effects of depression on anxiety treatment outcomes in a large primary care sample. Data were analyzed from a randomized controlled effectiveness trial that compared coordinated anxiety learning and management (CALM) to usual care. The study enrolled 1,004 patients between June 2006 and April 2008. Patients were referred by their primary care provider and met DSM-IV criteria for generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and/or social anxiety disorder. They were treated for approximately 3 to 12 months with CALM (computer-assisted cognitive-behavioral therapy, medication management, or their combination) or usual care. Outcomes were evaluated by blinded assessment at 6, 12, and 18 months. Effects of baseline major depressive disorder (MDD) on anxiety symptoms, anxiety-related disability, and response/remission rates were evaluated using statistical models accounting for baseline anxiety and patient demographics. MDD did not moderate the effects of CALM (relative to usual care) on anxiety symptoms, anxiety-related disability, or response/remission rates. Greater improvements in anxiety symptoms and anxiety-related disability were observed in depressed patients, regardless of treatment assignment (P values < .005). However, cross-sectionally depressed patients displayed higher anxiety symptom and anxiety-related disability scores at baseline and all subsequent assessments (P values < .001). Depressed patients also displayed lower remission rates at each follow-up (P values < .001). CALM had comparable advantages over usual care for patients with and without MDD. Depressed patients displayed more severe anxiety symptoms and anxiety-related disability at baseline, but their clinical improvement was substantial and larger in magnitude than that observed in the nondepressed patients. Results support the use of empirically supported interventions for anxiety disorders in patients with co-occurring depression. ClinicalTrials.gov identifier: NCT00347269. © Copyright 2012 Physicians Postgraduate Press, Inc.

Cognitive procedural learning among children and adolescents with or without spastic cerebral palsy: the differential effect of age.

PubMed

Gofer-Levi, M; Silberg, T; Brezner, A; Vakil, E

2014-09-01

Children learn to engage their surroundings skillfully, adopting implicit knowledge of complex regularities and associations. Probabilistic classification learning (PCL) is a type of cognitive procedural learning in which different cues are probabilistically associated with specific outcomes. Little is known about the effects of developmental disorders on cognitive skill acquisition. Twenty-four children and adolescents with cerebral palsy (CP) were compared to 24 typically developing (TD) youth in their ability to learn probabilistic associations. Performance was examined in relation to general cognitive abilities, level of motor impairment and age. Improvement in PCL was observed for all participants, with no relation to IQ. An age effect was found only among TD children. Learning curves of children with CP on a cognitive procedural learning task differ from those of TD peers and do not appear to be age sensitive. Copyright © 2014 Elsevier Ltd. All rights reserved.

Social Tools And Rules for Teens (The START Program): Program Description and Preliminary Outcomes of an Experiential Socialization Intervention for Adolescents with Autism Spectrum Disorder.

PubMed

Vernon, Ty W; Miller, Amber R; Ko, Jordan A; Wu, Victoria L

2016-05-01

Experiential learning is an essential process in the development of core social competencies. Unfortunately, adolescents with autism spectrum disorders often do not possess the prerequisite skillset and motivation to sustain the level of social immersion needed to benefit from this learning process. These persisting social vulnerabilities can limit their long-term relational success and associated quality of life, creating a need for comprehensive social programming. This paper describes a multi-component socialization intervention that simultaneously targets motivational, conceptual, and skill deficits using a hybrid experiential/didactic treatment approach. Evidence of social competence improvements was noted in survey and live conversational measures, indicating that the START program may hold promise as a method for improving the social success of participating adolescents with ASD.

The Effectiveness of Music in Pediatric Healthcare: A Systematic Review of Randomized Controlled Trials

PubMed Central

Treurnicht Naylor, Karline; Kingsnorth, Shauna; Lamont, Andrea; McKeever, Patricia; Macarthur, Colin

2011-01-01

The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain). Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention. PMID:20976017

A comparison study of early non-psychotic deviant behavior in Afrikaner and US patients with schizophrenia or schizoaffective disorder.

PubMed

Sobin, Christina; Roos, J Louw; Pretorius, Herman; Lundy, Laura S; Karayiorgou, Maria

2003-02-15

In a previous study early non-psychotic deviant behaviors in US adult schizophrenic patients recruited for a large-scale genetic study were examined (Psychiatry Research, 101, 101). Early deviance characterized a distinct subgroup of patients at rates that were consistent with earlier reports. In addition, specific early non-psychotic deviant behaviors were meaningfully associated with later disease outcomes. In the present study, we examined the demographic, syndrome course, symptom and early deviant behavior history of 109 Afrikaner probands who met criteria for DSM schizophrenia or schizoaffective disorder, and compared them to 109 age- and gender-matched US probands. Consistent with past findings, 68% of Afrikaner probands, as compared to 67% of age- and gender-matched US probands, reported one or more forms of early non-psychotic deviance, including poor socialization, extreme fears/chronic sadness, and/or attention/learning impairment. The remaining 32 and 33% of probands, respectively, were without behavioral deviance until the onset of schizophrenia or schizoaffective disorder. The frequency and distribution of individual deviant behaviors were strikingly consistent between the samples. However, logistic regression analyses revealed different patterns of associations between the early deviant behaviors manifested and disease outcome. Afrikaner participants with early fears/chronic sadness were 3 times more likely to attempt suicide, while among US participants, this form of early deviance conferred 3.5 times more risk for later schizoaffective disorder, and 3 times greater likelihood of later sensory (tactile and/or olfactory) hallucinations. Afrikaner participants with attention/learning impairment were 2.5 times more likely to experience later auditory hallucinations, while US participants with these early difficulties were 3 times more likely to experience thought disorder. We concluded that early non-psychotic childhood deviance in this independently collected Afrikaner population distinguished a distinct subtype of patients and that the forms of early deviance manifested were meaningfully linked to later disease outcome. Possible reasons for the association pattern differences in these two populations are considered. Copyright 2002 Elsevier Science Ireland Ltd.

Brief Report: Predictors of Outcomes in the Early Start Denver Model Delivered in a Group Setting

ERIC Educational Resources Information Center

Vivanti, Giacomo; Dissanayake, Cheryl; Zierhut, Cynthia; Rogers, Sally J.

2013-01-01

There is a paucity of studies that have looked at factors associated with responsiveness to interventions in preschoolers with autism spectrum disorder (ASD). We investigated learning profiles associated with response to the Early Start Denver Model delivered in a group setting. Our preliminary results from 21 preschool children with an ASD aged…

Establishing Positive Relationships with Secondary Gifted Students and Students with Emotional/ Behavioural Disorders: Giving These Diverse Learners What They Need

ERIC Educational Resources Information Center

Capern, Trevor; Hammond, Lorraine

2014-01-01

The relationships between teachers and their students play a vital role in the creation of positive learning outcomes and environments for all learners, but particularly for those individuals with diverse needs. This study examined the teacher behaviours that contributed to positive student-teacher relationships with gifted secondary students (GS)…

Definition and Outcome of a Curriculum to Prevent Disordered Eating and Body-Shaping Drug Use

ERIC Educational Resources Information Center

Elliot, Diane L.; Moe, Esther L.; Goldberg, Linn; DeFrancesco, Carol A.; Durham, Melissa B.; Hix-Small, Hollie

2006-01-01

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to…

Effects of an Employer-Based Intervention on Employment Outcomes for Youth with Significant Support Needs Due to Autism

ERIC Educational Resources Information Center

Wehman, Paul; Schall, Carol M.; McDonough, Jennifer; Graham, Carolyn; Brooke, Valerie; Riehle, J. Erin; Brooke, Alissa; Ham, Whitney; Lau, Stephanie; Allen, Jaclyn; Avellone, Lauren

2017-01-01

The purpose of this study was to develop and investigate an employer-based 9-month intervention for high school youth with autism spectrum disorder to learn job skills and acquire employment. The intervention modified a program titled Project SEARCH and incorporated the use of applied behavior analysis to develop Project SEARCH plus Autism…

Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety.

PubMed

Sonuga-Barke, Edmund J S; Cortese, Samuele; Fairchild, Graeme; Stringaris, Argyris

2016-03-01

Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review. We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes. Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

A fine balance and a shared learning journey: Exploring healthcare engagement through the experiences of youth with Neuromuscular Disorders.

PubMed

Travlos, Vivienne; Bulsara, Caroline; Patman, Shane; Downs, Jenny

2016-10-14

Youth with Neuromuscular Disorders (NMD) who are wheelchair users can now survive well into adulthood if their multisystem comorbidities are prudently managed. Uptake of health behaviors may optimize their health outcomes. To explore youths' perceptions of health, health behaviors and healthcare engagement. This qualitative study purposefully recruited 11 youth with NMD from a concurrent, population-based study for variability of age, gender, type of NMD and their ratings of motivation and engagement. Interview data were analyzed and synthesized by thematic content. Participants perceived healthcare engagement as being given tools (knowledge and responsibility) and using them to maintain their finely balanced health. Nested in adequate social, emotional and physical support, they took responsibility for creatively integrating health behaviors they felt were informed by credible knowledge, gained primarily through personal experience. Cognizant of their compromised health, youth with NMD in this study were motivated to maintain their physical health. Limited NMD condition specific knowledge challenged youths' uptake of health behaviors. They valued a learning partnership with their healthcare professionals. By embracing the youth's experience based knowledge and through facilitating supportive relationships, healthcare professionals co-construct youth's healthcare engagement that may optimize health behaviors and outcomes.

Neuroeconomics of attention-deficit/hyperactivity disorder: differential influences of medial, dorsal, and ventral prefrontal brain networks on suboptimal decision making?

PubMed

Sonuga-Barke, Edmund J S; Fairchild, Graeme

2012-07-15

Psychiatric neuroeconomics offers an alternative approach to understanding mental disorders by studying the way disorder-related neurobiological alterations constrain economic agency, as revealed through decisions about choices between future goods. In this article, we apply this perspective to understand suboptimal decision making in attention-deficit/hyperactivity disorder (ADHD) by integrating recent advances in the neuroscience of decision making and studies of the pathophysiology of ADHD. We identify three brain networks as candidates for further study and develop specific hypotheses about how these could be implicated in ADHD. First, we postulate that altered patterns of connectivity within a network linking medial prefrontal cortex and posterior cingulate cortex (i.e., the default mode network) disrupts ordering of utilities, prospection about desired future states, setting of future goals, and implementation of aims. Second, we hypothesize that deficits in dorsal frontostriatal networks, including the dorsolateral prefrontal cortex and dorsal striatum, produce executive dysfunction-mediated impairments in the ability to compare outcome options and make choices. Third, we propose that dopaminergic dysregulation in a ventral frontostriatal network encompassing the orbitofrontal cortex, ventral striatum, and amygdala disrupts processing of cues of future utility, evaluation of experienced outcomes (feedback), and learning of associations between cues and outcomes. Finally, we extend this perspective to consider three contemporary themes in ADHD research. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Are individuals with Parkinson's disease capable of speech-motor learning? - A preliminary evaluation.

PubMed

Kaipa, Ramesh; Jones, Richard D; Robb, Michael P

2016-07-01

The benefits of different practice conditions in limb-based rehabilitation of motor disorders are well documented. Conversely, the role of practice structure in the treatment of motor-based speech disorders has only been minimally investigated. Considering this limitation, the current study aimed to investigate the effectiveness of selected practice conditions in spatial and temporal learning of novel speech utterances in individuals with Parkinson's disease (PD). Participants included 16 individuals with PD who were randomly and equally assigned to constant, variable, random, and blocked practice conditions. Participants in all four groups practiced a speech phrase for two consecutive days, and reproduced the speech phrase on the third day without further practice or feedback. There were no significant differences (p > 0.05) between participants across the four practice conditions with respect to either spatial or temporal learning of the speech phrase. Overall, PD participants demonstrated diminished spatial and temporal learning in comparison to healthy controls. Tests of strength of association between participants' demographic/clinical characteristics and speech-motor learning outcomes did not reveal any significant correlations. The findings from the current study suggest that repeated practice facilitates speech-motor learning in individuals with PD irrespective of the type of practice. Clinicians need to be cautious in applying practice conditions to treat speech deficits associated with PD based on the findings of non-speech-motor learning tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Model-based learning protects against forming habits.

PubMed

Gillan, Claire M; Otto, A Ross; Phelps, Elizabeth A; Daw, Nathaniel D

2015-09-01

Studies in humans and rodents have suggested that behavior can at times be "goal-directed"-that is, planned, and purposeful-and at times "habitual"-that is, inflexible and automatically evoked by stimuli. This distinction is central to conceptions of pathological compulsion, as in drug abuse and obsessive-compulsive disorder. Evidence for the distinction has primarily come from outcome devaluation studies, in which the sensitivity of a previously learned behavior to motivational change is used to assay the dominance of habits versus goal-directed actions. However, little is known about how habits and goal-directed control arise. Specifically, in the present study we sought to reveal the trial-by-trial dynamics of instrumental learning that would promote, and protect against, developing habits. In two complementary experiments with independent samples, participants completed a sequential decision task that dissociated two computational-learning mechanisms, model-based and model-free. We then tested for habits by devaluing one of the rewards that had reinforced behavior. In each case, we found that individual differences in model-based learning predicted the participants' subsequent sensitivity to outcome devaluation, suggesting that an associative mechanism underlies a bias toward habit formation in healthy individuals.

Neuroenhancement of Exposure Therapy in Anxiety Disorders

PubMed Central

Hofmann, Stefan G.; Mundy, Elizabeth A.; Curtiss, Joshua

2015-01-01

Although exposure-based treatments and anxiolytic medications are more effective than placebo for treating anxiety disorders, there is still considerable room for further improvement. Interestingly, combining these two modalities is usually not more effective than the monotherapies. Recent translational research has identified a number of novel approaches for treating anxiety disorders using agents that serve as neuroenhancers (also known as cognitive enhancers). Several of these agents have been studied to determine their efficacy at improving treatment outcome for patients with anxiety and other psychiatric disorders. In this review, we examine d-cycloserine, yohimbine, cortisol, catecholamines, oxytocin, modafinil, and nutrients such as caffeine and amino fatty acids as potential neuroenhancers. Of these agents, d-cycloserine shows the most promise as an effective neuroenhancer for extinction learning and exposure therapy. Yet, the optimal dosing and dose timing for drug administration remains uncertain. There is partial support for cortisol, catecholamines, yohimbine and oxytocin for improving extinction learning and exposure therapy. There is less evidence to indicate that modafinil and nutrients such as caffeine and amino fatty acids are effective neuroenhancers. More research is needed to determine their long term efficacy and clinical utility of these agents. PMID:26306326

Maternal smoking during pregnancy and child outcomes: Real or spurious effect?

PubMed Central

Knopik, Valerie S.

2013-01-01

Maternal smoking during pregnancy (MSDP) is a major public health concern with clearly established consequences to both mother and newborn (e.g., low birth weight, altered cardiorespiratory responses). MSDP has also been associated with higher rates of a variety of poor cognitive and behavioral outcomes in children, including ADHD, conduct disorder, impaired learning and memory, and cognitive dysfunction. However, the evidence suggesting causal effects of MSDP for these outcomes is muddied in the existing literature due to the frequent inability to separate prenatal exposure effects from other confounding environmental and genetic factors. Carefully designed studies using genetically sensitive strategies can build upon current evidence and begin to elucidate the likely complex factors contributing to associations between MSDP and child outcomes. PMID:19142764

Learning Disorders

MedlinePlus

... more of a challenge. What causes learning disorders? Learning disabilities don't have anything to do with intelligence. ... for learning disorders? The most common treatment for learning disabilities is special education. A teacher or other learning ...

Role of the medial prefrontal cortex in impaired decision making in juvenile attention-deficit/hyperactivity disorder.

PubMed

Hauser, Tobias U; Iannaccone, Reto; Ball, Juliane; Mathys, Christoph; Brandeis, Daniel; Walitza, Susanne; Brem, Silvia

2014-10-01

Attention-deficit/hyperactivity disorder (ADHD) has been associated with deficient decision making and learning. Models of ADHD have suggested that these deficits could be caused by impaired reward prediction errors (RPEs). Reward prediction errors are signals that indicate violations of expectations and are known to be encoded by the dopaminergic system. However, the precise learning and decision-making deficits and their neurobiological correlates in ADHD are not well known. To determine the impaired decision-making and learning mechanisms in juvenile ADHD using advanced computational models, as well as the related neural RPE processes using multimodal neuroimaging. Twenty adolescents with ADHD and 20 healthy adolescents serving as controls (aged 12-16 years) were examined using a probabilistic reversal learning task while simultaneous functional magnetic resonance imaging and electroencephalogram were recorded. Learning and decision making were investigated by contrasting a hierarchical Bayesian model with an advanced reinforcement learning model and by comparing the model parameters. The neural correlates of RPEs were studied in functional magnetic resonance imaging and electroencephalogram. Adolescents with ADHD showed more simplistic learning as reflected by the reinforcement learning model (exceedance probability, Px = .92) and had increased exploratory behavior compared with healthy controls (mean [SD] decision steepness parameter β: ADHD, 4.83 [2.97]; controls, 6.04 [2.53]; P = .02). The functional magnetic resonance imaging analysis revealed impaired RPE processing in the medial prefrontal cortex during cue as well as during outcome presentation (P < .05, family-wise error correction). The outcome-related impairment in the medial prefrontal cortex could be attributed to deficient processing at 200 to 400 milliseconds after feedback presentation as reflected by reduced feedback-related negativity (ADHD, 0.61 [3.90] μV; controls, -1.68 [2.52] μV; P = .04). The combination of computational modeling of behavior and multimodal neuroimaging revealed that impaired decision making and learning mechanisms in adolescents with ADHD are driven by impaired RPE processing in the medial prefrontal cortex. This novel, combined approach furthers the understanding of the pathomechanisms in ADHD and may advance treatment strategies.

Measures of outcome for stimulant trials: ACTTION recommendations and research agenda.

PubMed

Kiluk, Brian D; Carroll, Kathleen M; Duhig, Amy; Falk, Daniel E; Kampman, Kyle; Lai, Shengan; Litten, Raye Z; McCann, David J; Montoya, Ivan D; Preston, Kenzie L; Skolnick, Phil; Weisner, Constance; Woody, George; Chandler, Redonna; Detke, Michael J; Dunn, Kelly; Dworkin, Robert H; Fertig, Joanne; Gewandter, Jennifer; Moeller, F Gerard; Ramey, Tatiana; Ryan, Megan; Silverman, Kenneth; Strain, Eric C

2016-01-01

The development and approval of an efficacious pharmacotherapy for stimulant use disorders has been limited by the lack of a meaningful indicator of treatment success, other than sustained abstinence. In March, 2015, a meeting sponsored by Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was convened to discuss the current state of the evidence regarding meaningful outcome measures in clinical trials for stimulant use disorders. Attendees included members of academia, funding and regulatory agencies, pharmaceutical companies, and healthcare organizations. The goal was to establish a research agenda for the development of a meaningful outcome measure that may be used as an endpoint in clinical trials for stimulant use disorders. Based on guidelines for the selection of clinical trial endpoints, the lessons learned from prior addiction clinical trials, and the process that led to identification of a meaningful indicator of treatment success for alcohol use disorders, several recommendations for future research were generated. These include a focus on the validation of patient reported outcome measures of functioning, the exploration of patterns of stimulant abstinence that may be associated with physical and/or psychosocial benefits, the role of urine testing for validating self-reported measures of stimulant abstinence, and the operational definitions for reduction-based measures in terms of frequency rather than quantity of stimulant use. These recommendations may be useful for secondary analyses of clinical trial data, and in the design of future clinical trials that may help establish a meaningful indicator of treatment success. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Children with Learning Disorders

MedlinePlus

... for Families - Vietnamese Spanish Facts for Families Guide Learning Disorders No. 16; Updated August 2013 Parents are often ... failure, but a common one is a specific learning disorder. Children with learning disorders can have intelligence in ...

Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder

PubMed Central

Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

2015-01-01

This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

Synaptic potentiation onto habenula neurons in the learned helplessness model of depression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, B.; Schulz, D.; Li, B

The cellular basis of depressive disorders is poorly understood. Recent studies in monkeys indicate that neurons in the lateral habenula (LHb), a nucleus that mediates communication between forebrain and midbrain structures, can increase their activity when an animal fails to receive an expected positive reward or receives a stimulus that predicts aversive conditions (that is, disappointment or anticipation of a negative outcome). LHb neurons project to, and modulate, dopamine-rich regions, such as the ventral tegmental area (VTA), that control reward-seeking behaviour and participate in depressive disorders. Here we show that in two learned helplessness models of depression, excitatory synapses ontomore » LHb neurons projecting to the VTA are potentiated. Synaptic potentiation correlates with an animal's helplessness behaviour and is due to an enhanced presynaptic release probability. Depleting transmitter release by repeated electrical stimulation of LHb afferents, using a protocol that can be effective for patients who are depressed, markedly suppresses synaptic drive onto VTA-projecting LHb neurons in brain slices and can significantly reduce learned helplessness behaviour in rats. Our results indicate that increased presynaptic action onto LHb neurons contributes to the rodent learned helplessness model of depression.« less

Synaptic potentiation onto habenula neurons in learned helplessness model of depression

PubMed Central

Li, Bo; Piriz, Joaquin; Mirrione, Martine; Chung, ChiHye; Proulx, Christophe D.; Schulz, Daniela; Henn, Fritz; Malinow, Roberto

2010-01-01

The cellular basis of depressive disorders is poorly understood1. Recent studies in monkeys indicate that neurons in the lateral habenula (LHb), a nucleus that mediates communication between forebrain and midbrain structures, can increase their activity when an animal fails to receive an expected positive reward or receives a stimulus that predicts aversive conditions (i.e. disappointment or anticipation of a negative outcome)2, 3, 4. LHb neurons project to and modulate dopamine-rich regions such as the ventral-tegmental area (VTA)2, 5 that control reward-seeking behavior6 and participate in depressive disorders7. Here we show in two learned helplessness models of depression that excitatory synapses onto LHb neurons projecting to the VTA are potentiated. Synaptic potentiation correlates with an animal’s helplessness behavior and is due to an enhanced presynaptic release probability. Depleting transmitter release by repeated electrical stimulation of LHb afferents, using a protocol that can be effective on depressed patients8, 9, dramatically suppresses synaptic drive onto VTA-projecting LHb neurons in brain slices and can significantly reduce learned helplessness behavior in rats. Our results indicate that increased presynaptic action onto LHb neurons contributes to the rodent learned helplessness model of depression. PMID:21350486

Synaptic potentiation onto habenula neurons in the learned helplessness model of depression.

PubMed

Li, Bo; Piriz, Joaquin; Mirrione, Martine; Chung, ChiHye; Proulx, Christophe D; Schulz, Daniela; Henn, Fritz; Malinow, Roberto

2011-02-24

The cellular basis of depressive disorders is poorly understood. Recent studies in monkeys indicate that neurons in the lateral habenula (LHb), a nucleus that mediates communication between forebrain and midbrain structures, can increase their activity when an animal fails to receive an expected positive reward or receives a stimulus that predicts aversive conditions (that is, disappointment or anticipation of a negative outcome). LHb neurons project to, and modulate, dopamine-rich regions, such as the ventral tegmental area (VTA), that control reward-seeking behaviour and participate in depressive disorders. Here we show that in two learned helplessness models of depression, excitatory synapses onto LHb neurons projecting to the VTA are potentiated. Synaptic potentiation correlates with an animal's helplessness behaviour and is due to an enhanced presynaptic release probability. Depleting transmitter release by repeated electrical stimulation of LHb afferents, using a protocol that can be effective for patients who are depressed, markedly suppresses synaptic drive onto VTA-projecting LHb neurons in brain slices and can significantly reduce learned helplessness behaviour in rats. Our results indicate that increased presynaptic action onto LHb neurons contributes to the rodent learned helplessness model of depression.

Neural Basis of Empathy and Its Dysfunction in Autism Spectrum Disorders (ASD)

DTIC Science & Technology

2014-10-01

mediated by neurons in homologous circuits governing social perception and reward learn - ing in non-human primates and humans ( Bandura and Rosenthal...and donations to public goods: a theory of warm glow giving. Econ. J. 100, 464–477. Bandura , A., and McDonald, F. J. (1963). Influence of social ...is involved in  social   learning  when monkeys  observe outcomes occurring to others, and that the orbitofrontal cortex (OFC) is involved only in self

Service system and cognitive outcomes for young children with autism spectrum disorders in a rural area of Taiwan.

PubMed

Chu, Ching-Lin; Chiang, Chung-Hsin; Wu, Chin-Chin; Hou, Yuh-Ming; Liu, Jiun-Horng

2017-07-01

Chiayi is a rural county located in southwestern Taiwan, and the effectiveness of its early intervention service system for autism spectrum disorders was studied in detail. A total of 71 children with autism spectrum disorders ( n = 35) and developmental delay ( n = 36) aged 2.5 years were referred from the only Early Intervention Reporting and Referral Center in Chiayi and followed up at 4 years. Results showed relatively low and varied services of early intervention for both groups during two time-point periods and a relative lack of specific early intervention programs for children with autism spectrum disorders. It was found, however, that cognitive abilities were increased for autism spectrum disorders and developmental delay groups. Additionally, the Early Learning Score at the initial evaluation could contribute to the high learner autism spectrum disorders subgroup. Parental socio-economic level was also determined to benefit the high learner developmental delay subgroup.

Design and Analysis of Blast Induced Traumatic Brain Injury Mechanism Using a Surrogate Headform: Instrumentation and Outcomes

DTIC Science & Technology

2011-05-01

51 4.5.1: FABRY -PÉROT FIBER OPTIC GAUGES...aggressive social behavior, impaired thinking, language, learning, emotions, behavior, sensation, and neuro-degenerative diseases such as epilepsy...Alzheimer’s disease , Parkinson’s disease , and other brain disorders that become more prevalent with age [9, Figure 2.1: Causes of TBI- A diagram of

Learning to live with a hand nerve disorder: A constructed grounded theory.

PubMed

Ashwood, Mark; Jerosch-Herold, Christina; Shepstone, Lee

2017-11-29

Grounded theory. The broader perspective of health offered by the World Health Organization's International Classification of Functioning, Disability and Health has had a significant bearing on how we view the measurement of health outcomes after surgical or therapy interventions for peripheral nerve disorders affecting the hand. The value of the patient's perspective is now recognized and outcomes which reflect this are being advocated in the clinical management and support of this population. This qualitative study sought to explore the lived experience of a hand nerve disorder and in particular the impact on body structure/function, activities, and participation. In depth, one-to-one interviews with 14 people with a range of hand nerve disorders were conducted. Constructivist grounded theory methods were used to collect and analyze the data. Patients were also given the option of taking photographs to visually represent what it is like to live with a nerve disorder, to bring with them for discussion during the interview. The impact of hand nerve disorders forms part of a wider narrative on adaptation. A process of "struggling" and then "overcoming" was experienced. This was followed by an interior aspect of adaptation described as "accepting." This gave rise to participants "transforming," being changed as a result of the journey that they had been on. This study provides an explanatory theory on the adaptive process following a hand nerve disorder which may inform future patient-therapist interactions. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Stereotactic amygdalotomy in the management of severe aggressive behavioral disorders.

PubMed

Mpakopoulou, Maria; Gatos, Haralambos; Brotis, Alexandros; Paterakis, Konstantinos N; Fountas, Kostas N

2008-01-01

Stereotactic amygdalotomy has been utilized as a surgical treatment for severe aggressive behavioral disorders. Several clinical studies have been reported since the first description of the procedure. In the current study, the authors reviewed the literature and evaluated the surgical results, neuropsychological outcome, and complication rate in patients who had undergone stereotactic amygdalotomy for severe aggressive behavioral disorders. The PubMed database was searched using the following terms: "amygdalotomy," "amygdalectomy," "amygdaloidectomy," "psychosurgery," "aggressive disorder," and "behavioral disorder." Clinical series with more than 5 patients undergoing stereotactic amygdalotomy for aggressive or other behavioral disorders were included in this review. The surgical technique, anatomical target, improvement in psychiatric symptomatology, postoperative employment and social rehabilitation, postoperative neurocognitive function, procedure-related complications, and long-term follow-up were evaluated. Thirteen clinical studies met our inclusion criteria. Reported postoperative improvement in aggressive behavior varied between 33 and 100%. Procedure-related complication rates ranged from 0 to 42%, whereas the mortality rate was as high as 3.8%. In the majority of the reviewed clinical series, the performance of stereotactic amygdalotomy did not compromise a patient's learning, language, and intellectual capabilities. The long-term follow-up, although very limited, revealed that initially observed improvement was maintained in most cases. Stereotactic amygdalotomy can be considered a valid surgical treatment option for carefully selected patients with medically refractory aggressive behavioral disorders. Recent advances in imaging and stereotactic navigation can further improve outcome and minimize the complication rate associated with this psychosurgical procedure.

Specific Learning Disorder: Prevalence and Gender Differences

PubMed Central

Moll, Kristina; Kunze, Sarah; Neuhoff, Nina; Bruder, Jennifer; Schulte-Körne, Gerd

2014-01-01

Comprehensive models of learning disorders have to consider both isolated learning disorders that affect one learning domain only, as well as comorbidity between learning disorders. However, empirical evidence on comorbidity rates including all three learning disorders as defined by DSM-5 (deficits in reading, writing, and mathematics) is scarce. The current study assessed prevalence rates and gender ratios for isolated as well as comorbid learning disorders in a representative sample of 1633 German speaking children in 3rd and 4th Grade. Prevalence rates were analysed for isolated as well as combined learning disorders and for different deficit criteria, including a criterion for normal performance. Comorbid learning disorders occurred as frequently as isolated learning disorders, even when stricter cutoff criteria were applied. The relative proportion of isolated and combined disorders did not change when including a criterion for normal performance. Reading and spelling deficits differed with respect to their association with arithmetic problems: Deficits in arithmetic co-occurred more often with deficits in spelling than with deficits in reading. In addition, comorbidity rates for arithmetic and reading decreased when applying stricter deficit criteria, but stayed high for arithmetic and spelling irrespective of the chosen deficit criterion. These findings suggest that the processes underlying the relationship between arithmetic and reading might differ from those underlying the relationship between arithmetic and spelling. With respect to gender ratios, more boys than girls showed spelling deficits, while more girls were impaired in arithmetic. No gender differences were observed for isolated reading problems and for the combination of all three learning disorders. Implications of these findings for assessment and intervention of learning disorders are discussed. PMID:25072465

Specific learning disorder: prevalence and gender differences.

PubMed

Moll, Kristina; Kunze, Sarah; Neuhoff, Nina; Bruder, Jennifer; Schulte-Körne, Gerd

2014-01-01

Comprehensive models of learning disorders have to consider both isolated learning disorders that affect one learning domain only, as well as comorbidity between learning disorders. However, empirical evidence on comorbidity rates including all three learning disorders as defined by DSM-5 (deficits in reading, writing, and mathematics) is scarce. The current study assessed prevalence rates and gender ratios for isolated as well as comorbid learning disorders in a representative sample of 1633 German speaking children in 3rd and 4th Grade. Prevalence rates were analysed for isolated as well as combined learning disorders and for different deficit criteria, including a criterion for normal performance. Comorbid learning disorders occurred as frequently as isolated learning disorders, even when stricter cutoff criteria were applied. The relative proportion of isolated and combined disorders did not change when including a criterion for normal performance. Reading and spelling deficits differed with respect to their association with arithmetic problems: Deficits in arithmetic co-occurred more often with deficits in spelling than with deficits in reading. In addition, comorbidity rates for arithmetic and reading decreased when applying stricter deficit criteria, but stayed high for arithmetic and spelling irrespective of the chosen deficit criterion. These findings suggest that the processes underlying the relationship between arithmetic and reading might differ from those underlying the relationship between arithmetic and spelling. With respect to gender ratios, more boys than girls showed spelling deficits, while more girls were impaired in arithmetic. No gender differences were observed for isolated reading problems and for the combination of all three learning disorders. Implications of these findings for assessment and intervention of learning disorders are discussed.

Yohimbine enhancement of exposure therapy for social anxiety disorder: a randomized controlled trial.

PubMed

Smits, Jasper A J; Rosenfield, David; Davis, Michelle L; Julian, Kristin; Handelsman, Pamela R; Otto, Michael W; Tuerk, Peter; Shiekh, Michael; Rosenfield, Ben; Hofmann, Stefan G; Powers, Mark B

2014-06-01

Preclinical and clinical trials suggest that yohimbine may augment extinction learning without significant side effects. However, previous clinical trials have only examined adults with specific phobias. Yohimbine has not yet been investigated in the augmentation of exposure therapy for other anxiety disorders. Adults (n = 40) with a DSM-IV diagnosis of social anxiety disorder were randomized to placebo or yohimbine HCl (10.8 mg) 1 hour before each of four exposure sessions. Outcome measures were collected at baseline, each treatment session, posttreatment, and 1-month follow-up. Yohimbine was well tolerated. Yohimbine augmentation, relative to placebo augmentation, resulted in faster improvement and better outcomes on self-report measures of social anxiety disorder severity (Liebowitz Social Anxiety Scale, d = .53) and depressed mood severity (Beck Depression Inventory, d = .37) but not on the clinician-rated measures (Clinical Global Impressions-Severity Scale, d = .09; Clinical Global Impressions-Improvement Scale, d = .25). Between-group differences on the Liebowitz Social Anxiety Scale were moderated by the level of fear reported at the end of an exposure exercise (end fear), such that the advantage of yohimbine over placebo was only evident among patients who reported low end fear. The results provide moderate support for yohimbine as a therapeutic augmentation strategy for exposure therapy in social anxiety disorder, one that may be especially effective when coupled with successful exposure experiences. Beneficial effects for yohimbine were readily evident for self-report measures but not for clinician-rated outcomes of social anxiety severity and improvement. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

Research Review: Environmental exposures, neurodevelopment and child mental health – new paradigms for the study of brain and behavioral effects

PubMed Central

Rauh, Virginia A.; Margolis, Amy

2016-01-01

Background Environmental exposures play a critical role in the genesis of some child mental health problems. Methods We open with a discussion of children’s vulnerability to neurotoxic substances, changes in the distribution of toxic exposures, and co-occurrence of social and physical exposures. We address trends in prevalence of mental health disorders, and approaches to the definition of disorders that are sensitive to the subtle effects of toxic exposures. We suggest broadening outcomes to include dimensional measures of autism spectrum disorders, attention deficit hyperactivity disorder, and child learning capacity, as well as direct assessment of brain function. Findings We consider the impact of two important exposures on children’s mental health: lead and pesticides. We argue that longitudinal research designs may capture the cascading effects of exposures across biological systems and the full-range of neuropsychological endpoints. Neuroimaging is a valuable tool for observing brain maturation under varying environmental conditions. A dimensional approach to measurement may be sensitive to subtle sub-clinical toxic effects, permitting the development of exposure-related profiles and testing of complex functional relationships between brain and behavior. Questions about the neurotoxic effects of chemicals become more pressing when viewed through the lens of environmental justice. Conclusions Reduction in the burden of child mental health disorders will require longitudinal study of neurotoxic exposures, incorporating dimensional approaches to outcome assessment and measures of brain function. Research that seeks to identify links between toxic exposures and mental health outcomes has enormous public health and societal value. PMID:26987761

Research Review: Environmental exposures, neurodevelopment, and child mental health - new paradigms for the study of brain and behavioral effects.

PubMed

Rauh, Virginia A; Margolis, Amy E

2016-07-01

Environmental exposures play a critical role in the genesis of some child mental health problems. We open with a discussion of children's vulnerability to neurotoxic substances, changes in the distribution of toxic exposures, and cooccurrence of social and physical exposures. We address trends in prevalence of mental health disorders, and approaches to the definition of disorders that are sensitive to the subtle effects of toxic exposures. We suggest broadening outcomes to include dimensional measures of autism spectrum disorders, attention-deficit hyperactivity disorder, and child learning capacity, as well as direct assessment of brain function. We consider the impact of two important exposures on children's mental health: lead and pesticides. We argue that longitudinal research designs may capture the cascading effects of exposures across biological systems and the full-range of neuropsychological endpoints. Neuroimaging is a valuable tool for observing brain maturation under varying environmental conditions. A dimensional approach to measurement may be sensitive to subtle subclinical toxic effects, permitting the development of exposure-related profiles and testing of complex functional relationships between brain and behavior. Questions about the neurotoxic effects of chemicals become more pressing when viewed through the lens of environmental justice. Reduction in the burden of child mental health disorders will require longitudinal study of neurotoxic exposures, incorporating dimensional approaches to outcome assessment, and measures of brain function. Research that seeks to identify links between toxic exposures and mental health outcomes has enormous public health and societal value. © 2016 Association for Child and Adolescent Mental Health.

Posttreatment attrition and its predictors, attrition bias, and treatment efficacy of the anxiety online programs.

PubMed

Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

2014-10-14

Although relatively new, the field of e-mental health is becoming more popular with more attention given to researching its various aspects. However, there are many areas that still need further research, especially identifying attrition predictors at various phases of assessment and treatment delivery. The present study identified the predictors of posttreatment assessment completers based on 24 pre- and posttreatment demographic and personal variables and 1 treatment variable, their impact on attrition bias, and the efficacy of the 5 fully automated self-help anxiety treatment programs for generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). A complex algorithm was used to diagnose participants' mental disorders based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR). Those who received a primary or secondary diagnosis of 1 of 5 anxiety disorders were offered an online 12-week disorder-specific treatment program. A total of 3199 individuals did not formally drop out of the 12-week treatment cycle, whereas 142 individuals formally dropped out. However, only 347 participants who completed their treatment cycle also completed the posttreatment assessment measures. Based on these measures, predictors of attrition were identified and attrition bias was examined. The efficacy of the 5 treatment programs was assessed based on anxiety-specific severity scores and 5 additional treatment outcome measures. On average, completers of posttreatment assessment measures were more likely to be seeking self-help online programs; have heard about the program from traditional media or from family and friends; were receiving mental health assistance; were more likely to learn best by reading, hearing and doing; had a lower pretreatment Kessler-6 total score; and were older in age. Predicted probabilities resulting from these attrition variables displayed no significant attrition bias using Heckman's method and thus allowing for the use of completer analysis. Six treatment outcome measures (Kessler-6 total score, number of diagnosed disorders, self-confidence in managing mental health issues, quality of life, and the corresponding pre- and posttreatment severity for each program-specific anxiety disorder and for major depressive episode) were used to assess the efficacy of the 5 anxiety treatment programs. Repeated measures MANOVA revealed a significant multivariate time effect for all treatment outcome measures for each treatment program. Follow-up repeated measures ANOVAs revealed significant improvements on all 6 treatment outcome measures for GAD and PTSD, 5 treatment outcome measures were significant for SAD and PD/A, and 4 treatment outcome measures were significant for OCD. Results identified predictors of posttreatment assessment completers and provided further support for the efficacy of self-help online treatment programs for the 5 anxiety disorders. Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

Rehabilitation robotics for the upper extremity: review with new directions for orthopaedic disorders.

PubMed

Hakim, Renée M; Tunis, Brandon G; Ross, Michael D

2017-11-01

The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks. Implications for Rehabilitation There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on the evidence in neurologic populations, virtual reality-enhanced robotics may be integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with UE disorders, specifically emphasizing the wrist and hand. Clinical application of a task-oriented approach may be accomplished using commercially available haptic robotic device to focus on training of grasp and manipulation tasks.

Using distance technologies to facilitate a learning collaborative to implement stagewise treatment.

PubMed

Covell, Nancy H; Foster, Forrest P; Margolies, Paul J; Lopez, Luis O; Dixon, Lisa B

2015-06-01

This report describes experiences and outcomes of an online learning collaborative focused on implementation of stagewise treatment. Eleven participating programs convened online monthly for a year. Between meetings, program staff created an implementation plan and programs collected performance indicator data, including assessment of staff knowledge of integrated treatment for people with co-occurring disorders, whether a person's current stage of treatment was documented in his or her chart, and whether the treatments were appropriate for the stage of treatment. Descriptive statistics were used to characterize performance indicators and feedback. Wilcoxon matched-pairs signed-rank tests examined changes in performance indicators over time. Program staff generally demonstrated significant improvements in performance indicators over time and rated the distance learning collaborative favorably. Distance learning collaboratives can be structured to provide opportunities for program staff to interact and learn from one another and to implement and sustain changes.

The role of GABAB receptors in human reinforcement learning.

PubMed

Ort, Andres; Kometer, Michael; Rohde, Judith; Seifritz, Erich; Vollenweider, Franz X

2014-10-01

Behavioral evidence from human studies suggests that the γ-aminobutyric acid type B receptor (GABAB receptor) agonist baclofen modulates reinforcement learning and reduces craving in patients with addiction spectrum disorders. However, in contrast to the well established role of dopamine in reinforcement learning, the mechanisms by which the GABAB receptor influences reinforcement learning in humans remain completely unknown. To further elucidate this issue, a cross-over, double-blind, placebo-controlled study was performed in healthy human subjects (N=15) to test the effects of baclofen (20 and 50mg p.o.) on probabilistic reinforcement learning. Outcomes were the feedback-induced P2 component of the event-related potential, the feedback-related negativity, and the P300 component of the event-related potential. Baclofen produced a reduction of P2 amplitude over the course of the experiment, but did not modulate the feedback-related negativity. Furthermore, there was a trend towards increased learning after baclofen administration relative to placebo over the course of the experiment. The present results extend previous theories of reinforcement learning, which focus on the importance of mesolimbic dopamine signaling, and indicate that stimulation of cortical GABAB receptors in a fronto-parietal network leads to better attentional allocation in reinforcement learning. This observation is a first step in our understanding of how baclofen may improve reinforcement learning in healthy subjects. Further studies with bigger sample sizes are needed to corroborate this conclusion and furthermore, test this effect in patients with addiction spectrum disorder. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Memory performance predicts recurrence of mania in bipolar disorder following psychotherapy: a preliminary study

PubMed Central

Bauer, Isabelle E.; Hautzinger, Martin; Meyer, Thomas D.

2016-01-01

Objective Cognitive complaints are common features of bipolar disorder (BD). Not much is, however, known about the potential moderator effects of these factors on the outcome of talking therapies. The goal of our study was to explore whether learning and memory abilities predict risk of recurrence of mood episodes or interact with a psychological intervention. Method We analyzed data collected as part of a clinical trial evaluating relapse rates following Cognitive Behavioral Therapy (CBT) and Supportive Therapy (ST) (Meyer & Hautzinger, 2012). We included cognitive (Auditive Verbal Learning Test, general intelligence - Leistungsprüfsystem) and clinical measures from 76 euthymic patients with BD randomly assigned to either 9 months of CBT or ST and followed up for 2 years. Results Survival analyses including treatment condition, AVLT measures, and general intelligence revealed that recurrence of mania was predicted by verbal free recall. The significant interaction between therapy condition and free recall indicated that while in CBT recurrence of mania was unrelated to free recall performance, in ST patients with a better free recall were more likely to remain euthymic, and those with a poorer free recall were less likely to remain mania-free1. Conclusions These findings constitute first evidence that, when considering treatment outcome in BD, differences in verbal free recall might interact with the kind of psychotherapy provided. More research is needed to determine what other areas of cognitive functioning are related to outcome in psychological interventions. PMID:27764692

Can Executive Functions Help to Understand Children with Mathematical Learning Disorders and to Improve Instruction?

ERIC Educational Resources Information Center

Desoete, Annemie; De Weerdt, Frauke

2013-01-01

Working memory, inhibition and naming speed was assessed in 22 children with mathematical learning disorders (MD), 17 children with a reading learning disorder (RD), and 45 children without any learning problems between 8 and 12 years old. All subjects with learning disorders performed poorly on working memory tasks, providing evidence that they…

Frontostriatal Dysfunction During Decision Making in Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder.

PubMed

Norman, Luke J; Carlisi, Christina O; Christakou, Anastasia; Murphy, Clodagh M; Chantiluke, Kaylita; Giampietro, Vincent; Simmons, Andrew; Brammer, Michael; Mataix-Cols, David; Rubia, Katya

2018-03-24

The aim of the current paper is to provide the first comparison of computational mechanisms and neurofunctional substrates in adolescents with attention-deficit/hyperactivity disorder (ADHD) and adolescents with obsessive-compulsive disorder (OCD) during decision making under ambiguity. Sixteen boys with ADHD, 20 boys with OCD, and 20 matched control subjects (12-18 years of age) completed a functional magnetic resonance imaging version of the Iowa Gambling Task. Brain activation was compared between groups using three-way analysis of covariance. Hierarchical Bayesian analysis was used to compare computational modeling parameters between groups. Patient groups shared reduced choice consistency and relied less on reinforcement learning during decision making relative to control subjects, while adolescents with ADHD alone demonstrated increased reward sensitivity. During advantageous choices, both disorders shared underactivation in ventral striatum, while OCD patients showed disorder-specific underactivation in the ventromedial orbitofrontal cortex. During outcome evaluation, shared underactivation to losses in patients relative to control subjects was found in the medial prefrontal cortex and shared underactivation to wins was found in the left putamen/caudate. ADHD boys showed disorder-specific dysfunction in the right putamen/caudate, which was activated more to losses in patients with ADHD but more to wins in control subjects. The findings suggest shared deficits in using learned reward expectancies to guide decision making, as well as shared dysfunction in medio-fronto-striato-limbic brain regions. However, findings of unique dysfunction in the ventromedial orbitofrontal cortex in OCD and in the right putamen in ADHD indicate additional, disorder-specific abnormalities and extend similar findings from inhibitory control tasks in the disorders to the domain of decision making under ambiguity. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Common visual problems in children with disability

PubMed Central

Salt, Alison; Sargent, Jenefer

2014-01-01

Children with disability are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. The aetiology of VI in children with disability reflects that of the general population and includes cerebral VI, optic atrophy, as well as primary visual disorders such as retinal dystrophies and structural eye anomalies. VI and other potentially correctable ocular disorders may not be recognised without careful assessment and are frequently unidentified in children with complex needs. Although assessment may be more challenging than in other children, identifying these potential additional barriers to learning and development may be critical. There is a need to develop clearer guidelines, referral pathways and closer working between all professionals involved in the care of children with disability and visual disorders to improve our focus on the assessment of vision and outcomes for children with disability. PMID:25165073

Cross-generational influences on childhood anxiety disorders: pathways and mechanisms

PubMed Central

Leckman, James F.; Silverman, Wendy K.; Feldman, Ruth

2016-01-01

Anxiety disorders are common across the lifespan, cause severe distress and impairment, and usually have their onset in childhood. Substantial clinical and epidemiological research has demonstrated the existence of links between anxiety and its disorders in children and parents. Research on the pathways and mechanisms underlying these links has pointed to both behavioral and biological systems. This review synthesizes and summarizes several major aspects of this research. Behavioral systems include vicarious learning, social referencing, and modeling of parental anxiety; overly protective or critical parenting styles; and aspects of parental responses to child anxiety including family accommodation of the child’s symptoms. Biological systems include aspects of the prenatal environment affected by maternal anxiety, development and functioning of the oxytocinergic system, and genetic and epigenetic transmission. Implications for the prevention and treatment of child anxiety disorders are discussed, including the potential to enhance child anxiety treatment outcomes through biologically informed parent-based interventions. PMID:27145763

Cross-generational influences on childhood anxiety disorders: pathways and mechanisms.

PubMed

Lebowitz, Eli R; Leckman, James F; Silverman, Wendy K; Feldman, Ruth

2016-09-01

Anxiety disorders are common across the lifespan, cause severe distress and impairment, and usually have their onset in childhood. Substantial clinical and epidemiological research has demonstrated the existence of links between anxiety and its disorders in children and parents. Research on the pathways and mechanisms underlying these links has pointed to both behavioral and biological systems. This review synthesizes and summarizes several major aspects of this research. Behavioral systems include vicarious learning, social referencing, and modeling of parental anxiety; overly protective or critical parenting styles; and aspects of parental responses to child anxiety including family accommodation of the child's symptoms. Biological systems include aspects of the prenatal environment affected by maternal anxiety, development and functioning of the oxytocinergic system, and genetic and epigenetic transmission. Implications for the prevention and treatment of child anxiety disorders are discussed, including the potential to enhance child anxiety treatment outcomes through biologically informed parent-based interventions.

Correlates of head circumference growth in infants later diagnosed with autism spectrum disorders.

PubMed

Mraz, Krista D; Green, James; Dumont-Mathieu, Thyde; Makin, Sarah; Fein, Deborah

2007-06-01

Previous research has demonstrated that children diagnosed with autism spectrum disorder show an abnormal acceleration of head growth during the first year of life. This study attempts to replicate these findings and to determine whether overgrowth is associated with clinical outcome. Measurements of head circumference, body length, and body weight taken during the first 2 years of life were obtained from a sample of 35 children diagnosed with autism spectrum disorder and compared to both national normative data (Centers for Disease Control and Prevention) and a control group of 37 healthy infants. Results demonstrated that compared to national averages, infants who were later diagnosed with autism spectrum disorder had a significantly smaller head circumference at birth to 2 weeks and a significantly larger head circumference by 10 to 14 months. Children with autism spectrum disorder were also significantly longer and heavier beginning at 1 to 2 months. However, when overall length and weight were controlled, head circumference was not bigger in the autistic spectrum disorder group compared to local controls. Correlations between head circumference and clinical outcome were significant for 5 of the 30 clinical variables that were run, suggesting that there appears to be no simple or straightforward relationship between head circumference and clinical outcome. Smaller head circumference at birth to 2 weeks was associated with a greater number of symptoms related to social impairment and a greater total number of autism spectrum disorder symptoms based on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition criteria. Larger head circumference at 15 to 25 months was also associated with a greater number of symptoms of social impairment. In addition, greater head circumference change during the first 2 years was associated with poorer performance on the visual reception subtest of the Mullen Scales of Early Learning and a smaller number of stereotyped and repetitive behaviors and interests based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. These findings support previous findings of accelerated brain growth during the first year of life in autism spectrum disorder and question whether growth factors might contribute to both accelerated brain growth and overall body growth.

Reward Prediction Errors in Drug Addiction and Parkinson's Disease: from Neurophysiology to Neuroimaging.

PubMed

García-García, Isabel; Zeighami, Yashar; Dagher, Alain

2017-06-01

Surprises are important sources of learning. Cognitive scientists often refer to surprises as "reward prediction errors," a parameter that captures discrepancies between expectations and actual outcomes. Here, we integrate neurophysiological and functional magnetic resonance imaging (fMRI) results addressing the processing of reward prediction errors and how they might be altered in drug addiction and Parkinson's disease. By increasing phasic dopamine responses, drugs might accentuate prediction error signals, causing increases in fMRI activity in mesolimbic areas in response to drugs. Chronic substance dependence, by contrast, has been linked with compromised dopaminergic function, which might be associated with blunted fMRI responses to pleasant non-drug stimuli in mesocorticolimbic areas. In Parkinson's disease, dopamine replacement therapies seem to induce impairments in learning from negative outcomes. The present review provides a holistic overview of reward prediction errors across different pathologies and might inform future clinical strategies targeting impulsive/compulsive disorders.

Examination of the relation between an assessment of skills and performance on auditory-visual conditional discriminations for children with autism spectrum disorder.

PubMed

Kodak, Tiffany; Clements, Andrea; Paden, Amber R; LeBlanc, Brittany; Mintz, Joslyn; Toussaint, Karen A

2015-01-01

The current investigation evaluated repertoires that may be related to performance on auditory-to-visual conditional discrimination training with 9 students who had been diagnosed with autism spectrum disorder. The skills included in the assessment were matching, imitation, scanning, an auditory discrimination, and a visual discrimination. The results of the skills assessment showed that 4 participants failed to demonstrate mastery of at least 1 of the skills. We compared the outcomes of the assessment to the results of auditory-visual conditional discrimination training and found that training outcomes were related to the assessment outcomes for 7 of the 9 participants. One participant who did not demonstrate mastery of all assessment skills subsequently learned several conditional discriminations when blocked training trials were conducted. Another participant who did not demonstrate mastery of the auditory discrimination skill subsequently acquired conditional discriminations in 1 of the training conditions. We discuss the implications of the assessment for practice and suggest additional areas of research on this topic. © Society for the Experimental Analysis of Behavior.

Effects of a Computerized Working Memory Training Program on Working Memory, Attention, and Academics in Adolescents with Severe LD and Comorbid ADHD: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Gray, S. A.; Chaban, P.; Martinussen, R.; Goldberg, R.; Gotlieb, H.; Kronitz, R.; Hockenberry, M.; Tannock, R.

2012-01-01

Background: Youths with coexisting learning disabilities (LD) and attention deficit hyperactivity disorder (ADHD) are at risk for poor academic and social outcomes. The underlying cognitive deficits, such as poor working memory (WM), are not well targeted by current treatments for either LD or ADHD. Emerging evidence suggests that WM might be…

Patient learning of treatment contents in cognitive therapy.

PubMed

Gumport, Nicole B; Dong, Lu; Lee, Jason Y; Harvey, Allison G

2018-03-01

Research has demonstrated that both memory and learning for treatment contents are poor, and that both are associated with worse treatment outcome. The Memory Support Intervention has been shown to improve memory for treatment, but it has not yet been established if this intervention can also improve learning of treatment contents. This study was designed to document the number of times participants exhibited each of the indices of learning, to examine the indices of learning and their relationship to recall of treatment points, and to investigate the association between the indices of learning and depression outcome. Adults diagnosed with major depressive disorder (N = 48) were randomly assigned to 14 sessions of cognitive therapy-as-usual (CT-as-usual) or cognitive therapy plus the Memory Support Intervention (CT + Memory Support). Measures of learning, memory, and depressive symptomatology were taken at mid-treatment, post-treatment, and at 6-month follow-up. Relative to the CT-as-usual group, participants in the CT + Memory Support group reported more accurate thoughts and applications of treatment points at mid-treatment, post-treatment, and 6-month follow-up. Patient recall was significantly correlated with application and cognitive generalization. Thoughts and application at mid-treatment were associated with increased odds of treatment response at post-treatment. The learning measure for this study has not yet been psychometrically validated. The results are based on a small sample. Learning during treatment is poor, but modifiable via the Memory Support Intervention. These results provide encouraging data that improving learning of treatment contents can reduce symptoms during and following treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials.

PubMed

Cortese, Samuele; Ferrin, Maite; Brandeis, Daniel; Holtmann, Martin; Aggensteiner, Pascal; Daley, David; Santosh, Paramala; Simonoff, Emily; Stevenson, Jim; Stringaris, Argyris; Sonuga-Barke, Edmund J S

2016-06-01

We performed meta-analyses of randomized controlled trials to examine the effects of neurofeedback on attention-deficit/hyperactivity disorder (ADHD) symptoms and neuropsychological deficits in children and adolescents with ADHD. We searched PubMed, Ovid, Web of Science, ERIC, and CINAHAL through August 30, 2015. Random-effects models were employed. Studies were evaluated with the Cochrane Risk of Bias tool. We included 13 trials (520 participants with ADHD). Significant effects were found on ADHD symptoms rated by assessors most proximal to the treatment setting, that is, the least blinded outcome measure (standardized mean difference [SMD]: ADHD total symptoms = 0.35, 95% CI = 0.11-0.59; inattention = 0.36, 95% CI = 0.09-0.63; hyperactivity/impulsivity = 0.26, 95% CI = 0.08-0.43). Effects were not significant when probably blinded ratings were the outcome or in trials with active/sham controls. Results were similar when only frequency band training trials, the most common neurofeedback approach, were analyzed separately. Effects on laboratory measures of inhibition (SMD = 0.30, 95% CI = -0.10 to 0.70) and attention (SMD = 0.13, 95% CI = -0.09 to 0.36) were not significant. Only 4 studies directly assessed whether learning occurred after neurofeedback training. The risk of bias was unclear for many Cochrane Risk of Bias domains in most studies. Evidence from well-controlled trials with probably blinded outcomes currently fails to support neurofeedback as an effective treatment for ADHD. Future efforts should focus on implementing standard neurofeedback protocols, ensuring learning, and optimizing clinically relevant transfer. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

[Five years of ROM in substance abuse treatment centres in the Netherlands].

PubMed

Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

2012-01-01

Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

Touchscreen learning deficits in Ube3a, Ts65Dn and Mecp2 mouse models of neurodevelopmental disorders with intellectual disabilities.

PubMed

Leach, P T; Crawley, J N

2017-12-20

Mutant mouse models of neurodevelopmental disorders with intellectual disabilities provide useful translational research tools, especially in cases where robust cognitive deficits are reproducibly detected. However, motor, sensory and/or health issues consequent to the mutation may introduce artifacts that preclude testing in some standard cognitive assays. Touchscreen learning and memory tasks in small operant chambers have the potential to circumvent these confounds. Here we use touchscreen visual discrimination learning to evaluate performance in the maternally derived Ube3a mouse model of Angelman syndrome, the Ts65Dn trisomy mouse model of Down syndrome, and the Mecp2 Bird mouse model of Rett syndrome. Significant deficits in acquisition of a 2-choice visual discrimination task were detected in both Ube3a and Ts65Dn mice. Procedural control measures showed no genotype differences during pretraining phases or during acquisition. Mecp2 males did not survive long enough for touchscreen training, consistent with previous reports. Most Mecp2 females failed on pretraining criteria. Significant impairments on Morris water maze spatial learning were detected in both Ube3a and Ts65Dn, replicating previous findings. Abnormalities on rotarod in Ube3a, and on open field in Ts65Dn, replicating previous findings, may have contributed to the observed acquisition deficits and swim speed abnormalities during water maze performance. In contrast, these motor phenotypes do not appear to have affected touchscreen procedural abilities during pretraining or visual discrimination training. Our findings of slower touchscreen learning in 2 mouse models of neurodevelopmental disorders with intellectual disabilities indicate that operant tasks offer promising outcome measures for the preclinical discovery of effective pharmacological therapeutics. © 2017 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

Sleep Disorders as a Risk to Language Learning and Use. EBP Briefs. Volume 10, Issue 1

ERIC Educational Resources Information Center

McGregor, Karla K.; Alper, Rebecca M.

2015-01-01

Clinical Question: Are people with sleep disorders at higher risk for language learning deficits than healthy sleepers? Method: Scoping Review. Study Sources: PubMed, Google Scholar, Trip Database, ClinicalTrials.gov. Search Terms: sleep disorders AND language AND learning; sleep disorders language learning--deprivation--epilepsy; sleep disorders…

Learning to Obtain Reward, but Not Avoid Punishment, Is Affected by Presence of PTSD Symptoms in Male Veterans: Empirical Data and Computational Model

PubMed Central

Myers, Catherine E.; Moustafa, Ahmed A.; Sheynin, Jony; VanMeenen, Kirsten M.; Gilbertson, Mark W.; Orr, Scott P.; Beck, Kevin D.; Pang, Kevin C. H.; Servatius, Richard J.

2013-01-01

Post-traumatic stress disorder (PTSD) symptoms include behavioral avoidance which is acquired and tends to increase with time. This avoidance may represent a general learning bias; indeed, individuals with PTSD are often faster than controls on acquiring conditioned responses based on physiologically-aversive feedback. However, it is not clear whether this learning bias extends to cognitive feedback, or to learning from both reward and punishment. Here, male veterans with self-reported current, severe PTSD symptoms (PTSS group) or with few or no PTSD symptoms (control group) completed a probabilistic classification task that included both reward-based and punishment-based trials, where feedback could take the form of reward, punishment, or an ambiguous “no-feedback” outcome that could signal either successful avoidance of punishment or failure to obtain reward. The PTSS group outperformed the control group in total points obtained; the PTSS group specifically performed better than the control group on reward-based trials, with no difference on punishment-based trials. To better understand possible mechanisms underlying observed performance, we used a reinforcement learning model of the task, and applied maximum likelihood estimation techniques to derive estimated parameters describing individual participants’ behavior. Estimations of the reinforcement value of the no-feedback outcome were significantly greater in the control group than the PTSS group, suggesting that the control group was more likely to value this outcome as positively reinforcing (i.e., signaling successful avoidance of punishment). This is consistent with the control group’s generally poorer performance on reward trials, where reward feedback was to be obtained in preference to the no-feedback outcome. Differences in the interpretation of ambiguous feedback may contribute to the facilitated reinforcement learning often observed in PTSD patients, and may in turn provide new insight into how pathological behaviors are acquired and maintained in PTSD. PMID:24015254

Specific Language Impairment, Nonverbal IQ, Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cochlear Implants, Bilingualism, and Dialectal Variants: Defining the Boundaries, Clarifying Clinical Conditions, and Sorting Out Causes

PubMed Central

2016-01-01

Purpose The purpose of this research forum article is to provide an overview of a collection of invited articles on the topic “specific language impairment (SLI) in children with concomitant health conditions or nonmainstream language backgrounds.” Topics include SLI, attention-deficit/hyperactivity disorder, autism spectrum disorder, cochlear implants, bilingualism, and dialectal language learning contexts. Method The topic is timely due to current debates about the diagnosis of SLI. An overarching comparative conceptual framework is provided for comparisons of SLI with other clinical conditions. Comparisons of SLI in children with low-normal or normal nonverbal IQ illustrate the unexpected outcomes of 2 × 2 comparison designs. Results Comparative studies reveal unexpected relationships among speech, language, cognitive, and social dimensions of children's development as well as precise ways to identify children with SLI who are bilingual or dialect speakers. Conclusions The diagnosis of SLI is essential for elucidating possible causal pathways of language impairments, risks for language impairments, assessments for identification of language impairments, linguistic dimensions of language impairments, and long-term outcomes. Although children's language acquisition is robust under high levels of risk, unexplained individual variations in language acquisition lead to persistent language impairments. PMID:26502218

Implementation and Evaluation of Two Educational Strategies to Improve Screening for Eating Disorders in Pediatric Primary Care.

PubMed

Gooding, Holly C; Cheever, Elizabeth; Forman, Sara F; Hatoun, Jonathan; Jooma, Farah; Touloumtzis, Currie; Vernacchio, Louis

2017-05-01

Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the "active-learning" group would have an increase in documented screening after intervention. We studied 303 practitioners in a large independent practice association located in the northeastern United States. We used a quasi-experimental design to test the effect of printed educational materials ("print-learning" group, n = 280 participants) compared with in-person shared learning followed by on-line spaced education ("active-learning" group, n = 23 participants) on documented screening of adolescents for eating disorder symptoms during preventive care visits. A subset of 88 participants completed additional surveys regarding knowledge of eating disorders, comfort screening for, diagnosing, and treating eating disorders, and satisfaction with their training regarding eating disorders. During the preintervention period, 4.5% of patients seen by practitioners in both the print-learning and active-learning groups had chart documentation of screening for eating disorder symptoms or body image concerns. This increased to 22% in the active-learning group and 5.7% in the print-learning group in the postintervention period, a statistically significant result. Compared with print-learning participants, active-learning group participants had greater eating disorder knowledge scores, increases in comfort diagnosing eating disorders, and satisfaction with their training in this area. In-person shared learning followed by on-line spaced education is more effective than print educational materials for increasing provider documentation of screening for eating disorders in primary care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Sleep Disorders as a Risk to Language Learning and Use.

PubMed

McGregor, Karla K; Alper, Rebecca M

2015-05-01

Are people with sleep disorders at higher risk for language learning deficits than healthy sleepers? Scoping Review. PubMed, Google Scholar, Trip Database, ClinicalTrials.gov. sleep disorders AND language AND learning; sleep disorders language learning -deprivation -epilepsy; sleep disorders AND verbal learning. 36. Children and adults with sleep disorders were at a higher risk for language problems than healthy sleepers. The language problems typically co-occurred with problems of attention and executive function (in children and adults), behavior (in children), and visual-spatial processing (in adults). Effects were typically small. Language problems seldom rose to a level of clinical concern but there were exceptions involving phonological deficits in children with sleep-disordered breathing and verbal memory deficits among adults with sleep-disordered breathing or idiopathic REM sleep behavior disorder. Case history interviews should include questions about limited sleep, poor-quality sleep, snoring, and excessive daytime sleepiness. Medical referrals for clients with suspected sleep disorders are prudent.

Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

PubMed Central

Kuhn, Kurt W.; Cambron, Jerrilyn

2013-01-01

Objective The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. Clinical features A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. Intervention and outcome The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners’ Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. Conclusion The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature. PMID:24396330

Sleep supports cued fear extinction memory consolidation independent of circadian phase.

PubMed

Melo, Irene; Ehrlich, Ingrid

2016-07-01

Sleep promotes memory, particularly for declarative learning. However, its role in non-declarative, emotional memories is less well understood. Some studies suggest that sleep may influence fear-related memories, and thus may be an important factor determining the outcome of treatments for emotional disorders such as post-traumatic stress disorder. Here, we investigated the effect of sleep deprivation and time of day on fear extinction memory consolidation. Mice were subjected to a cued Pavlovian fear and extinction paradigm at the beginning of their resting or active phase. Immediate post-extinction learning sleep deprivation for 5h compromised extinction memory when tested 24h after learning. Context-dependent extinction memory recall was completely prevented by sleep-manipulation during the resting phase, while impairment was milder during the active phase and extinction memory retained its context-specificity. Importantly, control experiments excluded confounding factors such as differences in baseline locomotion, fear generalization and stress hormone levels. Together, our findings indicate that post-learning sleep supports cued fear extinction memory consolidation in both circadian phases. The lack of correlation between memory efficacy and sleep time suggests that extinction memory may be influenced by specific sleep events in the early consolidation period. Copyright © 2016 Elsevier Inc. All rights reserved.

Mediodorsal thalamus hypofunction impairs flexible goal-directed behavior.

PubMed

Parnaudeau, Sébastien; Taylor, Kathleen; Bolkan, Scott S; Ward, Ryan D; Balsam, Peter D; Kellendonk, Christoph

2015-03-01

Cognitive inflexibility is a core symptom of several mental disorders including schizophrenia. Brain imaging studies in schizophrenia patients performing cognitive tasks have reported decreased activation of the mediodorsal thalamus (MD). Using a pharmacogenetic approach to model MD hypofunction, we recently showed that decreasing MD activity impairs reversal learning in mice. While this demonstrates causality between MD hypofunction and cognitive inflexibility, questions remain about the elementary cognitive processes that account for the deficit. Using the Designer Receptors Exclusively Activated by Designer Drugs system, we reversibly decreased MD activity during behavioral tasks assessing elementary cognitive processes inherent to flexible goal-directed behaviors, including extinction, contingency degradation, outcome devaluation, and Pavlovian-to-instrumental transfer (n = 134 mice). While MD hypofunction impaired reversal learning, it did not affect the ability to learn about nonrewarded cues or the ability to modulate action selection based on the outcome value. In contrast, decreasing MD activity delayed the ability to adapt to changes in the contingency between actions and their outcomes. In addition, while Pavlovian learning was not affected by MD hypofunction, decreasing MD activity during Pavlovian learning impaired the ability of conditioned stimuli to modulate instrumental behavior. Mediodorsal thalamus hypofunction causes cognitive inflexibility reflected by an impaired ability to adapt actions when their consequences change. Furthermore, it alters the encoding of environmental stimuli so that they cannot be properly utilized to guide behavior. Modulating MD activity could be a potential therapeutic strategy for promoting adaptive behavior in human subjects with cognitive inflexibility. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Academic Achievements, Behavioral Problems, and Loneliness as Predictors of Social Skills among Students with and without Learning Disorders

ERIC Educational Resources Information Center

Zach, Sima; Yazdi-Ugav, Orly; Zeev, Aviva

2016-01-01

This study aimed to examine to what extent academic achievements, learning disorders, behavior problems and loneliness explain the variance of students' social skills. The differences between students diagnosed with learning disorders and students without learning disorders in all four variables were examined. Participants were 733 elementary…

Maternal Stress in Nonverbal Learning Disorder: A Comparison with Reading Disorder

ERIC Educational Resources Information Center

Antshel, Kevin M.; Joseph, Guy-Ronald

2006-01-01

Maternal stress was assessed in mothers of children ages 8 to 11 years with learning disorders (LD). Age-, gender-, and IQ-matched children with reading disorders (RD; n = 31), children with nonverbal learning disorders (NVLD; n = 21), and typically developing control participants (n = 23) participated. Mothers of children with LD reported higher…

Machine Learning and Neurosurgical Outcome Prediction: A Systematic Review.

PubMed

Senders, Joeky T; Staples, Patrick C; Karhade, Aditya V; Zaki, Mark M; Gormley, William B; Broekman, Marike L D; Smith, Timothy R; Arnaout, Omar

2018-01-01

Accurate measurement of surgical outcomes is highly desirable to optimize surgical decision-making. An important element of surgical decision making is identification of the patient cohort that will benefit from surgery before the intervention. Machine learning (ML) enables computers to learn from previous data to make accurate predictions on new data. In this systematic review, we evaluate the potential of ML for neurosurgical outcome prediction. A systematic search in the PubMed and Embase databases was performed to identify all potential relevant studies up to January 1, 2017. Thirty studies were identified that evaluated ML algorithms used as prediction models for survival, recurrence, symptom improvement, and adverse events in patients undergoing surgery for epilepsy, brain tumor, spinal lesions, neurovascular disease, movement disorders, traumatic brain injury, and hydrocephalus. Depending on the specific prediction task evaluated and the type of input features included, ML models predicted outcomes after neurosurgery with a median accuracy and area under the receiver operating curve of 94.5% and 0.83, respectively. Compared with logistic regression, ML models performed significantly better and showed a median absolute improvement in accuracy and area under the receiver operating curve of 15% and 0.06, respectively. Some studies also demonstrated a better performance in ML models compared with established prognostic indices and clinical experts. In the research setting, ML has been studied extensively, demonstrating an excellent performance in outcome prediction for a wide range of neurosurgical conditions. However, future studies should investigate how ML can be implemented as a practical tool supporting neurosurgical care. Copyright © 2017 Elsevier Inc. All rights reserved.

Intrinsic motivation and learning in a schizophrenia spectrum sample.

PubMed

Choi, Jimmy; Medalia, Alice

2010-05-01

A motivation is a telling hallmark of negative symptomatology in schizophrenia, and it impacts nearly every facet of behavior, including inclination to attempt the difficult cognitive tasks involved in cognitive remediation therapy. Experiences of external reward, reinforcement, and hedonic anticipatory enjoyment are diminished in psychosis, so therapeutics which instead target intrinsic motivation for cognitive tasks may enhance task engagement, and subsequently, remediation outcome. We examined whether outpatients could attain benefits from an intrinsically motivating instructional approach which (a) presents learning materials in a meaningful game-like context, (b) personalizes elements of the learning materials into themes of high interest value, and (c) offers choices so patients can increase their control over the learning process. We directly compared one learning method that incorporated the motivational paradigm into an arithmetic learning program against another method that carefully manipulated out the motivational variables in the same learning program. Fifty-seven subjects with schizophrenia or schizoaffective disorder were randomly assigned to one of the two learning programs for 10 thirty-minute sessions while an intent-to-treat convenience subsample (n=15) was used to account for practice effect. Outcome measures were arithmetic learning, attention, motivation, self competency, and symptom severity. Results showed the motivational group (a) acquired more arithmetic skill, (b) possessed greater intrinsic motivation for the task, (c) reported greater feelings of self competency post-treatment, and (d) demonstrated better post-test attention. Interestingly, baseline perception of self competency was a significant predictor of post-test arithmetic scores. Results demonstrated that incorporating intrinsically motivating instructional techniques into a difficult cognitive task promoted greater learning of the material, higher levels of intrinsic motivation to attempt the demanding task, and greater feelings of self efficacy and achievement to learn. Copyright (c) 2009 Elsevier B.V. All rights reserved.

Uncovering precision phenotype-biomarker associations in traumatic brain injury using topological data analysis

PubMed Central

Nielson, Jessica L.; Cooper, Shelly R.; Sorani, Marco D.; Inoue, Tomoo; Yuh, Esther L.; Mukherjee, Pratik; Petrossian, Tanya C.; Lum, Pek Y.; Lingsma, Hester F.; Gordon, Wayne A.; Okonkwo, David O.; Manley, Geoffrey T.

2017-01-01

Background Traumatic brain injury (TBI) is a complex disorder that is traditionally stratified based on clinical signs and symptoms. Recent imaging and molecular biomarker innovations provide unprecedented opportunities for improved TBI precision medicine, incorporating patho-anatomical and molecular mechanisms. Complete integration of these diverse data for TBI diagnosis and patient stratification remains an unmet challenge. Methods and findings The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot multicenter study enrolled 586 acute TBI patients and collected diverse common data elements (TBI-CDEs) across the study population, including imaging, genetics, and clinical outcomes. We then applied topology-based data-driven discovery to identify natural subgroups of patients, based on the TBI-CDEs collected. Our hypothesis was two-fold: 1) A machine learning tool known as topological data analysis (TDA) would reveal data-driven patterns in patient outcomes to identify candidate biomarkers of recovery, and 2) TDA-identified biomarkers would significantly predict patient outcome recovery after TBI using more traditional methods of univariate statistical tests. TDA algorithms organized and mapped the data of TBI patients in multidimensional space, identifying a subset of mild TBI patients with a specific multivariate phenotype associated with unfavorable outcome at 3 and 6 months after injury. Further analyses revealed that this patient subset had high rates of post-traumatic stress disorder (PTSD), and enrichment in several distinct genetic polymorphisms associated with cellular responses to stress and DNA damage (PARP1), and in striatal dopamine processing (ANKK1, COMT, DRD2). Conclusions TDA identified a unique diagnostic subgroup of patients with unfavorable outcome after mild TBI that were significantly predicted by the presence of specific genetic polymorphisms. Machine learning methods such as TDA may provide a robust method for patient stratification and treatment planning targeting identified biomarkers in future clinical trials in TBI patients. Trial Registration ClinicalTrials.gov Identifier NCT01565551 PMID:28257413

Using a kinesthetic learning strategy to engage nursing student thinking, enhance retention, and improve critical thinking.

PubMed

Wagner, Elissa A

2014-06-01

This article reports the outcomes of a kinesthetic learning strategy used during a cardiac lecture to engage students and to improve the use of classroom-acquired knowledge in today's challenging clinical settings. Nurse educators are constantly faced with finding new ways to engage students, stimulate critical thinking, and improve clinical application in a rapidly changing and complex health care system. Educators who deviate from the traditional pedagogy of didactic, content-driven teaching to a concept-based, student-centered approach using active and kinesthetic learning activities can enhance engagement and improve clinical problem solving, communication skills, and critical thinking to provide graduates with the tools necessary to be successful. The goals of this learning activity were to decrease the well-known classroom-clinical gap by enhancing engagement, providing deeper understanding of cardiac function and disorders, enhancing critical thinking, and improving clinical application. Copyright 2014, SLACK Incorporated.

CACNA1C gene regulates behavioral strategies in operant rule learning

PubMed Central

Berger, Stefan; Bartsch, Dusan; Gass, Peter

2017-01-01

Behavioral experiments are usually designed to tap into a specific cognitive function, but animals may solve a given task through a variety of different and individual behavioral strategies, some of them not foreseen by the experimenter. Animal learning may therefore be seen more as the process of selecting among, and adapting, potential behavioral policies, rather than mere strengthening of associative links. Calcium influx through high-voltage-gated Ca2+ channels is central to synaptic plasticity, and altered expression of Cav1.2 channels and the CACNA1C gene have been associated with severe learning deficits and psychiatric disorders. Given this, we were interested in how specifically a selective functional ablation of the Cacna1c gene would modulate the learning process. Using a detailed, individual-level analysis of learning on an operant cue discrimination task in terms of behavioral strategies, combined with Bayesian selection among computational models estimated from the empirical data, we show that a Cacna1c knockout does not impair learning in general but has a much more specific effect: the majority of Cacna1c knockout mice still managed to increase reward feedback across trials but did so by adapting an outcome-based strategy, while the majority of matched controls adopted the experimentally intended cue-association rule. Our results thus point to a quite specific role of a single gene in learning and highlight that much more mechanistic insight could be gained by examining response patterns in terms of a larger repertoire of potential behavioral strategies. The results may also have clinical implications for treating psychiatric disorders. PMID:28604818

CACNA1C gene regulates behavioral strategies in operant rule learning.

PubMed

Koppe, Georgia; Mallien, Anne Stephanie; Berger, Stefan; Bartsch, Dusan; Gass, Peter; Vollmayr, Barbara; Durstewitz, Daniel

2017-06-01

Behavioral experiments are usually designed to tap into a specific cognitive function, but animals may solve a given task through a variety of different and individual behavioral strategies, some of them not foreseen by the experimenter. Animal learning may therefore be seen more as the process of selecting among, and adapting, potential behavioral policies, rather than mere strengthening of associative links. Calcium influx through high-voltage-gated Ca2+ channels is central to synaptic plasticity, and altered expression of Cav1.2 channels and the CACNA1C gene have been associated with severe learning deficits and psychiatric disorders. Given this, we were interested in how specifically a selective functional ablation of the Cacna1c gene would modulate the learning process. Using a detailed, individual-level analysis of learning on an operant cue discrimination task in terms of behavioral strategies, combined with Bayesian selection among computational models estimated from the empirical data, we show that a Cacna1c knockout does not impair learning in general but has a much more specific effect: the majority of Cacna1c knockout mice still managed to increase reward feedback across trials but did so by adapting an outcome-based strategy, while the majority of matched controls adopted the experimentally intended cue-association rule. Our results thus point to a quite specific role of a single gene in learning and highlight that much more mechanistic insight could be gained by examining response patterns in terms of a larger repertoire of potential behavioral strategies. The results may also have clinical implications for treating psychiatric disorders.

Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder.

PubMed

Nitzburg, George C; Cuesta-Diaz, Armando; Ospina, Luz H; Russo, Manuela; Shanahan, Megan; Perez-Rodriguez, Mercedes; Larsen, Emmett; Mulaimovic, Sandra; Burdick, Katherine E

2017-04-01

Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or "chunking" techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358-366).

Updates on attention-deficit/hyperactivity disorder and learning disorders.

PubMed

Semrud-Clikeman, Margaret; Bledsoe, Jesse

2011-10-01

The relationship of attention-deficit/hyperactivity disorder (ADHD) to learning disorders was reviewed and included reading disability, mathematics learning disability, and nonverbal learning disability. Genetic, neuroimaging, and neuropsychological functioning were examined for each disorder, along with a discussion of any existing literature when ADHD co-occurred with the disorder. All the disorders were found to frequently co-occur with ADHD. A review of the underlying neuroanatomic and neurofunctional data found specific structures that frequently co-occur in these disorders with others that are specific to the individual diagnosis. Aberrations in structure and/or function were found for the caudate, corpus callosum, and cerebellum, making these structures sensitive for the disorder but not specific. Suggestions for future research, particularly in relation to intervention, are provided.

Pioneering the psychiatric nurse role in foster care.

PubMed

Bertram, Julie E; Narendorf, Sarah Carter; McMillen, J Curtis

2013-12-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. © 2013.

Pioneering the Psychiatric Nurse Role in Foster Care (*)

PubMed Central

Bertram, Julie E.; Narendorf, Sarah Carter; McMillen, J. Curtis

2013-01-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse’s work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. PMID:24238008

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial.

PubMed

ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; DeJong, Cor A J

2013-11-16

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. The protocol for this study is registered with the Netherlands Trial Registry NTR2415.

Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Methods/design This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. Discussion This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. Trial registration The protocol for this study is registered with the Netherlands Trial Registry NTR2415. PMID:24238630

Procedural learning in Parkinson's disease, specific language impairment, dyslexia, schizophrenia, developmental coordination disorder, and autism spectrum disorders: A second-order meta-analysis.

PubMed

Clark, Gillian M; Lum, Jarrad A G

2017-10-01

The serial reaction time task (SRTT) has been used to study procedural learning in clinical populations. In this report, second-order meta-analysis was used to investigate whether disorder type moderates performance on the SRTT. Using this approach to quantitatively summarise past research, it was tested whether autism spectrum disorder, developmental coordination disorder, dyslexia, Parkinson's disease, schizophrenia, and specific language impairment differentially affect procedural learning on the SRTT. The main analysis revealed disorder type moderated SRTT performance (p=0.010). This report demonstrates comparable levels of procedural learning impairment in developmental coordination disorder, dyslexia, Parkinson's disease, schizophrenia, and specific language impairment. However, in autism, procedural learning is spared. Copyright © 2017 Elsevier Inc. All rights reserved.

Stress attenuates the flexible updating of aversive value

PubMed Central

Raio, Candace M.; Hartley, Catherine A.; Orederu, Temidayo A.; Li, Jian; Phelps, Elizabeth A.

2017-01-01

In a dynamic environment, sources of threat or safety can unexpectedly change, requiring the flexible updating of stimulus−outcome associations that promote adaptive behavior. However, aversive contexts in which we are required to update predictions of threat are often marked by stress. Acute stress is thought to reduce behavioral flexibility, yet its influence on the modulation of aversive value has not been well characterized. Given that stress exposure is a prominent risk factor for anxiety and trauma-related disorders marked by persistent, inflexible responses to threat, here we examined how acute stress affects the flexible updating of threat responses. Participants completed an aversive learning task, in which one stimulus was probabilistically associated with an electric shock, while the other stimulus signaled safety. A day later, participants underwent an acute stress or control manipulation before completing a reversal learning task during which the original stimulus−outcome contingencies switched. Skin conductance and neuroendocrine responses provided indices of sympathetic arousal and stress responses, respectively. Despite equivalent initial learning, stressed participants showed marked impairments in reversal learning relative to controls. Additionally, reversal learning deficits across participants were related to heightened levels of alpha-amylase, a marker of noradrenergic activity. Finally, fitting arousal data to a computational reinforcement learning model revealed that stress-induced reversal learning deficits emerged from stress-specific changes in the weight assigned to prediction error signals, disrupting the adaptive adjustment of learning rates. Our findings provide insight into how stress renders individuals less sensitive to changes in aversive reinforcement and have implications for understanding clinical conditions marked by stress-related psychopathology. PMID:28973957

Cognitive Training and Work Therapy for the Treatment of Verbal Learning and Memory Deficits in Veterans With Alcohol Use Disorders.

PubMed

Bell, Morris D; Vissicchio, Nicholas A; Weinstein, Andrea J

2016-01-01

This study focused on the efficacy of cognitive training for verbal learning and memory deficits in a population of older veterans with alcohol use disorders. Veterans with alcohol use disorders, who were in outpatient treatment at VA facilities and in early-phase recovery (N = 31), were randomized to receive a three-month trial of daily cognitive training plus work therapy (n = 15) or work therapy alone (n = 16), along with treatment as usual. Participants completed assessments at baseline and at three- and six-month follow-ups; the Hopkins Verbal Learning Task (HVLT) was the primary outcome measure. Participants were primarily male (97%) and in their mid-50s (M = 55.16, SD = 5.16) and had been sober for 1.64 (SD = 2.81) months. Study retention was excellent (91% at three-month follow-up) and adherence to treatment in both conditions was very good. On average, participants in the cognitive training condition had more than 41 hours of cognitive training, and both conditions had more than 230 hours of productive activity. HVLT results at three-month follow-up revealed significant condition effects favoring cognitive training for verbal learning (HVLT Trial-3 T-score, p < .005, Cohen's d = 1.3) and verbal memory (HVLT Total T-score, p < .01, Cohen's d = 1.1). Condition effects were sustained at six-month follow-up. At baseline, 55.9% of participants showed a significant deficit in verbal memory and 58.8% showed a deficit in verbal learning compared with a premorbid estimate of verbal IQ. At three-month follow-up there was a significant reduction in the number of participants in the cognitive training condition with clinically significant verbal memory deficits (p < .01, number needed to treat = 3.0) compared with the work therapy alone condition and a trend toward significance for verbal learning deficits, which was not sustained at six-month follow-up. This National Institute on Drug Abuse-funded pilot study demonstrates that cognitive training within the context of another activating intervention (work therapy) may have efficacy in remediating verbal learning and memory deficits in patients with alcohol use disorder. Findings indicate a large effect for cognitive training in this pilot study, which suggests that further research is warranted. This study is registered on ClinicalTrials.gov (NCT 01410110).

iSocial: delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D virtual learning environment for youth with high functioning autism.

PubMed

Stichter, Janine P; Laffey, James; Galyen, Krista; Herzog, Melissa

2014-02-01

One consistent area of need for students with autism spectrum disorders is in the area of social competence. However, the increasing need to provide qualified teachers to deliver evidence-based practices in areas like social competence leave schools, such as those found in rural areas, in need of support. Distance education and in particular, 3D Virtual Learning, holds great promise for supporting schools and youth to gain social competence through knowledge and social practice in context. iSocial, a distance education, 3D virtual learning environment implemented the 31-lesson social competence intervention for adolescents across three small cohorts totaling 11 students over a period of 4 months. Results demonstrated that the social competence curriculum was delivered with fidelity in the 3D virtual learning environment. Moreover, learning outcomes suggest that the iSocial approach shows promise for social competence benefits for youth.

Effects of outcome on the covariance between risk level and brain activity in adolescents with internet gaming disorder.

PubMed

Qi, Xin; Yang, Yongxin; Dai, Shouping; Gao, Peihong; Du, Xin; Zhang, Yang; Du, Guijin; Li, Xiaodong; Zhang, Quan

2016-01-01

Individuals with internet gaming disorder (IGD) often have impaired risky decision-making abilities, and IGD-related functional changes have been observed during neuroimaging studies of decision-making tasks. However, it is still unclear how feedback (outcomes of decision-making) affects the subsequent risky decision-making in individuals with IGD. In this study, twenty-four adolescents with IGD and 24 healthy controls (HCs) were recruited and underwent functional magnetic resonance imaging while performing the balloon analog risk task (BART) to evaluate the effects of prior outcomes on brain activity during subsequent risky decision-making in adolescents with IGD. The covariance between risk level and activation of the bilateral ventral medial prefrontal cortex, left inferior frontal cortex, right ventral striatum (VS), left hippocampus/parahippocampus, right inferior occipital gyrus/fusiform gyrus and right inferior temporal gyrus demonstrated interaction effects of group by outcome ( P  < 0.05, AlphaSim correction). The regions with interactive effects were defined as ROI, and ROI-based intergroup comparisons showed that the covariance between risk level and brain activation was significantly greater in adolescents with IGD compared with HCs after a negative outcome occurred ( P  < 0.05). Our results indicated that negative outcomes affected the covariance between risk level and activation of the brain regions related to value estimation (prefrontal cortex), anticipation of rewards (VS), and emotional-related learning (hippocampus/parahippocampus), which may be one of the underlying neural mechanisms of disadvantageous risky decision-making in adolescents with IGD.

The Enigmatic Persistence of Anorexia Nervosa

PubMed Central

Walsh, B. Timothy

2014-01-01

Objective In this review, based on recent advances in cognitive neuroscience, the author presents a formulation in which the marked persistence of anorexia nervosa can be usefully understood as a well-ingrained maladaptive habit. Method The author reviewed the relevant literature on the development and course of anorexia nervosa and interpreted critical features in light of developments in cognitive neuroscience. Results Anorexia nervosa is a well characterized disorder with remarkable persistence both across history and among affected individuals. Food restriction, the salient behavioral feature of the disorder, often begins innocently but gradually takes on a life of its own. Over time, it becomes highly entrenched and resistant to change through either psychological or pharmacological treatment. Cognitive neuroscience has described two related but distinct processes that underlie the acquisition of new patterns of behavior, namely, action-outcome and stimulus-response learning. It is likely that both processes are engaged in the development of anorexia nervosa and that stimulus-response learning (that is, habit formation) is critical to the persistence of the dieting behavior. Conclusions The formulation of the dieting behavior characteristic of anorexia nervosa as a well-entrenched habit provides a basis for understanding the striking persistence of this disorder. This model helps explain the resistance of anorexia nervosa to interventions that have established efficacy in related disorders and implies that addressing the dieting behavior is critical, especially early in the course of the illness, before it has become ingrained. PMID:23429750

Concurrent validity of the differential ability scales, second edition with the Mullen Scales of Early Learning in young children with and without neurodevelopmental disorders.

PubMed

Farmer, Cristan; Golden, Christine; Thurm, Audrey

2016-01-01

Estimates of intelligence in young children with neurodevelopmental disorders are critical for making diagnoses, in characterizing symptoms of disorders, and in predicting future outcomes. The limitations of standardized testing for children with developmental delay or cognitive impairment are well known: Tests do not exist that provide developmentally appropriate material along with norms that extend to the lower reaches of ability. Two commonly used and interchanged instruments are the Mullen Scales of Early Learning (MSEL), a test of developmental level, and the Differential Ability Scales, second edition (DAS-II), a more traditional cognitive test. We evaluated the correspondence of contemporaneous MSEL and the DAS-II scores in a mixed sample of children aged 2-10 years with autism spectrum disorder (ASD), non-ASD developmental delays, and typically developing children across the full spectrum of cognitive ability. Consistent with published data on the original DAS and the MSEL, scores on the DAS-II and MSEL were highly correlated. However, curve estimation revealed large mean differences that varied as a function of the child's cognitive ability level. We conclude that interchanging MSEL and DAS-II scores without regard to the discrepancy in scores may produce misleading results in both cross-sectional and longitudinal studies of children with and without ASD, and, thus, this practice should be implemented with caution.

Statistical word learning in children with autism spectrum disorder and specific language impairment.

PubMed

Haebig, Eileen; Saffran, Jenny R; Ellis Weismer, Susan

2017-11-01

Word learning is an important component of language development that influences child outcomes across multiple domains. Despite the importance of word knowledge, word-learning mechanisms are poorly understood in children with specific language impairment (SLI) and children with autism spectrum disorder (ASD). This study examined underlying mechanisms of word learning, specifically, statistical learning and fast-mapping, in school-aged children with typical and atypical development. Statistical learning was assessed through a word segmentation task and fast-mapping was examined in an object-label association task. We also examined children's ability to map meaning onto newly segmented words in a third task that combined exposure to an artificial language and a fast-mapping task. Children with SLI had poorer performance on the word segmentation and fast-mapping tasks relative to the typically developing and ASD groups, who did not differ from one another. However, when children with SLI were exposed to an artificial language with phonemes used in the subsequent fast-mapping task, they successfully learned more words than in the isolated fast-mapping task. There was some evidence that word segmentation abilities are associated with word learning in school-aged children with typical development and ASD, but not SLI. Follow-up analyses also examined performance in children with ASD who did and did not have a language impairment. Children with ASD with language impairment evidenced intact statistical learning abilities, but subtle weaknesses in fast-mapping abilities. As the Procedural Deficit Hypothesis (PDH) predicts, children with SLI have impairments in statistical learning. However, children with SLI also have impairments in fast-mapping. Nonetheless, they are able to take advantage of additional phonological exposure to boost subsequent word-learning performance. In contrast to the PDH, children with ASD appear to have intact statistical learning, regardless of language status; however, fast-mapping abilities differ according to broader language skills. © 2017 Association for Child and Adolescent Mental Health.

Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders.

PubMed

Pelletier, René; Higgins, Johanne; Bourbonnais, Daniel

2015-11-01

Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across distributed areas of the nervous system may help to improve outcomes in patients with chronic musculoskeletal disorders. © 2015 American Physical Therapy Association.

A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder

PubMed Central

Scott, J. Cobb; Matt, Georg E.; Wrocklage, Kristen M.; Crnich, Cassandra; Jordan, Jessica; Southwick, Steven M.; Krystal, John H.; Schweinsburg, Brian C.

2014-01-01

Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect size estimates were calculated using a mixed-effects meta-analysis for nine cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d =−.62), speed of information processing (d =−.59), attention/working memory (d =−.50), and verbal memory (d =−.46). Effect size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature. PMID:25365762

Presynaptic D2 dopamine receptors control long-term depression expression and memory processes in the temporal hippocampus.

PubMed

Rocchetti, Jill; Isingrini, Elsa; Dal Bo, Gregory; Sagheby, Sara; Menegaux, Aurore; Tronche, François; Levesque, Daniel; Moquin, Luc; Gratton, Alain; Wong, Tak Pan; Rubinstein, Marcelo; Giros, Bruno

2015-03-15

Dysfunctional mesocorticolimbic dopamine signaling has been linked to alterations in motor and reward-based functions associated with psychiatric disorders. Converging evidence from patients with psychiatric disorders and use of antipsychotics suggests that imbalance of dopamine signaling deeply alters hippocampal functions. However, given the lack of full characterization of a functional mesohippocampal pathway, the precise role of dopamine transmission in memory deficits associated with these disorders and their dedicated therapies is unknown. In particular, the positive outcome of antipsychotic treatments, commonly antagonizing D2 dopamine receptors (D2Rs), on cognitive deficits and memory impairments remains questionable. Following pharmacologic and genetic manipulation of dopamine transmission, we performed anatomic, neurochemical, electrophysiologic, and behavioral investigations to uncover the role of D2Rs in hippocampal-dependent plasticity and learning. Naïve mice (n = 4-21) were used in the different procedures. Dopamine modulated both long-term potentiation and long-term depression in the temporal hippocampus as well as spatial and recognition learning and memory in mice through D2Rs. Although genetic deletion or pharmacologic blockade of D2Rs led to the loss of long-term potentiation expression, the specific genetic removal of presynaptic D2Rs impaired long-term depression and performances on spatial memory tasks. Presynaptic D2Rs in dopamine fibers of the temporal hippocampus tightly modulate long-term depression expression and play a major role in the regulation of hippocampal learning and memory. This direct role of mesohippocampal dopamine input as uncovered here adds a new dimension to dopamine involvement in the physiology underlying deficits associated with neuropsychiatric disorders. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Use of a machine learning framework to predict substance use disorder treatment success

PubMed Central

Kelmansky, Diana; van der Laan, Mark; Sahker, Ethan; Jones, DeShauna; Arndt, Stephan

2017-01-01

There are several methods for building prediction models. The wealth of currently available modeling techniques usually forces the researcher to judge, a priori, what will likely be the best method. Super learning (SL) is a methodology that facilitates this decision by combining all identified prediction algorithms pertinent for a particular prediction problem. SL generates a final model that is at least as good as any of the other models considered for predicting the outcome. The overarching aim of this work is to introduce SL to analysts and practitioners. This work compares the performance of logistic regression, penalized regression, random forests, deep learning neural networks, and SL to predict successful substance use disorders (SUD) treatment. A nationwide database including 99,013 SUD treatment patients was used. All algorithms were evaluated using the area under the receiver operating characteristic curve (AUC) in a test sample that was not included in the training sample used to fit the prediction models. AUC for the models ranged between 0.793 and 0.820. SL was superior to all but one of the algorithms compared. An explanation of SL steps is provided. SL is the first step in targeted learning, an analytic framework that yields double robust effect estimation and inference with fewer assumptions than the usual parametric methods. Different aspects of SL depending on the context, its function within the targeted learning framework, and the benefits of this methodology in the addiction field are discussed. PMID:28394905

Use of a machine learning framework to predict substance use disorder treatment success.

PubMed

Acion, Laura; Kelmansky, Diana; van der Laan, Mark; Sahker, Ethan; Jones, DeShauna; Arndt, Stephan

2017-01-01

There are several methods for building prediction models. The wealth of currently available modeling techniques usually forces the researcher to judge, a priori, what will likely be the best method. Super learning (SL) is a methodology that facilitates this decision by combining all identified prediction algorithms pertinent for a particular prediction problem. SL generates a final model that is at least as good as any of the other models considered for predicting the outcome. The overarching aim of this work is to introduce SL to analysts and practitioners. This work compares the performance of logistic regression, penalized regression, random forests, deep learning neural networks, and SL to predict successful substance use disorders (SUD) treatment. A nationwide database including 99,013 SUD treatment patients was used. All algorithms were evaluated using the area under the receiver operating characteristic curve (AUC) in a test sample that was not included in the training sample used to fit the prediction models. AUC for the models ranged between 0.793 and 0.820. SL was superior to all but one of the algorithms compared. An explanation of SL steps is provided. SL is the first step in targeted learning, an analytic framework that yields double robust effect estimation and inference with fewer assumptions than the usual parametric methods. Different aspects of SL depending on the context, its function within the targeted learning framework, and the benefits of this methodology in the addiction field are discussed.

Multivariate Analysis and Machine Learning in Cerebral Palsy Research

PubMed Central

Zhang, Jing

2017-01-01

Cerebral palsy (CP), a common pediatric movement disorder, causes the most severe physical disability in children. Early diagnosis in high-risk infants is critical for early intervention and possible early recovery. In recent years, multivariate analytic and machine learning (ML) approaches have been increasingly used in CP research. This paper aims to identify such multivariate studies and provide an overview of this relatively young field. Studies reviewed in this paper have demonstrated that multivariate analytic methods are useful in identification of risk factors, detection of CP, movement assessment for CP prediction, and outcome assessment, and ML approaches have made it possible to automatically identify movement impairments in high-risk infants. In addition, outcome predictors for surgical treatments have been identified by multivariate outcome studies. To make the multivariate and ML approaches useful in clinical settings, further research with large samples is needed to verify and improve these multivariate methods in risk factor identification, CP detection, movement assessment, and outcome evaluation or prediction. As multivariate analysis, ML and data processing technologies advance in the era of Big Data of this century, it is expected that multivariate analysis and ML will play a bigger role in improving the diagnosis and treatment of CP to reduce mortality and morbidity rates, and enhance patient care for children with CP. PMID:29312134

Multivariate Analysis and Machine Learning in Cerebral Palsy Research.

PubMed

Zhang, Jing

2017-01-01

Cerebral palsy (CP), a common pediatric movement disorder, causes the most severe physical disability in children. Early diagnosis in high-risk infants is critical for early intervention and possible early recovery. In recent years, multivariate analytic and machine learning (ML) approaches have been increasingly used in CP research. This paper aims to identify such multivariate studies and provide an overview of this relatively young field. Studies reviewed in this paper have demonstrated that multivariate analytic methods are useful in identification of risk factors, detection of CP, movement assessment for CP prediction, and outcome assessment, and ML approaches have made it possible to automatically identify movement impairments in high-risk infants. In addition, outcome predictors for surgical treatments have been identified by multivariate outcome studies. To make the multivariate and ML approaches useful in clinical settings, further research with large samples is needed to verify and improve these multivariate methods in risk factor identification, CP detection, movement assessment, and outcome evaluation or prediction. As multivariate analysis, ML and data processing technologies advance in the era of Big Data of this century, it is expected that multivariate analysis and ML will play a bigger role in improving the diagnosis and treatment of CP to reduce mortality and morbidity rates, and enhance patient care for children with CP.

Transition from early intervention program to primary school in children with autism spectrum disorder

PubMed Central

Eapen, Valsamma; Grove, Rachel; Aylward, Elizabeth; Joosten, Annette V; Miller, Scott I; Van Der Watt, Gerdamari; Fordyce, Kathryn; Dissanayake, Cheryl; Maya, Jacqueline; Tucker, Madonna; DeBlasio, Antonia

2017-01-01

AIM To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism. METHODS Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child’s school adjustment. The relationship between child characteristics and school outcomes was evaluated. RESULTS Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement. CONCLUSION Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential. PMID:29259892

Transition from early intervention program to primary school in children with autism spectrum disorder.

PubMed

Eapen, Valsamma; Grove, Rachel; Aylward, Elizabeth; Joosten, Annette V; Miller, Scott I; Van Der Watt, Gerdamari; Fordyce, Kathryn; Dissanayake, Cheryl; Maya, Jacqueline; Tucker, Madonna; DeBlasio, Antonia

2017-11-08

To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism. Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child's school adjustment. The relationship between child characteristics and school outcomes was evaluated. Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement. Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential.

GWAS-based machine learning approach to predict duloxetine response in major depressive disorder.

PubMed

Maciukiewicz, Malgorzata; Marshe, Victoria S; Hauschild, Anne-Christin; Foster, Jane A; Rotzinger, Susan; Kennedy, James L; Kennedy, Sidney H; Müller, Daniel J; Geraci, Joseph

2018-04-01

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders and is commonly treated with antidepressant drugs. However, large variability is observed in terms of response to antidepressants. Machine learning (ML) models may be useful to predict treatment outcomes. A sample of 186 MDD patients received treatment with duloxetine for up to 8 weeks were categorized as "responders" based on a MADRS change >50% from baseline; or "remitters" based on a MADRS score ≤10 at end point. The initial dataset (N = 186) was randomly divided into training and test sets in a nested 5-fold cross-validation, where 80% was used as a training set and 20% made up five independent test sets. We performed genome-wide logistic regression to identify potentially significant variants related to duloxetine response/remission and extracted the most promising predictors using LASSO regression. Subsequently, classification-regression trees (CRT) and support vector machines (SVM) were applied to construct models, using ten-fold cross-validation. With regards to response, none of the pairs performed significantly better than chance (accuracy p > .1). For remission, SVM achieved moderate performance with an accuracy = 0.52, a sensitivity = 0.58, and a specificity = 0.46, and 0.51 for all coefficients for CRT. The best performing SVM fold was characterized by an accuracy = 0.66 (p = .071), sensitivity = 0.70 and a sensitivity = 0.61. In this study, the potential of using GWAS data to predict duloxetine outcomes was examined using ML models. The models were characterized by a promising sensitivity, but specificity remained moderate at best. The inclusion of additional non-genetic variables to create integrated models may improve prediction. Copyright © 2017. Published by Elsevier Ltd.

Factors Associated with HIV Testing Among Participants from Substance Use Disorder Treatment Programs in the US: A Machine Learning Approach.

PubMed

Pan, Yue; Liu, Hongmei; Metsch, Lisa R; Feaster, Daniel J

2017-02-01

HIV testing is the foundation for consolidated HIV treatment and prevention. In this study, we aim to discover the most relevant variables for predicting HIV testing uptake among substance users in substance use disorder treatment programs by applying random forest (RF), a robust multivariate statistical learning method. We also provide a descriptive introduction to this method for those who are unfamiliar with it. We used data from the National Institute on Drug Abuse Clinical Trials Network HIV testing and counseling study (CTN-0032). A total of 1281 HIV-negative or status unknown participants from 12 US community-based substance use disorder treatment programs were included and were randomized into three HIV testing and counseling treatment groups. The a priori primary outcome was self-reported receipt of HIV test results. Classification accuracy of RF was compared to logistic regression, a standard statistical approach for binary outcomes. Variable importance measures for the RF model were used to select the most relevant variables. RF based models produced much higher classification accuracy than those based on logistic regression. Treatment group is the most important predictor among all covariates, with a variable importance index of 12.9%. RF variable importance revealed that several types of condomless sex behaviors, condom use self-efficacy and attitudes towards condom use, and level of depression are the most important predictors of receipt of HIV testing results. There is a non-linear negative relationship between count of condomless sex acts and the receipt of HIV testing. In conclusion, RF seems promising in discovering important factors related to HIV testing uptake among large numbers of predictors and should be encouraged in future HIV prevention and treatment research and intervention program evaluations.

Prologue: Toward Accurate Identification of Developmental Language Disorder Within Linguistically Diverse Schools.

PubMed

Oetting, Janna B

2018-04-05

Although the 5 studies presented within this clinical forum include children who differ widely in locality, language learning profile, and age, all were motivated by a desire to improve the accuracy at which developmental language disorder is identified within linguistically diverse schools. The purpose of this prologue is to introduce the readers to a conceptual framework that unites the studies while also highlighting the approaches and methods each research team is pursuing to improve assessment outcomes within their respective linguistically diverse community. A disorder within diversity framework is presented to replace previous difference vs. disorder approaches. Then, the 5 studies within the forum are reviewed by clinical question, type of tool(s), and analytical approach. Across studies of different linguistically diverse groups, research teams are seeking answers to similar questions about child language screening and diagnostic practices, using similar analytical approaches to answer their questions, and finding promising results with tools focused on morphosyntax. More studies that are modeled after or designed to extend those in this forum are needed to improve the accuracy at which developmental language disorder is identified.

Personality disorder and treatment outcome in alcohol use disorder.

PubMed

Newton-Howes, Giles; Foulds, James

2018-01-01

As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

Effectiveness of team-based learning methodology in teaching transfusion medicine to medical undergraduates in third semester: A comparative study.

PubMed

Doshi, Neena Piyush

2017-01-01

Team-based learning (TBL) combines small and large group learning by incorporating multiple small groups in a large group setting. It is a teacher-directed method that encourages student-student interaction. This study compares student learning and teaching satisfaction between conventional lecture and TBL in the subject of pathology. The present study is aimed to assess the effectiveness of TBL method of teaching over the conventional lecture. The present study was conducted in the Department of Pathology, GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat. The study population comprised 126 students of second-year MBBS, in their third semester of the academic year 2015-2016. "Hemodynamic disorders" were taught by conventional method and "transfusion medicine" by TBL method. Effectiveness of both the methods was assessed. A posttest multiple choice question was conducted at the end of "hemodynamic disorders." Assessment of TBL was based on individual score, team score, and each member's contribution to the success of the team. The individual score and overall score were compared with the posttest score on "hemodynamic disorders." A feedback was taken from the students regarding their experience with TBL. Tukey's multiple comparisons test and ANOVA summary were used to find the significance of scores between didactic and TBL methods. Student feedback was taken using "Student Satisfaction Scale" based on Likert scoring method. The mean of student scores by didactic, Individual Readiness Assurance Test (score "A"), and overall (score "D") was 49.8% (standard deviation [SD]-14.8), 65.6% (SD-10.9), and 65.6% (SD-13.8), respectively. The study showed positive educational outcome in terms of knowledge acquisition, participation and engagement, and team performance with TBL.

Shared and Disorder-Specific Neurocomputational Mechanisms of Decision-Making in Autism Spectrum Disorder and Obsessive-Compulsive Disorder.

PubMed

Carlisi, Christina O; Norman, Luke; Murphy, Clodagh M; Christakou, Anastasia; Chantiluke, Kaylita; Giampietro, Vincent; Simmons, Andrew; Brammer, Michael; Murphy, Declan G; Mataix-Cols, David; Rubia, Katya

2017-12-01

Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) often share phenotypes of repetitive behaviors, possibly underpinned by abnormal decision-making. To compare neural correlates underlying decision-making between these disorders, brain activation of boys with ASD (N = 24), OCD (N = 20) and typically developing controls (N = 20) during gambling was compared, and computational modeling compared performance. Patients were unimpaired on number of risky decisions, but modeling showed that both patient groups had lower choice consistency and relied less on reinforcement learning compared to controls. ASD individuals had disorder-specific choice perseverance abnormalities compared to OCD individuals. Neurofunctionally, ASD and OCD boys shared dorsolateral/inferior frontal underactivation compared to controls during decision-making. During outcome anticipation, patients shared underactivation compared to controls in lateral inferior/orbitofrontal cortex and ventral striatum. During reward receipt, ASD boys had disorder-specific enhanced activation in inferior frontal/insular regions relative to OCD boys and controls. Results showed that ASD and OCD individuals shared decision-making strategies that differed from controls to achieve comparable performance to controls. Patients showed shared abnormalities in lateral-(orbito)fronto-striatal reward circuitry, but ASD boys had disorder-specific lateral inferior frontal/insular overactivation, suggesting that shared and disorder-specific mechanisms underpin decision-making in these disorders. Findings provide evidence for shared neurobiological substrates that could serve as possible future biomarkers. © The Author 2017. Published by Oxford University Press.

Use of personalized Dynamic Treatment Regimes (DTRs) and Sequential Multiple Assignment Randomized Trials (SMARTs) in mental health studies

PubMed Central

Liu, Ying; ZENG, Donglin; WANG, Yuanjia

2014-01-01

Summary Dynamic treatment regimens (DTRs) are sequential decision rules tailored at each point where a clinical decision is made based on each patient’s time-varying characteristics and intermediate outcomes observed at earlier points in time. The complexity, patient heterogeneity, and chronicity of mental disorders call for learning optimal DTRs to dynamically adapt treatment to an individual’s response over time. The Sequential Multiple Assignment Randomized Trial (SMARTs) design allows for estimating causal effects of DTRs. Modern statistical tools have been developed to optimize DTRs based on personalized variables and intermediate outcomes using rich data collected from SMARTs; these statistical methods can also be used to recommend tailoring variables for designing future SMART studies. This paper introduces DTRs and SMARTs using two examples in mental health studies, discusses two machine learning methods for estimating optimal DTR from SMARTs data, and demonstrates the performance of the statistical methods using simulated data. PMID:25642116

Obsessive–compulsive disorder patients have a reduced sense of control on the illusion of control task

PubMed Central

Gillan, Claire M.; Morein-Zamir, Sharon; Durieux, Alice M. S.; Fineberg, Naomi A.; Sahakian, Barbara J.; Robbins, Trevor W.

2014-01-01

There is disagreement regarding the role of perceived control in obsessive–compulsive disorder (OCD). The present study used a traditional illusion of control paradigm (Alloy and Abramson, 1979) to empirically test control estimation in OCD. Twenty-six OCD patients and 26 matched comparison subjects completed an illusion of control task wherein their goal was to attempt to exert control over a light bulb. The density of reinforcement (high, low) and the valence of trials (gain, loss) were experimentally manipulated within subjects. Unbeknownst to participants, the illumination of the light bulb was predetermined and irrespective of their behavior. OCD patients exhibited lower estimates of control compared with healthy comparison subjects. There were no interactions between group and outcome density or group and valence. We found that OCD patients endorse lower estimates of control than comparison subjects. This finding highlights a potential role for contingency learning in the disorder. PMID:24659974

Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

PubMed Central

Frank, Guido K.W.; Shott, Megan E.

2016-01-01

Anorexia nervosa is a severe psychiatric disorder without approved medication intervention. Every class of psychoactive medication has been tried to improve treatment outcome; however, randomized controlled trials have been ambiguous at best and across studies have not shown robust improvements in weight gain and recovery. Here we review the available literature on pharmacological interventions since anorexia nervosa came to greater public recognition in the 1960s. This will include a critical review of why those trials may not have been successful. We further provide a neurobiological background for the disorder and discuss how cognition, learning and emotion-regulating circuits could become treatment targets in the future. Making every effort to develop effective pharmacological treatment options for anorexia nervosa is imperative, as it continues to be a complex psychiatric disorder with high disease burden and mortality. PMID:27106297

Learning Curve Analyses in Neurodevelopmental Disorders: Are Children with Autism Spectrum Disorder Truly Visual Learners?

ERIC Educational Resources Information Center

Erdodi, Laszlo; Lajiness-O'Neill, Renee; Schmitt, Thomas A.

2013-01-01

Visual and auditory verbal learning using a selective reminding format was studied in a mixed clinical sample of children with autism spectrum disorder (ASD) (n = 42), attention-deficit hyperactivity disorder (n = 83), velocardiofacial syndrome (n = 17) and neurotypicals (n = 38) using the Test of Memory and Learning to (1) more thoroughly…

Neural markers of errors as endophenotypes in neuropsychiatric disorders

PubMed Central

Manoach, Dara S.; Agam, Yigal

2013-01-01

Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a potentially promising approach. PMID:23882201

Neural markers of errors as endophenotypes in neuropsychiatric disorders.

PubMed

Manoach, Dara S; Agam, Yigal

2013-01-01

Learning from errors is fundamental to adaptive human behavior. It requires detecting errors, evaluating what went wrong, and adjusting behavior accordingly. These dynamic adjustments are at the heart of behavioral flexibility and accumulating evidence suggests that deficient error processing contributes to maladaptively rigid and repetitive behavior in a range of neuropsychiatric disorders. Neuroimaging and electrophysiological studies reveal highly reliable neural markers of error processing. In this review, we evaluate the evidence that abnormalities in these neural markers can serve as sensitive endophenotypes of neuropsychiatric disorders. We describe the behavioral and neural hallmarks of error processing, their mediation by common genetic polymorphisms, and impairments in schizophrenia, obsessive-compulsive disorder, and autism spectrum disorders. We conclude that neural markers of errors meet several important criteria as endophenotypes including heritability, established neuroanatomical and neurochemical substrates, association with neuropsychiatric disorders, presence in syndromally-unaffected family members, and evidence of genetic mediation. Understanding the mechanisms of error processing deficits in neuropsychiatric disorders may provide novel neural and behavioral targets for treatment and sensitive surrogate markers of treatment response. Treating error processing deficits may improve functional outcome since error signals provide crucial information for flexible adaptation to changing environments. Given the dearth of effective interventions for cognitive deficits in neuropsychiatric disorders, this represents a potentially promising approach.

Autism and the mirror neuron system: insights from learning and teaching

PubMed Central

Vivanti, Giacomo; Rogers, Sally J.

2014-01-01

Individuals with autism have difficulties in social learning domains which typically involve mirror neuron system (MNS) activation. However, the precise role of the MNS in the development of autism and its relevance to treatment remain unclear. In this paper, we argue that three distinct aspects of social learning are critical for advancing knowledge in this area: (i) the mechanisms that allow for the implicit mapping of and learning from others' behaviour, (ii) the motivation to attend to and model conspecifics and (iii) the flexible and selective use of social learning. These factors are key targets of the Early Start Denver Model, an autism treatment approach which emphasizes social imitation, dyadic engagement, verbal and non-verbal communication and affect sharing. Analysis of the developmental processes and treatment-related changes in these different aspects of social learning in autism can shed light on the nature of the neuropsychological mechanisms underlying social learning and positive treatment outcomes in autism. This knowledge in turn may assist in developing more successful pedagogic approaches to autism spectrum disorder. Thus, intervention research can inform the debate on relations among neuropsychology of social learning, the role of the MNS, and educational practice in autism. PMID:24778379

Autism and the mirror neuron system: insights from learning and teaching.

PubMed

Vivanti, Giacomo; Rogers, Sally J

2014-01-01

Individuals with autism have difficulties in social learning domains which typically involve mirror neuron system (MNS) activation. However, the precise role of the MNS in the development of autism and its relevance to treatment remain unclear. In this paper, we argue that three distinct aspects of social learning are critical for advancing knowledge in this area: (i) the mechanisms that allow for the implicit mapping of and learning from others' behaviour, (ii) the motivation to attend to and model conspecifics and (iii) the flexible and selective use of social learning. These factors are key targets of the Early Start Denver Model, an autism treatment approach which emphasizes social imitation, dyadic engagement, verbal and non-verbal communication and affect sharing. Analysis of the developmental processes and treatment-related changes in these different aspects of social learning in autism can shed light on the nature of the neuropsychological mechanisms underlying social learning and positive treatment outcomes in autism. This knowledge in turn may assist in developing more successful pedagogic approaches to autism spectrum disorder. Thus, intervention research can inform the debate on relations among neuropsychology of social learning, the role of the MNS, and educational practice in autism.

Life course persistent and adolescence limited conduct disorder in a nationally representative US sample: prevalence, predictors, and outcomes.

PubMed

Moore, Ashlee A; Silberg, Judy L; Roberson-Nay, Roxann; Mezuk, Briana

2017-04-01

The course of conduct disorder (CD) is heterogeneous. Moffitt proposed the heuristic of life course persistent (LCP) and adolescence limited (AL) to differentiate etiologically distinct forms of antisocial behavior (AB), each with distinct predictors and consequences, although a few studies have assessed this demarcation within the context of CD. The objective of this study was to apply Moffitt's taxonomy in a nationally representative US sample to investigate the prevalence, predictors, and outcomes of LCP and AL CD. Data come from the Collaborative Psychiatric Epidemiology Studies, a set of population-based nationally representative cross-sectional surveys (N = 20,130). Predictors included harsh discipline, maternal and paternal closeness, poverty in childhood, history of learning disability, parental deviance, and nativity. Outcomes included substance use, employment status, education attainment, marital status, income level, and self-rated mental and physical health. The prevalence of LCP and AL CD was 0.5 and 4.6%, respectively, for females, and 1.9 and 5.1%, respectively, for males. Low childhood SES [Odds Ratio (OR) = 3.49], lack of maternal closeness (OR = 2.50), and history of harsh discipline (OR = 2.17) increased odds of LCP group membership. The LCP group had higher odds of developing substance use disorders (OR = 2.00) relative to AL. LCP CD is more strongly influenced by childhood environment and confers increased odds for substance use problems in adulthood relative to AL CD.

Life course persistent and adolescence limited conduct disorder in a nationally representative US sample: Prevalence, predictors, and outcomes

PubMed Central

Moore, Ashlee A.; Silberg, Judy L.; Roberson-Nay, Roxann; Mezuk, Briana

2017-01-01

Purpose The course of conduct disorder (CD) is heterogeneous. Moffitt proposed the heuristic of life course persistent (LCP) and adolescence limited (AL) to differentiate etiologically distinct forms of antisocial behavior (AB), each with distinct predictors and consequences, although few studies have assessed this demarcation within the context of CD. The objective of this study was to apply Moffitt's taxonomy in a nationally representative U.S. sample to investigate the prevalence, predictors, and outcomes of LCP and AL CD. Methods Data come from the Collaborative Psychiatric Epidemiology Studies, a set of population-based nationally representative cross-sectional surveys (N = 20,130). Predictors included harsh discipline, maternal and paternal closeness, poverty in childhood, history of learning disability, parental deviance, and nativity. Outcomes included substance use, employment status, education attainment, marital status, income level, and self-rated mental and physical health. Results The prevalence of LCP and AL CD was 0.5% and 4.6%, respectively, for females and 1.9% and 5.1%, respectively, for males. Low childhood SES (Odds Ratio [OR] = 3.49), lack of maternal closeness (OR = 2.50), and history of harsh discipline (OR = 2.17) increased odds of LCP group membership. The LCP group had higher odds of developing substance use disorders (OR = 2.00) relative to AL. Conclusions LCP CD is more strongly influenced by childhood environment and confers increased odds for substance use problems in adulthood relative to AL CD. PMID:28180930

Educational and Behavioral Interventions in Management of Autism Spectrum Disorder.

PubMed

Sengupta, Koyeli; Lobo, Leera; Krishnamurthy, Vibha

2017-01-01

The increasing prevalence of autism spectrum disorder (ASD) makes early recognition, evaluation and management an important task for pediatricians, physicians and other professionals caring for children. Educational interventions form the mainstay of management for children with autism spectrum disorder. Such interventions focus on improving social interaction, communication and challenging behaviors, thereby promoting learning and independence in children. This article provides an overview of educational and behavioral interventions in autism spectrum disorder, with special reference to challenges and feasible solutions in the Indian context. Articles were retrieved from various databases including Google Scholar, Medscape, Cochrane, PubMed using the search terms 'autism spectrum disorder OR autism AND educational interventions'; 'autism spectrum disorder OR autism, educational interventions AND India' and 'autism spectrum disorder OR autism AND India'. Reference lists from retrieved articles as well as websites of organizations working in this space in India were also searched. Extracted manuscripts were analysed for content related to various aspects of educational and behavioral interventions in autism spectrum disorder. Intervention models for autism spectrum disorder are based on various theoretical orientations and target specific deficits associated with the disorder. In addition, evidence-based principles for effective intervention are highlighted. In developing countries like India, access to interventions is a challenge and resources are limited. In such settings, the pediatrician's or physician's role is vital in supporting families choose programs that are evidence-based, target individual needs and result in improved outcomes.

Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

PubMed Central

Khdour, Hussain Y.; Abushalbaq, Oday M.; Mughrabi, Ibrahim T.; Imam, Aya F.; Gluck, Mark A.; Herzallah, Mohammad M.; Moustafa, Ahmed A.

2016-01-01

Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits. PMID:27445719

Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation.

PubMed

Khdour, Hussain Y; Abushalbaq, Oday M; Mughrabi, Ibrahim T; Imam, Aya F; Gluck, Mark A; Herzallah, Mohammad M; Moustafa, Ahmed A

2016-01-01

Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits.

Signaling of Noncomprehension in Communication Breakdowns in Fragile X Syndrome, Down Syndrome, and Autism Spectrum Disorder

PubMed Central

Martin, Gary E.; Barstein, Jamie; Hornickel, Jane; Matherly, Sara; Durante, Genna; Losh, Molly

2017-01-01

The ability to indicate a failure to understand a message is a critical pragmatic (social) language skill for managing communication breakdowns and supporting successful communicative exchanges. The current study examined the ability to signal noncomprehension across different types of confusing message conditions in children and adolescents with fragile X syndrome (FXS), Down syndrome (DS), autism spectrum disorder (ASD), and typical development (TD). Controlling for nonverbal mental age and receptive vocabulary skills, youth with comorbid FXS and ASD and those with DS were less likely than TD controls to signal noncomprehension of confusing messages. Youth with FXS without ASD and those with idiopathic ASD did not differ from controls. No sex differences were detected in any group. Findings contribute to current knowledge of pragmatic profiles in different forms of genetically-based neurodevelopmental disorders associated with intellectual disability, and the role of sex in the expression of such profiles. Learning Outcomes Upon completion of this article, readers will have learned about: (1) the social-communicative profiles of youth with FXS, DS, and ASD, (2) the importance of signaling noncomprehension in response to a confusing message, and (3) the similarities and differences in noncomprehension signaling in youth with FXS (with and without ASD), DS, idiopathic ASD, and TD. PMID:28161297

Dysgraphia

MedlinePlus

Written expression disorder; Specific learning disorder with impairment in written expression ... can have dysgraphia only or along with other learning disabilities, such as: Developmental coordination disorder (includes poor handwriting) ...

Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well.

PubMed

Ormel, J; Oerlemans, A M; Raven, D; Laceulle, O M; Hartman, C A; Veenstra, R; Verhulst, F C; Vollebergh, W; Rosmalen, J G M; Reijneveld, S A; Oldehinkel, A J

2017-05-01

Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes. We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use). Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder. To understand current functioning, it is necessary to examine both current and past psychiatric status.

Assistive technology outcomes in post-secondary students with disabilities: the influence of diagnosis, gender, and class-level.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-01

This study investigated how outcomes of assistive technology (AT) services for college students with disabilities are influenced by diagnosis, gender and class-level (e.g., Freshman). Students' pre- and post-intervention ratings of their performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure, COPM) were analyzed, as well as students' responses on a survey about AT service provision, use, and preferences. Data from 455 students revealed "learning disability" to be the most prevalent diagnosis (38%), similar numbers of females and males served, and Freshmen (23.1%) as the largest class-level seeking AT services. For COPM data, each two-way analysis of variance (ANOVA) (grouping variable = diagnosis) revealed that pre-post change scores significantly improved for the entire sample, and that students with a mood disorder experienced the greatest changes compared to other diagnoses. COPM scores significantly and similarly improved for females and males, and across class levels. AT Survey ratings about timeliness of services and independent AT use were significantly lower for students with mobility deficits/pain and neurological damage, respectively. Gender and class-level variables did not significantly impact AT Survey ratings. The study results reveal that features of a college student's diagnosis may influence AT service outcomes, and student-perceptions of AT services ability to use AT. Implications for Rehabilitation College students who are Freshman and/or who have a learning disability are the most prevalent students referred for campus-based assistive technology services. While student ratings of academic task performance significantly increase across diagnostic groupings, these improvements were greatest for those with a mood disorder compared to other diagnostic groups. Service-providers should consider that features of certain diagnoses or disabilities may influence the student?s perception of AT service provision and their ability to use AT. A student's gender and class-level (e.g., Freshman) do not appear to influence the outcomes of AT services for college students with disabilities.

Measuring learning potential in people with schizophrenia: A comparison of two tasks.

PubMed

Rempfer, Melisa V; McDowd, Joan M; Brown, Catana E

2017-12-01

Learning potential measures utilize dynamic assessment methods to capture performance changes following training on a cognitive task. Learning potential has been explored in schizophrenia research as a predictor of functional outcome and there have been calls for psychometric development in this area. Because the majority of learning potential studies have utilized the Wisconsin Card Sorting Test (WCST), we extended this work using a novel measure, the Rey Osterrieth Complex Figure Test (ROCFT). This study had the following aims: 1) to examine relationships among different learning potential indices for two dynamic assessment tasks, 2) to examine the association between WCST and ROCFT learning potential measures, and 3) to address concurrent validity with a performance-based measure of functioning (Test of Grocery Shopping Skills; TOGSS). Eighty-one adults with schizophrenia or schizoaffective disorder completed WCST and ROCFT learning measures and the TOGSS. Results indicated the various learning potential computational indices are intercorrelated and, similar to other studies, we found support for regression residuals and post-test scores as optimal indices. Further, we found modest relationships between the two learning potential measures and the TOGSS. These findings suggest learning potential includes both general and task-specific constructs but future research is needed to further explore this question. Copyright © 2017 Elsevier B.V. All rights reserved.

Cognitive and psychomotor effects of risperidone in schizophrenia and schizoaffective disorder.

PubMed

Houthoofd, Sofie A M K; Morrens, Manuel; Sabbe, Bernard G C

2008-09-01

The aim of this review was to discuss data from double-blind, randomized controlled trials (RCTs) that have investigated the effects of oral and long-acting injectable risperidone on cognitive and psychomotor functioning in patients with schizophrenia or schizoaffective disorder. PubMed/MEDLINE and the Institute of Scientific Information Web of Science database were searched for relevant English-language double-blind RCTs published between March 2000 and July 2008, using the terms schizophrenia, schizoaffective disorder, cognition, risperidone, psychomotor, processing speed, attention, vigilance, working memory, verbal learning, visual learning, reasoning, problem solving, social cognition, MATRICS, and long-acting. Relevant studies included patients with schizophrenia or schizoaffective disorder. Cognitive domains were delineated at the Consensus Conferences of the National Institute of Mental Health-Measurement And Treatment Research to Improve Cognition in Schizophrenia (NIMH-MATRICS). The tests employed to assess each domain and psychomotor functioning, and the within-group and between-group comparisons of risperidone with haloperidol and other atypical antipsychotics, are presented. The results of individual tests were included when they were individually presented and interpretable for either drug; outcomes that were presented as cluster scores or factor structures were excluded. A total of 12 articles were included in this review. Results suggested that the use of oral risperidone appeared to be associated with within-group improvements on the cognitive domains of processing speed, attention/vigilance, verbal and visual learning and memory, and reasoning and problem solving in patients with schizophrenia or schizoaffective disorder. Risperidone and haloperidol seemed to generate similar beneficial effects (on the domains of processing speed, attention/vigilance, [verbal and nonverbal] working memory, and visual learning and memory, as well as psychomotor functioning), although the results for verbal fluency, verbal learning and memory, and reasoning and problem solving were not unanimous, and no comparative data on social cognition were available. Similar cognitive effects were found with risperidone, olanzapine, and quetiapine on the domains of verbal working memory and reasoning and problem solving, as well as verbal fluency. More research is needed on the domains in which study results were contradictory. For olanzapine versus risperidone, these were verbal and visual learning and memory and psychomotor functioning. No comparative data for olanzapine and risperidone were available for the social cognition domain. For quetiapine versus risperidone, the domains in which no unanimity was found were processing speed, attention/vigilance, nonverbal working memory, and verbal learning and memory. The limited available reports on risperidone versus clozapine suggest that: risperidone was associated with improved, and clozapine with worsened, performance on the nonverbal working memory domain; risperidone improved and clozapine did not improve reasoning and problem-solving performance; clozapine improved, and risperidone did not improve, social cognition performance. Use of long-acting injectable risperidone seemed to be associated with improved performance in the domains of attention/vigilance, verbal learning and memory, and reasoning and problem solving, as well as psychomotor functioning. The results for the nonverbal working memory domain were indeterminate, and no clear improvement was seen in the social cognition domain. The domains of processing speed, verbal working memory, and visual learning and memory, as well as verbal fluency, were not assessed. The results of this review of within-group comparisons of oral risperidone suggest that the agent appeared to be associated with improved functioning in the cognitive domains of processing speed, attention/vigilance, verbal and visual learning and memory, and reasoning and problem solving in patients with schizophrenia or schizoaffective disorder. Long-acting injectable risperidone seemed to be associated with improved functioning in the domains of attention/vigilance, verbal learning and memory, and reasoning and problem solving, as well as psychomotor functioning, in patients with schizophrenia or schizoaffective disorder.

Developmental Learning Disorders: From Generic Interventions to Individualized Remediation

PubMed Central

Moreau, David; Waldie, Karen E.

2016-01-01

Developmental learning disorders affect many children, impairing their experience in the classroom and hindering many aspects of their life. Once a bleak sentence associated with life-long difficulties, several learning disorders can now be successfully alleviated, directly benefiting from promising interventions. In this review, we focus on two of the most prevalent learning disorders, dyslexia and attention-deficit/hyperactivity disorder (ADHD). Recent advances have refined our understanding of the specific neural networks that are altered in these disorders, yet questions remain regarding causal links between neural changes and behavioral improvements. After briefly reviewing the theoretical foundations of dyslexia and ADHD, we explore their distinct and shared characteristics, and discuss the comorbidity of the two disorders. We then examine current interventions, and consider the benefits of approaches that integrate remediation within other activities to encourage sustained motivation and improvements. Finally, we conclude with a reflection on the potential for remediation programs to be personalized by taking into account the specificities and demands of each individual. The effective remediation of learning disorders is critical to modern societies, especially considering the far-reaching ramifications of successful early interventions. PMID:26793160

Examination of Predictors and Moderators for Self-help Treatments of Binge Eating Disorder

PubMed Central

Masheb, Robin M.; Grilo, Carlos M.

2008-01-01

Predictors and moderators of outcomes were examined in 75 overweight patients with binge eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments. Age variables, psychiatric and personality disorder comorbidity and clinical characteristics were tested as predictors and moderators of treatment outcomes. Current age and age of BED onset did not predict outcomes. Key dimensional outcomes (binge frequency, eating psychopathology, and negative affect) were predominately predicted, but not moderated, by their respective pretreatment levels. Presence of personality disorders, particularly Cluster C, predicted both post-treatment negative affect and eating disorder psychopathology. Negative affect, but not major depressive disorder, predicted attrition, and post-treatment negative affect and eating disorder psychopathology. Despite the prognostic significance of these findings for dimensional outcomes, none of the variables tested were predictive of binge remission (i.e., a categorical outcome). No moderator effects were found. The present study found poorer prognosis for patients with negative affect and personality disorders suggesting that treatment outcomes may be enhanced by attending to the cognitive and personality styles of these patients. PMID:18837607

Personality disorder and alcohol treatment outcome: systematic review and meta-analysis.

PubMed

Newton-Howes, Giles M; Foulds, James A; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

2017-07-01

Background Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes. Aims To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD. Method We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies. Results Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall. Conclusions Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area. © The Royal College of Psychiatrists 2017.

Emotional learning, stress, and development: An ever-changing landscape shaped by early-life experience.

PubMed

Pattwell, Siobhan S; Bath, Kevin G

2017-09-01

The capacity to learn to associate cues with negative outcomes is a highly adaptive process that appears to be conserved across species. However, when the cue is no longer a valid predictor of danger, but the emotional response persists, this can result in maladaptive behaviors, and in humans contribute to debilitating emotional disorders. Over the past several decades, work in neuroscience, psychiatry, psychology, and biology have uncovered key processes underlying, and structures governing, emotional responding and learning, as well as identified disruptions in the structural and functional integrity of these brain regions in models of pathology. In this review, we highlight some of this elegant body of work as well as incorporate emerging findings from the field of developmental neurobiology to emphasize how development contributes to changes in the ability to learn and express emotional responses, and how early experiences, such as stress, shape the development and functioning of these circuits. Copyright © 2017 Elsevier Inc. All rights reserved.

Accommodating Asperger's: An Autoethnography on the Learning Experience in an E-Learning Music Education Program

ERIC Educational Resources Information Center

Farrell, Riley Jarrett

2013-01-01

A student with Asperger's Syndrome faces a complex myriad of learning disabilities and social difficulties. The co-morbid conditions of dyslexia, Obsessive Compulsive Disorder, Attention Deficit Disorder, Attention Deficit Hyperactive Disorder and anxiety further complicate Asperger's Syndrome. Asperger's Syndrome and these conditions, singularly…

Comparison of Teacher-Rated Achievement Levels of Behaviorally Disordered, Learning Disabled, and Nonhandicapped Adolescents.

ERIC Educational Resources Information Center

Luebke, Jerry; And Others

1989-01-01

Teacher ratings on reading recognition, reading comprehension, arithmetic, and written expression revealed that behaviorally disordered and learning-disabled adolescents (N=200) were seen as performing significantly below expected levels of achievement. Differences between behaviorally disordered and learning-disabled students appeared to depend…

The Nature of Self-Directed Learning and Transformational Learning in Self-Managing Bipolar Disorder to Stay Well

ERIC Educational Resources Information Center

Francik, Wendy A.

2012-01-01

The purpose of the research was to explore the self-directed learning and transformational learning experiences among persons with bipolar disorder. A review of previous research pointed out how personal experiences with self-directed learning and transformational learning facilitated individuals' learning to manage HIV, Methicillan-resitant…

Psychoeducational and Cognitive Behavioral Treatment Programs: Implementation and Evaluation From 1995 to 2015 in Kraepelin's Former Hospital.

PubMed

Schaub, Annette; Hippius, Hanns; Möller, Hans-Jürgen; Falkai, Peter

2016-07-01

Programs that view individuals as capable of taking an active role in managing their illness have gained importance in Europe and the United States. This article describes the implementation and evaluation of group psychoeducational and cognitive behavioral treatment programs at the Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, over the past 20 years. Implementing psychoeducational programs was the first step to establish cognitive behavioral psychotherapy and dispel the myth of schizophrenia for patients. Programs are also provided for patients with mood disorders, substance use disorders, or both. These groups include topics such as psychoeducation about the illness, establishing rewarding activities, stress management, cognitive therapy, and relapse prevention. More than 1000 patients with schizophrenia or mood disorders (380 schizophrenia, 563 major depression, and 110 bipolar) have participated in illness management groups to learn about their illness and its treatment, and to learn skills to manage their illness. Patients have expressed satisfaction with the programs, and research has supported their effectiveness. Individuals with severe disorders can benefit from psychoeducational and cognitive treatment programs if the programs are adapted to the level of neuropsychological functioning and compensate for cognitive deficits and emotional overload. These findings suggest that providing information about the illness and coping skills for patients and relatives are important for treatment outcome. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD.

PubMed

Foa, Edna B; McLean, Carmen P

2016-01-01

In this review we describe the intricate interrelationship among basic research, conceptualization of psychopathology, treatment development, treatment outcome research, and treatment mechanism research and how the interactions among these areas of study further our knowledge about psychopathology and its treatment. In describing the work of Edna Foa and her colleagues in anxiety disorders, we demonstrate how emotional processing theory of anxiety-related disorders and their treatment using exposure therapy have generated hypotheses about the psychopathology of posttraumatic stress disorder and obsessive-compulsive anxiety disorder that have informed the development and refinement of specific treatment protocols for these disorders: prolonged exposure and exposure and response (ritual) prevention. Further, we have shown that the next step after the development of theoretically driven treatment protocols is to evaluate their efficacy. Once evidence for a treatment's efficacy has accumulated, studies of the mechanisms involved in the reduction of the targeted psychopathology are conducted, which in turn inform the theory and further refine the treatments. We conclude our review with a discussion of how the knowledge derived from Foa and colleagues' programmatic research together with knowledge emerging from basic research on extinction learning can inform future research on the psychopathology of anxiety disorders and their treatments.

Individuals With OCD Lack Unrealistic Optimism Bias in Threat Estimation.

PubMed

Zetsche, Ulrike; Rief, Winfried; Exner, Cornelia

2015-07-01

Overestimating the occurrence of threatening events has been highlighted as a central cognitive factor in the maintenance of obsessive-compulsive disorder (OCD). The present study examined the different facets of this cognitive bias, its underlying mechanisms, and its specificity to OCD. For this purpose, threat estimation, probabilistic classification learning (PCL) and psychopathological measures were assessed in 23 participants with OCD, 30 participants with social phobia, and 31 healthy controls. Whereas healthy participants showed an optimistic expectation bias regarding positive and negative future events, OCD participants lacked such a bias. This lack of an optimistic expectation bias was not specific to OCD. Compared to healthy controls, OCD participants overestimated their personal risk for experiencing negative events, but did not differ from controls in their risk estimation regarding other people. Finally, OCD participants' biases in the prediction of checking-related events were associated with their impairments in learning probabilistic cue-outcome associations in a disorder-relevant context. In sum, the present results add to a growing body of research demonstrating that cognitive biases in OCD are context-dependent. Copyright © 2015. Published by Elsevier Ltd.

Differences in stress and coping for mothers and fathers of children with Asperger's syndrome and nonverbal learning disorders.

PubMed

Little, Liza

2002-01-01

Research conducted on families of children with disabilities shows that family cohesion and positive family outcomes are influenced by how mothers and fathers cope with raising their child with disabilities. This study was designed to examine stress and coping differences between mothers and fathers (n = 103) of children with Asperger's syndrome (AS) and nonverbal learning disorders (NLD). A repeated measure design was used to compare how mothers and fathers cope with caring for a particular child to control for differences in the severity and nature of the disability across children. Few studies that compare mothers and fathers do so at the couple level. Responses indicated that mothers had higher rates of stress related to family problems and pessimism about their child's future, higher rates of antidepressant use, and higher rates of therapy use than did fathers. Mothers found some coping strategies more helpful than fathers did. Maternal education and child's age also were related to some stress and coping variables. Implications for nurses and future research are discussed.

Early-Life Nutritional Programming of Cognition-The Fundamental Role of Epigenetic Mechanisms in Mediating the Relation between Early-Life Environment and Learning and Memory Process.

PubMed

Moody, Laura; Chen, Hong; Pan, Yuan-Xiang

2017-03-01

The perinatal period is a window of heightened plasticity that lays the groundwork for future anatomic, physiologic, and behavioral outcomes. During this time, maternal diet plays a pivotal role in the maturation of vital organs and the establishment of neuronal connections. However, when perinatal nutrition is either lacking in specific micro- and macronutrients or overloaded with excess calories, the consequences can be devastating and long lasting. The brain is particularly sensitive to perinatal insults, with several neurologic and psychiatric disorders having been linked to a poor in utero environment. Diseases characterized by learning and memory impairments, such as autism, schizophrenia, and Alzheimer disease, are hypothesized to be attributed in part to environmental factors, and evidence suggests that the etiology of these conditions may date back to very early life. In this review, we discuss the role of the early-life diet in shaping cognitive outcomes in offspring. We explore the endocrine and immune mechanisms responsible for these phenotypes and discuss how these systemic factors converge to change the brain's epigenetic landscape and regulate learning and memory across the lifespan. Through understanding the maternal programming of cognition, critical steps may be taken toward preventing and treating diseases that compromise learning and memory. © 2017 American Society for Nutrition.

Relationships of Attention and Executive Functions to Oral Language, Reading, and Writing Skills and Systems in Middle Childhood and Early Adolescence.

PubMed

Berninger, Virginia; Abbott, Robert; Cook, Clayton R; Nagy, William

Relationships between attention/executive functions and language learning were investigated in students in Grades 4 to 9 ( N = 88) with and without specific learning disabilities (SLDs) in multiword syntax in oral and written language (OWL LD), word reading and spelling (dyslexia), and subword letter writing (dysgraphia). Prior attention-deficit/hyperactivity disorder (ADHD) diagnosis was correlated only with impaired handwriting. Parental ratings of inattention, but not hyperactivity, correlated with measures of written language but not oral language. Sustaining switching attention correlated with writing the alphabet from memory in manuscript or by keyboard and fast copying of a sentence with all the letters of the alphabet. Multiple regressions based on a principal component for composites of multiple levels of language (subword, word, and syntax/text) showed that measures of attention and executive function involving language processing rather than ratings of attention and executive function not specifically related to language accounted for more variance and identified more unique predictors in the composite outcomes for oral language, reading, and writing systems. Inhibition related to focused attention uniquely predicted outcomes for the oral language system. Findings are discussed in reference to implications for assessing and teaching students who are still learning to pay attention to heard and written language and self-regulate their language learning during middle childhood and adolescence.

Analysing learning outcomes in an Electrical Engineering curriculum using illustrative verbs derived from Bloom's Taxonomy

NASA Astrophysics Data System (ADS)

Meda, Lawrence; Swart, Arthur James

2018-05-01

Learning outcomes are essential to any curriculum in education, where they need to be clear, observable and measurable. However, some academics structure learning outcomes in a way that does not promote student learning. The purpose of this article is to present the analyses of learning outcomes of an Electrical Engineering curriculum offered at a University of Technology in South Africa, in order to determine if academics are structuring them in a way that enables student learning. A qualitative case study is used where the learning outcomes from 33 study guides are reviewed using illustrative verbs derived from Bloom's Taxonomy. Results indicate that 9% of all the learning outcomes are unclear, 10% are unobservable and 23% are unmeasurable. A key recommendation is to provide regular workshops to assist academics in reviewing their learning outcomes using the illustrative verbs derived from Bloom's Taxonomy, thereby ensuring that their learning outcomes promote student learning.

Learning Outcomes Assessment: Extrapolating from Study Abroad to International Service-Learning

ERIC Educational Resources Information Center

Rubin, Donald L.; Matthews, Paul H.

2013-01-01

For international service-learning to thrive, it must document student learning outcomes that accrue to participants. The approaches to international service-learning assessment must be compelling to a variety of stakeholders. Recent large-scale projects in study abroad learning outcomes assessment--including the Georgia Learning Outcomes of…

A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.

PubMed

Vannoy, Steven D; Mauer, Barbara; Kern, John; Girn, Kamaljeet; Ingoglia, Charles; Campbell, Jeannie; Galbreath, Laura; Unützer, Jürgen

2011-07-01

Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.

Differentiating Children with Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, Learning Disabilities and Autistic Spectrum Disorders by Means of Their Motor Behavior Characteristics

ERIC Educational Resources Information Center

Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan

2012-01-01

The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N = 22), Conduct Disorder (CD; N = 17), Learning Disabilities (LD; N = 24) and Autistic Spectrum Disorders (ASD; N = 20).…

Working Memory Functioning in Children with Learning Disorders and Specific Language Impairment

ERIC Educational Resources Information Center

Schuchardt, Kirsten; Bockmann, Ann-Katrin; Bornemann, Galina; Maehler, Claudia

2013-01-01

Purpose: On the basis of Baddeley's working memory model (1986), we examined working memory functioning in children with learning disorders with and without specific language impairment (SLI). We pursued the question whether children with learning disorders exhibit similar working memory deficits as children with additional SLI. Method: In…

Support for learning goes beyond academic support: Voices of students with Asperger's disorder and attention deficit hyperactivity disorder.

PubMed

Bolic Baric, Vedrana; Hellberg, Kristina; Kjellberg, Anette; Hemmingsson, Helena

2016-02-01

The purpose of this study was to describe and explore the experiences of support at school among young adults with Asperger's disorder and attention deficit hyperactivity disorder and also to examine what support they, in retrospect, described as influencing learning. Purposive sampling was used to enroll participants. Data were collected through semi-structured interviews with 13 young adults aged between 20 and 29 years. A qualitative analysis, based on interpreting people's experiences, was conducted by grouping and searching for patterns in data. The findings indicate that the participants experienced difficulties at school that included academic, social, and emotional conditions, all of which could influence learning. Support for learning included small groups, individualized teaching methods, teachers who cared, and practical and emotional support. These clusters together confirm the overall understanding that support for learning aligns academic and psychosocial support. In conclusion, academic support combined with psychosocial support at school seems to be crucial for learning among students with Asperger's disorder and attention deficit hyperactivity disorder. © The Author(s) 2015.

The Role of Balanced Training and Testing Data Sets for Binary Classifiers in Bioinformatics

PubMed Central

Wei, Qiong; Dunbrack, Roland L.

2013-01-01

Training and testing of conventional machine learning models on binary classification problems depend on the proportions of the two outcomes in the relevant data sets. This may be especially important in practical terms when real-world applications of the classifier are either highly imbalanced or occur in unknown proportions. Intuitively, it may seem sensible to train machine learning models on data similar to the target data in terms of proportions of the two binary outcomes. However, we show that this is not the case using the example of prediction of deleterious and neutral phenotypes of human missense mutations in human genome data, for which the proportion of the binary outcome is unknown. Our results indicate that using balanced training data (50% neutral and 50% deleterious) results in the highest balanced accuracy (the average of True Positive Rate and True Negative Rate), Matthews correlation coefficient, and area under ROC curves, no matter what the proportions of the two phenotypes are in the testing data. Besides balancing the data by undersampling the majority class, other techniques in machine learning include oversampling the minority class, interpolating minority-class data points and various penalties for misclassifying the minority class. However, these techniques are not commonly used in either the missense phenotype prediction problem or in the prediction of disordered residues in proteins, where the imbalance problem is substantial. The appropriate approach depends on the amount of available data and the specific problem at hand. PMID:23874456

Does d-Cycloserine Augmentation of CBT Improve Therapeutic Homework Compliance for Pediatric Obsessive-Compulsive Disorder?

PubMed

Park, Jennifer M; Small, Brent J; Geller, Daniel A; Murphy, Tanya K; Lewin, Adam B; Storch, Eric A

2014-07-01

Clinical studies in adults and children with obsessive-compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome.

Does d-Cycloserine Augmentation of CBT Improve Therapeutic Homework Compliance for Pediatric Obsessive–Compulsive Disorder?

PubMed Central

Park, Jennifer M.; Small, Brent J.; Geller, Daniel A.; Murphy, Tanya K.; Lewin, Adam B.; Storch, Eric A.

2014-01-01

Clinical studies in adults and children with obsessive–compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome. PMID:24999301

Applying cognitive training to target executive functions during early development.

PubMed

Wass, Sam V

2015-01-01

Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development.

Applying cognitive training to target executive functions during early development

PubMed Central

Wass, Sam V.

2015-01-01

Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development. PMID:24511910

Implicit Learning Abilities Predict Treatment Response in Autism Spectrum Disorders

DTIC Science & Technology

2015-09-01

2 AWARD NUMBER: W81XWH-14-1-0261 TITLE: Implicit Learning Abilities Predict Treatment Response in Autism Spectrum Disorders PRINCIPAL...Treatment Response in Autism Spectrum Disorders 5b. GRANT NUMBER W81XWH-14-1-0261 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER...for Autism Spectrum Disorder (ASD), but almost half of the children do not make significant gains. Implicit learning skills are integral to

An investigation of habit learning in Anorexia Nervosa

PubMed Central

Godier, Lauren R; de Wit, Sanne; Pinto, Anthony; Steinglass, Joanna E; Greene, Ashley L; Scaife, Jessica; Gillan, Claire M.; Walsh, B. Timothy; Simpson, Helen-Blair; Park, Rebecca J

2017-01-01

Anorexia Nervosa (AN) is a disorder characterised by compulsive behaviour, such as self-starvation and excessive exercise, which develop in the pursuit of weight-loss. Recent theory suggests that once established, compulsive weight-loss behaviours in AN may become habitual. In two parallel studies, we measured whether individuals with AN showed a bias toward habits using two outcome-devaluation tasks. In Study 1, 23 women with AN (restrictive and binge/purge subtypes), and 18 healthy controls (HC) completed the slips-of-action paradigm, designed to assess reward-based habits. In Study 2, 13 women with restrictive AN, 14 women recovered from restrictive AN, and 17 female HC participants completed the slips-of-action paradigm, and an avoidance paradigm, designed to assess aversive habits. AN participants showed no deficit relative to HCs in the ability to use feedback to respond correctly to stimuli. Following devaluation of outcomes, all groups in both studies were equally able to withhold inappropriate responses, suggesting no deficit in the balance between goal-directed and habitual control of behaviour in these tasks in AN. These results suggest that individuals with AN do not show a generalised tendency to rely on habits in two outcome-devaluation tasks. Future research is needed to investigate the potential role of disorder-specific habits in the maintenance of behaviour in AN. PMID:27497292

Using Electroencephalography for Treatment Guidance in Major Depressive Disorder.

PubMed

Wade, Elizabeth C; Iosifescu, Dan V

2016-09-01

Given the high prevalence of treatment-resistant depression and the long delays in finding effective treatments via trial and error, valid biomarkers of treatment outcome with the ability to guide treatment selection represent one of the most important unmet needs in mood disorders. A large body of research has investigated, for this purpose, biomarkers derived from electroencephalography (EEG), using resting state EEG or evoked potentials. Most studies have focused on specific EEG features (or combinations thereof), whereas more recently machine-learning approaches have been used to define the EEG features with the best predictive abilities without a priori hypotheses. While reviewing these different approaches, we have focused on the predictor characteristics and the quality of the supporting evidence. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

A long-term outcome study of selective mutism in childhood.

PubMed

Steinhausen, Hans-Christoph; Wachter, Miriam; Laimböck, Karin; Metzke, Christa Winkler

2006-07-01

Controlled study of the long-term outcome of selective mutism (SM) in childhood. A sample of 33 young adults with SM in childhood and two age- and gender-matched comparison groups were studied. The latter comprised 26 young adults with anxiety disorders in childhood (ANX) and 30 young adults with no psychiatric disorders during childhood. The three groups were compared with regard to psychiatric disorder in young adulthood by use of the Composite International Diagnostic Interview (CIDI). In addition, the effect of various predictors on outcome of SM was studied. The symptoms of SM improved considerably in the entire SM sample. However, both SM and ANX had significantly higher rates for phobic disorder and any psychiatric disorder than controls at outcome. Taciturnity in the family and, by trend, immigrant status and a severity indicator of SM had an impact on psychopathology and symptomatic outcome in young adulthood. This first controlled long-term outcome study of SM provides evidence of symptomatic improvement of SM in young adulthood. However, a high rate of phobic disorder at outcome points to the fact that SM may be regarded as an anxiety disorder variant.

[Is a specific disorder of arithmetic skills as common as reading/spelling disorder?].

PubMed

Wyschkon, Anne; Kohn, Juliane; Ballaschk, Katja; Esser, Günter

2009-11-01

Referring to the prevalence rates of learning disorders in the research literature, the numbers of mathematics disorder and reading/spelling disorder are often reported to be identical. However, the correlation between intelligence level and reading/spelling skills is much weaker than between intelligence and arithmetic skills. If the same definition criterion is applied to both disorders, a lower prevalence rate for mathematics disorder should be expected. Are there differences in the prevalence estimates for learning disorders depending on the definition criterion? A large representative sample of German students (N=1970) was used to review the hypothesis. Depending on the definition criterion, we could show a prevalence range of mathematics disorder between 0.1% and 8.1% in the same sample. Using the same definition criterion for both learning disorders, there are two to three times as many students with reading/spelling disorder than those with mathematics disorder. Whenever children with reading/spelling disorder are compared to children with mathematics disorder, the same definition criterion has to be applied.

Integrating Learning Outcome Typologies for HRD: Review and Current Status

ERIC Educational Resources Information Center

Lim, Doo Hun; Yoon, Seung Won; Park, Sunyoung

2013-01-01

This study reports the result of literature review in regards to learning outcome studies and presents a framework that integrates content types with learning outcomes. Analysis of learning outcome studies between 1992 and 2006 using the ERIC database indicated that most empirical studies have assessed the learning outcome at lower levels of…

Academic performance in ADHD when controlled for comorbid learning disorders, family income, and parental education in Brazil.

PubMed

Pastura, Giuseppe Mario Carmine; Mattos, Paulo; Araújo, Alexandra Prufer de Queiroz Campos

2009-03-01

Scholastic achievement in a nonclinical sample of ADHD children and adolescents was evaluated taking into consideration variables such as comorbid learning disorders, family income, and parental education which may also be associated with poor academic performance. After screening for ADHD in 396 students, the authors compared academic performance of 26 ADHD individuals and 31 controls paired for gender, age, and intelligence level considering both mathematics and Portuguese language scores. Learning disorders were investigated and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) criteria were met using structured interviews. The prevalence of academic underachievement was 2.98 times higher in students with ADHD, the most frequent subtype being predominantly inattentive. Parental educational level, family income, and comorbid learning disorders could not explain the discrepancies between ADHD students and controls. ADHD seems to be associated with poor academic performance even in the absence of comorbid learning disorders, lower family income, and parental educational level.

An integrative review of attention biases and their contribution to treatment for anxiety disorders

PubMed Central

Barry, Tom J.; Vervliet, Bram; Hermans, Dirk

2015-01-01

Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians. PMID:26217284

Common visual problems in children with disability.

PubMed

Salt, Alison; Sargent, Jenefer

2014-12-01

Children with disability are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. The aetiology of VI in children with disability reflects that of the general population and includes cerebral VI, optic atrophy, as well as primary visual disorders such as retinal dystrophies and structural eye anomalies. VI and other potentially correctable ocular disorders may not be recognised without careful assessment and are frequently unidentified in children with complex needs. Although assessment may be more challenging than in other children, identifying these potential additional barriers to learning and development may be critical. There is a need to develop clearer guidelines, referral pathways and closer working between all professionals involved in the care of children with disability and visual disorders to improve our focus on the assessment of vision and outcomes for children with disability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and posttraumatic stress disorder: implications for treatment

PubMed Central

McGuire, Joseph F.; Orr, Scott P.; Essoe, Joey K.-Y.; McCracken, James T.; Storch, Eric A.; Piacentini, John

2018-01-01

Introduction Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. Areas covered A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified. Expert Commentary Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed. PMID:27275519

Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder: implications for treatment.

PubMed

McGuire, Joseph F; Orr, Scott P; Essoe, Joey K-Y; McCracken, James T; Storch, Eric A; Piacentini, John

2016-10-01

Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.

Neuropsychological Functioning in Specific Learning Disorders--Reading, Writing and Mixed Groups

ERIC Educational Resources Information Center

Kohli, Adarsh; Kaur, Manreet; Mohanty, Manju; Malhotra, Savita

2006-01-01

Aim: The study compared the pattern of deficits, intelligence and neuropsychological functioning in subcategories of learning disorders. Methods: Forty-six children (16 with reading disorders, 11 with writing disorders and 19 with both reading and writing disorders--mixed group) in the age range of 7-14 years were assessed using the NIMHANS Index…

Three-year recovery outcomes for long-term patients with co-occurring schizophrenic and substance use disorders.

PubMed

Xie, Haiyi; McHugo, Gregory J; Helmstetter, Barbara S; Drake, Robert E

2005-06-15

Little is known about the expected treatment outcomes of patients with co-occurring schizophrenic and substance use disorders. This paper reports 3-year outcomes for 152 patients with schizophrenia or schizoaffective disorder and substance use disorders, all of whom received integrated dual disorders treatments in the New Hampshire Dual Diagnosis Study. Outcomes are defined as positive coping behaviors identified by consumers as indicators of recovery. Participants improved steadily in terms of controlling symptoms of schizophrenia, actively attaining remissions from substance abuse, increasing competitive employment, increasing social contacts with non-substance abusers, and improving life satisfaction. Though successful in reducing hospitalization and homelessness, they did not increase time in independent living situations. Outcomes were only weakly interrelated, suggesting that recovery is a multidimensional concept. Neither psychotic diagnosis (schizophrenia vs. schizoaffective disorder) nor substance abuse diagnosis (alcohol vs. other drug disorder vs. both) was related to outcomes. However, these patients with co-occurring schizophrenic and substance use disorders did significantly less well than patients with co-occurring bipolar and substance use disorders in terms of hospitalization, independent living, and quality of life. Overall, the findings provide a hopeful long-term perspective for dual diagnosis patients.

A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders: It's Not What You Thought it Was

ERIC Educational Resources Information Center

Mineka, Susan; Zinbarg, Richard

2006-01-01

The authors describe how contemporary learning theory and research provide the basis for perspectives on the etiology and maintenance of anxiety disorders that capture the complexity associated with individual differences in the development and course of these disorders. These insights from modern research on learning overcome the shortcomings of…

WISC-IV Intellectual Profiles in Italian Children with Specific Learning Disorder and Related Impairments in Reading, Written Expression, and Mathematics

ERIC Educational Resources Information Center

Poletti, Michele

2016-01-01

The fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" grouped specific learning disabilities in the single diagnostic category of specific learning disorder (SLD), with specifiers for impairments in reading, written expression, and mathematics. This study aimed at investigating the intellectual profile,…

Using Contact Work in Interactions with Adults with Learning Disabilities and Autistic Spectrum Disorders

ERIC Educational Resources Information Center

Brooks, Sharon; Paterson, Gail

2011-01-01

This article describes a project about using contact work with people with learning disabilities and autistic spectrum disorder. People with learning disabilities and additional autistic spectrum disorder are at risk of becoming socially isolated because of their difficulties in interacting with others. Contact work is a form of Pre-Therapy, which…

Training a new generation of speech-language pathologists with competences in the management of literacy disorders and learning disabilities in Hong Kong.

PubMed

Yuen, Kevin C P

2014-01-01

One of the recent developments in the education of speech-language pathology is to include literacy disorders and learning disabilities as key training components in the training curriculum. Disorders in reading and writing are interwoven with disorders in speaking and listening, which should be managed holistically, particularly in children and adolescents. With extensive training in clinical linguistics, language disorders, and other theoretical knowledge and clinical skills, speech-language pathologists (SLPs) are the best equipped and most competent professionals to screen, identify, diagnose, and manage individuals with literacy disorders. To tackle the challenges of and the huge demand for services in literacy as well as language and learning disorders, the Hong Kong Institute of Education has recently developed the Master of Science Programme in Educational Speech-Language Pathology and Learning Disabilities, which is one of the very first speech-language pathology training programmes in Asia to blend training components of learning disabilities, literacy disorders, and social-emotional-behavioural-developmental disabilities into a developmentally and medically oriented speech-language pathology training programme. This new training programme aims to prepare a new generation of SLPs to be able to offer comprehensive support to individuals with speech, language, literacy, learning, communication, and swallowing disorders of different developmental or neurogenic origins, particularly to infants and adolescents as well as to their family and educational team. © 2015 S. Karger AG, Basel.

The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity.

PubMed

Wardenaar, K J; van Loo, H M; Cai, T; Fava, M; Gruber, M J; Li, J; de Jonge, P; Nierenberg, A A; Petukhova, M V; Rose, S; Sampson, N A; Schoevers, R A; Wilcox, M A; Alonso, J; Bromet, E J; Bunting, B; Florescu, S E; Fukao, A; Gureje, O; Hu, C; Huang, Y Q; Karam, A N; Levinson, D; Medina Mora, M E; Posada-Villa, J; Scott, K M; Taib, N I; Viana, M C; Xavier, M; Zarkov, Z; Kessler, R C

2014-11-01

Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these distinctions can be refined by added information about co-morbid conditions. The current report presents results on this question. Data came from 8261 respondents with lifetime DSM-IV MDD in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Outcomes included four retrospectively reported measures of persistence/severity of course (years in episode; years in chronic episodes; hospitalization for MDD; disability due to MDD). Machine learning methods (regression tree analysis; lasso, ridge and elastic net penalized regression) followed by k-means cluster analysis were used to augment previously detected subtypes with information about prior co-morbidity to predict these outcomes. Predicted values were strongly correlated across outcomes. Cluster analysis of predicted values found three clusters with consistently high, intermediate or low values. The high-risk cluster (32.4% of cases) accounted for 56.6-72.9% of high persistence, high chronicity, hospitalization and disability. This high-risk cluster had both higher sensitivity and likelihood ratio positive (LR+; relative proportions of cases in the high-risk cluster versus other clusters having the adverse outcomes) than in a parallel analysis that excluded measures of co-morbidity as predictors. Although the results using the retrospective data reported here suggest that useful MDD subtyping distinctions can be made with machine learning and clustering across multiple indicators of illness persistence/severity, replication with prospective data is needed to confirm this preliminary conclusion.

Refining Prediction in Treatment-Resistant Depression: Results of Machine Learning Analyses in the TRD III Sample.

PubMed

Kautzky, Alexander; Dold, Markus; Bartova, Lucie; Spies, Marie; Vanicek, Thomas; Souery, Daniel; Montgomery, Stuart; Mendlewicz, Julien; Zohar, Joseph; Fabbri, Chiara; Serretti, Alessandro; Lanzenberger, Rupert; Kasper, Siegfried

The study objective was to generate a prediction model for treatment-resistant depression (TRD) using machine learning featuring a large set of 47 clinical and sociodemographic predictors of treatment outcome. 552 Patients diagnosed with major depressive disorder (MDD) according to DSM-IV criteria were enrolled between 2011 and 2016. TRD was defined as failure to reach response to antidepressant treatment, characterized by a Montgomery-Asberg Depression Rating Scale (MADRS) score below 22 after at least 2 antidepressant trials of adequate length and dosage were administered. RandomForest (RF) was used for predicting treatment outcome phenotypes in a 10-fold cross-validation. The full model with 47 predictors yielded an accuracy of 75.0%. When the number of predictors was reduced to 15, accuracies between 67.6% and 71.0% were attained for different test sets. The most informative predictors of treatment outcome were baseline MADRS score for the current episode; impairment of family, social, and work life; the timespan between first and last depressive episode; severity; suicidal risk; age; body mass index; and the number of lifetime depressive episodes as well as lifetime duration of hospitalization. With the application of the machine learning algorithm RF, an efficient prediction model with an accuracy of 75.0% for forecasting treatment outcome could be generated, thus surpassing the predictive capabilities of clinical evaluation. We also supply a simplified algorithm of 15 easily collected clinical and sociodemographic predictors that can be obtained within approximately 10 minutes, which reached an accuracy of 70.6%. Thus, we are confident that our model will be validated within other samples to advance an accurate prediction model fit for clinical usage in TRD. © Copyright 2017 Physicians Postgraduate Press, Inc.

[From brain imaging to good teaching? implicating from neuroscience for research on learning and instruction].

PubMed

Stubenrauch, Christa; Krinzinger, Helga; Konrad, Kerstin

2014-07-01

Psychiatric disorders in childhood and adolescence, in particular attention deficit disorder or specific learning disorders like developmental dyslexia and developmental dyscalculia, affect academic performance and learning at school. Recent advances in neuroscientific research have incited an intensive debate both in the general public and in the field of educational and instructional science as well as to whether and to what extent these new findings in the field of neuroscience might be of importance for school-related learning and instruction. In this review, we first summarize neuroscientific findings related to the development of attention, working memory and executive functions in typically developing children and then evaluate their relevance for school-related learning. We present an overview of neuroimaging studies of specific learning disabilities such as developmental dyslexia and developmental dyscalculia, and critically discuss their practical implications for educational and teaching practice, teacher training, early diagnosis as well as prevention and disorder-specific therapy. We conclude that the new interdisciplinary field of neuroeducation cannot be expected to provide direct innovative educational applications (e.g., teaching methods). Rather, the future potential of neuroscience lies in creating a deeper understanding of the underlying cognitive mechanisms and pathomechanisms of learning processes and learning disorders.

d-Cycloserine facilitates extinction learning and enhances extinction-related brain activation.

PubMed

Klass, Anne; Glaubitz, Benjamin; Tegenthoff, Martin; Lissek, Silke

2017-10-01

Extinction learning is modulated by N-methyl d-aspartate receptors (NMDAR) particularly in prefrontal and hippocampal brain regions. The use of of NMDA agonists in exposure therapy of anxiety disorders has been investigated in various patient groups. Behavioral results showed beneficial effects of pre-learning administration of the partial NMDAR agonist d-Cycloserine (DCS) on therapy success. However, the impact of DCS upon non-fear-related contextual extinction, and associated recruitment of extinction-relevant brain regions is as yet unknown. In the present fMRI study, healthy human participants performed a context-related associative learning and extinction task. A single dose of DCS, administered prior to extinction learning, enhanced extinction learning performance in an identical context, and increased activation in prefrontal, temporal as well as hippocampal/insular regions, compared to placebo controls. In contrast, DCS did not affect extinction learning in a novel context, nor the renewal effect, which describes the recovery of an extinguished response if the context of extinction differs from the context of recall. Our findings demonstrate a specific involvement of prefrontal and hippocampal NMDAR in the modification of established stimulus-outcome associations in identical contexts and thus their role in behavioral flexibility, underlining their potential for enhancing AAA extinction learning. Copyright © 2017. Published by Elsevier Inc.

The effects of neurologic assessment E-learning in nurses.

PubMed

Shin, Ji Yeon; Issenberg, S Barry; Roh, Young Sook

2017-10-01

A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. This study used a non-equivalent control group pretest-posttest design. Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26). The experimental group participated in the self-directed e-learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and self-confidence were measured at pretest and posttest. There were no significant differences in knowledge (U=270, p=0.399) and self-confidence (U=241.5, p=0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U=199, p=0.028). Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Molecular substrates of action control in cortico-striatal circuits.

PubMed

Shiflett, Michael W; Balleine, Bernard W

2011-09-15

The purpose of this review is to describe the molecular mechanisms in the striatum that mediate reward-based learning and action control during instrumental conditioning. Experiments assessing the neural bases of instrumental conditioning have uncovered functional circuits in the striatum, including dorsal and ventral striatal sub-regions, involved in action-outcome learning, stimulus-response learning, and the motivational control of action by reward-associated cues. Integration of dopamine (DA) and glutamate neurotransmission within these striatal sub-regions is hypothesized to enable learning and action control through its role in shaping synaptic plasticity and cellular excitability. The extracellular signal regulated kinase (ERK) appears to be particularly important for reward-based learning and action control due to its sensitivity to combined DA and glutamate receptor activation and its involvement in a range of cellular functions. ERK activation in striatal neurons is proposed to have a dual role in both the learning and performance factors that contribute to instrumental conditioning through its regulation of plasticity-related transcription factors and its modulation of intrinsic cellular excitability. Furthermore, perturbation of ERK activation by drugs of abuse may give rise to behavioral disorders such as addiction. Copyright © 2011 Elsevier Ltd. All rights reserved.

Vicarious learning of children's social-anxiety-related fear beliefs and emotional Stroop bias.

PubMed

Askew, Chris; Hagel, Anna; Morgan, Julie

2015-08-01

Models of social anxiety suggest that negative social experiences contribute to the development of social anxiety, and this is supported by self-report research. However, there is relatively little experimental evidence for the effects of learning experiences on social cognitions. The current study examined the effect of observing a social performance situation with a negative outcome on children's (8 to 11 years old) fear-related beliefs and cognitive processing. Two groups of children were each shown 1 of 2 animated films of a person trying to score in basketball while being observed by others; in 1 film, the outcome was negative, and in the other, it was neutral. Children's fear-related beliefs about performing in front of others were measured before and after the film and children were asked to complete an emotional Stroop task. Results showed that social fear beliefs increased for children who saw the negative social performance film. In addition, these children showed an emotional Stroop bias for social-anxiety-related words compared to children who saw the neutral film. The findings have implications for our understanding of social anxiety disorder and suggest that vicarious learning experiences in childhood may contribute to the development of social anxiety. (c) 2015 APA, all rights reserved).

Advances in psychological interventions for lifestyle disorders: overview of interventions in cardiovascular disorder and type 2 diabetes mellitus.

PubMed

Sudhir, Paulomi M

2017-09-01

The present review examines the recent advances in psychological interventions for two major lifestyle disorders in adults namely, type 2 diabetes mellitus and cardiovascular disorders. The review summarizes findings from studies carried out between the years 2015 and 2017. The effectiveness of psychological interventions in the management of lifestyle disorders has been examined with respect to adaptation, self-care, adherence, negative emotions and improving quality of life. There is an increasing recognition that psychological interventions are important for prevention of lifestyle disorders and promotion of health. Key psychological interventions include self-management and educational interventions based on learning and motivational principles, patient empowerment, cognitive behaviour therapy, behavioural skills and coaching. Recent developments also include the use of information technology to deliver these interventions through internet, mobile applications and text messages. Another significant development is that of mindfulness-based interventions within the third-generation behaviour therapy approaches to reduce distress and increase acceptance. In addition, family and couples interventions have also been emphasised as necessary in maintenance of healthy behaviours. Studies examining psychological interventions in cardiovascular and type 2 diabetes mellitus support the efficacy of these interventions in bringing about changes in biochemical / physiological parameters and in psychological outcomes such as self-efficacy, knowledge, quality of life and a sense of empowerment.

Gut microbiota: Implications in Parkinson's disease.

PubMed

Parashar, Arun; Udayabanu, Malairaman

2017-05-01

Gut microbiota (GM) can influence various neurological outcomes, like cognition, learning, and memory. Commensal GM modulates brain development and behavior and has been implicated in several neurological disorders like Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, anxiety, stress and much more. A recent study has shown that Parkinson's disease patients suffer from GM dysbiosis, but whether it is a cause or an effect is yet to be understood. In this review, we try to connect the dots between GM and PD pathology using direct and indirect evidence. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neural mechanisms of reinforcement learning in unmedicated patients with major depressive disorder.

PubMed

Rothkirch, Marcus; Tonn, Jonas; Köhler, Stephan; Sterzer, Philipp

2017-04-01

According to current concepts, major depressive disorder is strongly related to dysfunctional neural processing of motivational information, entailing impairments in reinforcement learning. While computational modelling can reveal the precise nature of neural learning signals, it has not been used to study learning-related neural dysfunctions in unmedicated patients with major depressive disorder so far. We thus aimed at comparing the neural coding of reward and punishment prediction errors, representing indicators of neural learning-related processes, between unmedicated patients with major depressive disorder and healthy participants. To this end, a group of unmedicated patients with major depressive disorder (n = 28) and a group of age- and sex-matched healthy control participants (n = 30) completed an instrumental learning task involving monetary gains and losses during functional magnetic resonance imaging. The two groups did not differ in their learning performance. Patients and control participants showed the same level of prediction error-related activity in the ventral striatum and the anterior insula. In contrast, neural coding of reward prediction errors in the medial orbitofrontal cortex was reduced in patients. Moreover, neural reward prediction error signals in the medial orbitofrontal cortex and ventral striatum showed negative correlations with anhedonia severity. Using a standard instrumental learning paradigm we found no evidence for an overall impairment of reinforcement learning in medication-free patients with major depressive disorder. Importantly, however, the attenuated neural coding of reward in the medial orbitofrontal cortex and the relation between anhedonia and reduced reward prediction error-signalling in the medial orbitofrontal cortex and ventral striatum likely reflect an impairment in experiencing pleasure from rewarding events as a key mechanism of anhedonia in major depressive disorder. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Emotional and Meta-Emotional Intelligence as Predictors of Adjustment Problems in Students with Specific Learning Disorders

ERIC Educational Resources Information Center

D'Amico, Antonella; Guastaferro, Teresa

2017-01-01

The purpose of this study was to analyse adjustment problems in a group of adolescents with a Specific Learning Disorder (SLD), examining to what extent they depend on the severity level of the learning disorder and/or on the individual's level of emotional intelligence. Adjustment problems,, perceived severity levels of SLD, and emotional and…

Current Issues in the Neurology and Genetics of Learning-Related Traits and Disorders: Introduction to the Special Issue.

ERIC Educational Resources Information Center

Gilger, Jeffrey W.

2001-01-01

This introductory article briefly describes each of the following eight articles in this special issue on the neurology and genetics of learning related disorders. It notes the greater appreciation of learning disability as a set of complex disorders with broad and intricate neurological bases and of the large individual differences in how these…

Behavioural and neural basis of anomalous motor learning in children with autism.

PubMed

Marko, Mollie K; Crocetti, Deana; Hulst, Thomas; Donchin, Opher; Shadmehr, Reza; Mostofsky, Stewart H

2015-03-01

Autism spectrum disorder is a developmental disorder characterized by deficits in social and communication skills and repetitive and stereotyped interests and behaviours. Although not part of the diagnostic criteria, individuals with autism experience a host of motor impairments, potentially due to abnormalities in how they learn motor control throughout development. Here, we used behavioural techniques to quantify motor learning in autism spectrum disorder, and structural brain imaging to investigate the neural basis of that learning in the cerebellum. Twenty children with autism spectrum disorder and 20 typically developing control subjects, aged 8-12, made reaching movements while holding the handle of a robotic manipulandum. In random trials the reach was perturbed, resulting in errors that were sensed through vision and proprioception. The brain learned from these errors and altered the motor commands on the subsequent reach. We measured learning from error as a function of the sensory modality of that error, and found that children with autism spectrum disorder outperformed typically developing children when learning from errors that were sensed through proprioception, but underperformed typically developing children when learning from errors that were sensed through vision. Previous work had shown that this learning depends on the integrity of a region in the anterior cerebellum. Here we found that the anterior cerebellum, extending into lobule VI, and parts of lobule VIII were smaller than normal in children with autism spectrum disorder, with a volume that was predicted by the pattern of learning from visual and proprioceptive errors. We suggest that the abnormal patterns of motor learning in children with autism spectrum disorder, showing an increased sensitivity to proprioceptive error and a decreased sensitivity to visual error, may be associated with abnormalities in the cerebellum. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Implementation of psychological clinical trials in epilepsy: Review and guide.

PubMed

Modi, Avani C; Wagner, Janelle; Smith, Aimee W; Kellermann, Tanja S; Michaelis, Rosa

2017-09-01

The International League Against Epilepsy (ILAE) Neuropsychiatry commission and United States Institute of Medicine report both identified cognitive and psychological comorbidities as a significant issue for individuals with epilepsy, with rates as high as 60%. However, there is a paucity of evidence-based treatments for many psychological conditions (e.g., learning disorders, cognitive disorders, behavioral disorders). Because of inherent challenges in the implementation of psychological therapy trials and specific considerations for the population with epilepsy, the focus of the current review was to provide guidance and recommendations to conduct psychological trials for individuals with epilepsy. Several key areas will be discussed, including selection of patients, trial design, psychological intervention considerations, outcomes and evaluation of results, publication of trial results, and special issues related to pediatric clinical trials. Rigorously designed psychological therapy trials will set the stage for evidence-based practice in the care of individuals with epilepsy, with the goal of improving seizures, side effects, and HRQOL. Copyright © 2017 Elsevier Inc. All rights reserved.

Stress and Fear Extinction

PubMed Central

Maren, Stephen; Holmes, Andrew

2016-01-01

Stress has a critical role in the development and expression of many psychiatric disorders, and is a defining feature of posttraumatic stress disorder (PTSD). Stress also limits the efficacy of behavioral therapies aimed at limiting pathological fear, such as exposure therapy. Here we examine emerging evidence that stress impairs recovery from trauma by impairing fear extinction, a form of learning thought to underlie the suppression of trauma-related fear memories. We describe the major structural and functional abnormalities in brain regions that are particularly vulnerable to stress, including the amygdala, prefrontal cortex, and hippocampus, which may underlie stress-induced impairments in extinction. We also discuss some of the stress-induced neurochemical and molecular alterations in these brain regions that are associated with extinction deficits, and the potential for targeting these changes to prevent or reverse impaired extinction. A better understanding of the neurobiological basis of stress effects on extinction promises to yield novel approaches to improving therapeutic outcomes for PTSD and other anxiety and trauma-related disorders. PMID:26105142

Comparison of Conditioning Impairments in Children with Down Syndrome, Autistic Spectrum Disorders and Mental Age-Matched Controls

ERIC Educational Resources Information Center

Reed, P.; Staytom, L.; Stott, S.; Truzoli, R.

2011-01-01

Background: This study investigated the relative ease of learning across four tasks suggested by an adaptation of Thomas's hierarchy of learning in children with Down syndrome, autism spectrum disorders and mental age-matched controls. Methods: Learning trials were carried out to investigate observational learning, instrumental learning, reversal…

Hoarding behaviors in children with learning disabilities.

PubMed

Testa, Renée; Pantelis, Christos; Fontenelle, Leonardo F

2011-05-01

Our objective was to describe the prevalence, comorbidity, and neuropsychological profiles of children with hoarding and learning disabilities. From 61 children with learning disabilities, 16.4% exhibited hoarding as a major clinical issue. Although children with learning disabilities and hoarding displayed greater rates of obsessive-compulsive disorder (30%) as compared to those with learning disabilities without hoarding (5.9%), the majority of patients belonging to the former group did not display obsessive-compulsive disorder diagnosis. When learning disability patients with hoarding were compared to age-, sex-, and IQ-matched learning disability subjects without hoarding, hoarders exhibited a slower learning curve on word list-learning task. In conclusion, salient hoarding behaviors were found to be relatively common in a sample of children with learning disabilities and not necessarily associated with obsessive-compulsive disorder, supporting its nosological independence. It is unclear whether underlying cognitive features may play a major role in the development of hoarding behaviors in children with learning disabilities.

Are They Learning? Are We? Learning Outcomes and the Academic Library

ERIC Educational Resources Information Center

Oakleaf, Megan

2011-01-01

Since the 1990s, the assessment of learning outcomes in academic libraries has accelerated rapidly, and librarians have come to recognize the necessity of articulating and assessing student learning outcomes. Initially, librarians developed tools and instruments to assess information literacy student learning outcomes. Now, academic librarians are…

Algorithmic analysis of relational learning processes in instructional technology: Some implications for basic, translational, and applied research.

PubMed

McIlvane, William J; Kledaras, Joanne B; Gerard, Christophe J; Wilde, Lorin; Smelson, David

2018-07-01

A few noteworthy exceptions notwithstanding, quantitative analyses of relational learning are most often simple descriptive measures of study outcomes. For example, studies of stimulus equivalence have made much progress using measures such as percentage consistent with equivalence relations, discrimination ratio, and response latency. Although procedures may have ad hoc variations, they remain fairly similar across studies. Comparison studies of training variables that lead to different outcomes are few. Yet to be developed are tools designed specifically for dynamic and/or parametric analyses of relational learning processes. This paper will focus on recent studies to develop (1) quality computer-based programmed instruction for supporting relational learning in children with autism spectrum disorders and intellectual disabilities and (2) formal algorithms that permit ongoing, dynamic assessment of learner performance and procedure changes to optimize instructional efficacy and efficiency. Because these algorithms have a strong basis in evidence and in theories of stimulus control, they may have utility also for basic and translational research. We present an overview of the research program, details of algorithm features, and summary results that illustrate their possible benefits. It also presents arguments that such algorithm development may encourage parametric research, help in integrating new research findings, and support in-depth quantitative analyses of stimulus control processes in relational learning. Such algorithms may also serve to model control of basic behavioral processes that is important to the design of effective programmed instruction for human learners with and without functional disabilities. Copyright © 2018 Elsevier B.V. All rights reserved.

Learning Disorder Diagnosis in High-Aptitude Postsecondary Students

ERIC Educational Resources Information Center

Wood, Sarah Clark

2012-01-01

The current study utilized data from screening and full evaluations for learning disabilities conducted at a university-based learning center. Results from the screening assessments were analyzed to determine the extent to which they predicted the diagnosis of learning disorders in postsecondary students. Mean scores from the screening assessments…

Working Memory in Children with Learning Disabilities: Rethinking the Criterion of Discrepancy

ERIC Educational Resources Information Center

Maehler, Claudia; Schuchardt, Kirsten

2011-01-01

The criterion of discrepancy is used to distinguish children with learning disorders from children with intellectual disabilities. The justification of the criterion of discrepancy for the diagnosis of learning disorders relies on the conviction of fundamental differences between children with learning difficulties with versus without discrepancy…

Evaluation of an online training program in eating disorders for health professionals in Australia.

PubMed

Brownlow, Rachel S; Maguire, Sarah; O'Dell, Adrienne; Dias-da-Costa, Catia; Touyz, Stephen; Russell, Janice

2015-01-01

Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders. The results of this study demonstrated that the online training program was an effective tool in increasing health professionals' level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals' personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings. The findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.

Can Cooperative Learning Achieve the Four Learning Outcomes of Physical Education? A Review of Literature

ERIC Educational Resources Information Center

Casey, Ashley; Goodyear, Victoria A.

2015-01-01

Physical learning, cognitive learning, social learning, and affective learning are positioned as the legitimate learning outcomes of physical education. It has been argued that these four learning outcomes go toward facilitating students' engagement with the physically active life (Bailey et al., 2009; Kirk, 2013). With Cooperative Learning…

Neurocomputational mechanisms of prosocial learning and links to empathy.

PubMed

Lockwood, Patricia L; Apps, Matthew A J; Valton, Vincent; Viding, Essi; Roiser, Jonathan P

2016-08-30

Reinforcement learning theory powerfully characterizes how we learn to benefit ourselves. In this theory, prediction errors-the difference between a predicted and actual outcome of a choice-drive learning. However, we do not operate in a social vacuum. To behave prosocially we must learn the consequences of our actions for other people. Empathy, the ability to vicariously experience and understand the affect of others, is hypothesized to be a critical facilitator of prosocial behaviors, but the link between empathy and prosocial behavior is still unclear. During functional magnetic resonance imaging (fMRI) participants chose between different stimuli that were probabilistically associated with rewards for themselves (self), another person (prosocial), or no one (control). Using computational modeling, we show that people can learn to obtain rewards for others but do so more slowly than when learning to obtain rewards for themselves. fMRI revealed that activity in a posterior portion of the subgenual anterior cingulate cortex/basal forebrain (sgACC) drives learning only when we are acting in a prosocial context and signals a prosocial prediction error conforming to classical principles of reinforcement learning theory. However, there is also substantial variability in the neural and behavioral efficiency of prosocial learning, which is predicted by trait empathy. More empathic people learn more quickly when benefitting others, and their sgACC response is the most selective for prosocial learning. We thus reveal a computational mechanism driving prosocial learning in humans. This framework could provide insights into atypical prosocial behavior in those with disorders of social cognition.

Spatial affect learning restricted in major depression relative to anxiety disorders and healthy controls.

PubMed

Gollan, Jackie K; Norris, Catherine J; Hoxha, Denada; Irick, John Stockton; Hawkley, Louise C; Cacioppo, John T

2014-01-01

Detecting and learning the location of unpleasant or pleasant scenarios, or spatial affect learning, is an essential skill that safeguards well-being (Crawford & Cacioppo, 2002). Potentially altered by psychiatric illness, this skill has yet to be measured in adults with and without major depressive disorder (MDD) and anxiety disorders (AD). This study enrolled 199 adults diagnosed with MDD and AD (n=53), MDD (n=47), AD (n=54), and no disorders (n=45). Measures included clinical interviews, self-reports, and a validated spatial affect task using affective pictures (IAPS; Lang, Bradley, & Cuthbert, 2005). Participants with MDD showed impaired spatial affect learning of negative stimuli and irrelevant learning of pleasant pictures compared with non-depressed adults. Adults with MDD may use a "GOOD is UP" heuristic reflected by their impaired learning of the opposite correlation (i.e., "BAD is UP") and performance in the pleasant version of the task.

Motor-auditory-visual integration: The role of the human mirror neuron system in communication and communication disorders

PubMed Central

Le Bel, Ronald M.; Pineda, Jaime A.; Sharma, Anu

2009-01-01

The mirror neuron system (MNS) is a trimodal system composed of neuronal populations that respond to motor, visual, and auditory stimulation, such as when an action is performed, observed, heard or read about. In humans, the MNS has been identified using neuro-imaging techniques (such as fMRI and mu suppression in the EEG). It reflects an integration of motor-auditory-visual information processing related to aspects of language learning including action understanding and recognition. Such integration may also form the basis for language-related constructs such as theory of mind. In this article, we review the MNS system as it relates to the cognitive development of language in typically developing children and in children at-risk for communication disorders, such as children with autism spectrum disorder (ASD) or hearing impairment. Studying MNS development in these children may help illuminate an important role of the MNS in children with communication disorders. Studies with deaf children are especially important because they offer potential insights into how the MNS is reorganized when one modality, such as audition, is deprived during early cognitive development, and this may have long-term consequences on language maturation and theory of mind abilities. Learning outcomes Readers will be able to (1) understand the concept of mirror neurons, (2) identify cortical areas associated with the MNS in animal and human studies, (3) discuss the use of mu suppression in the EEG for measuring the MNS in humans, and (4) discuss MNS dysfunction in children with (ASD). PMID:19419735

Invariance of Woodcock-Johnson III Scores for Students with Learning Disorders and Students without Learning Disorders

ERIC Educational Resources Information Center

Benson, Nicholas; Taub, Gordon E.

2013-01-01

The purpose of this study was to test the invariance of scores derived from the Woodcock-Johnson III Tests of Cognitive Ability (WJ III COG) and Woodcock-Johnson III Tests of Academic Achievement (WJ III ACH) across a group of students diagnosed with learning disorders (n = 994) and a matched sample of students without known clinical diagnoses (n…

Outcomes-Based Assessment and Learning: Trialling Change in a Postgraduate Civil Engineering Course

ERIC Educational Resources Information Center

El-Maaddawy, Tamer; Deneen, Christopher

2017-01-01

This paper aims to demonstrate how assessment tasks can function within an outcomes-based learning framework to evaluate student attainment of learning outcomes. An outcomes-based learning framework designed to integrate teaching, learning, and assessment activities was developed and implemented in a civil engineering master-level course. The…

Neural changes associated to procedural learning and automatization process in Developmental Coordination Disorder and/or Developmental Dyslexia.

PubMed

Biotteau, Maëlle; Péran, Patrice; Vayssière, Nathalie; Tallet, Jessica; Albaret, Jean-Michel; Chaix, Yves

2017-03-01

Recent theories hypothesize that procedural learning may support the frequent overlap between neurodevelopmental disorders. The neural circuitry supporting procedural learning includes, among others, cortico-cerebellar and cortico-striatal loops. Alteration of these loops may account for the frequent comorbidity between Developmental Coordination Disorder (DCD) and Developmental Dyslexia (DD). The aim of our study was to investigate cerebral changes due to the learning and automatization of a sequence learning task in children with DD, or DCD, or both disorders. fMRI on 48 children (aged 8-12) with DD, DCD or DD + DCD was used to explore their brain activity during procedural tasks, performed either after two weeks of training or in the early stage of learning. Firstly, our results indicate that all children were able to perform the task with the same level of automaticity, but recruit different brain processes to achieve the same performance. Secondly, our fMRI results do not appear to confirm Nicolson and Fawcett's model. The neural correlates recruited for procedural learning by the DD and the comorbid groups are very close, while the DCD group presents distinct characteristics. This provide a promising direction on the neural mechanisms associated with procedural learning in neurodevelopmental disorders and for understanding comorbidity. Published by Elsevier Ltd.

ASSESSING THE KNOWLEDGE, ATTITUDES AND PRACTICES OF SCHOOL TEACHERS REGARDING DYSLEXIA, ATTENTION-DEFICIT/ HYPERACTIVITY AND AUTISTIC SPECTRUM DISORDERS IN KARACHI, PAKISTAN.

PubMed

Lodhi, Shaia Kan; Thaver, Danyal; Akhtar, Irfan Nake; Javaid, Hina; Masoor, Maman; Bano, Shah; Malik, Fatima Noor; Iqbal, Mehreen Rizwana; Hashmi, Hassan Raza; Siddiqullah, Syed; Saleem, Sarah

2016-01-01

Learning impairments in children consist of a spectrum of disorders that are under diagnosed in Pakistan. Most learning disorders have long term consequences for a child and early detection is thus imperative. Teachers may be able to play a key role in such identification. The objective of our study was to survey knowledge, attitudes and practices of school teachers regarding dyslexia, Attention-deficit/hyperactivity disorder (ADHD) and autistic spectrum disorder, and assess their ability to identify learning disabilities. A cross-sectional study was conducted with 233 primary school teachers from Karachi using a self-administered questionnaire. Mean scores for the knowledge test and the ability to identify learning- impaired children were 58.8% and 53.3%, respectively. Better qualified teachers scored significantly more on the knowledge and ability to identify learning impairments sections. Most teachers believed that these students should study in mainstream schools with special educators. Majority of the teachers belonged to schools where children with learning disabilities were detected using teachers' judgment. Most teachers manage these children by involving them in discussions, seating them at the front of the class, and giving them extra time. Knowledge about learning disabilities is very low amongst school teachers, which may limit their ability to identify learning impairments.

Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

ERIC Educational Resources Information Center

O'Neil, Kelly A.; Kendall, Philip C.

2012-01-01

This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety…

Learning from other people’s fear: amygdala-based social reference learning in social anxiety disorder

PubMed Central

Blair, K. S.; Otero, M.; Teng, C.; Geraci, M.; Lewis, E.; Hollon, N.; Blair, R. J. R.; Ernst, Monique; Grillon, C.; Pine, D. S.

2016-01-01

Background Social anxiety disorder involves fear of social objects or situations. Social referencing may play an important role in the acquisition of this fear and could be a key determinant in future biomarkers and treatment pathways. However, the neural underpinnings mediating such learning in social anxiety are unknown. Using event-related functional magnetic resonance imaging, we examined social reference learning in social anxiety disorder. Specifically, would patients with the disorder show increased amygdala activity during social reference learning, and further, following social reference learning, show particularly increased response to objects associated with other people’s negative reactions? Method A total of 32 unmedicated patients with social anxiety disorder and 22 age-, intelligence quotient- and gender-matched healthy individuals responded to objects that had become associated with others’ fearful, angry, happy or neutral reactions. Results During the social reference learning phase, a significant group × social context interaction revealed that, relative to the comparison group, the social anxiety group showed a significantly greater response in the amygdala, as well as rostral, dorsomedial and lateral frontal and parietal cortices during the social, relative to non-social, referencing trials. In addition, during the object test phase, relative to the comparison group, the social anxiety group showed increased bilateral amygdala activation to objects associated with others’ fearful reactions, and a trend towards decreased amygdala activation to objects associated with others’ happy and neutral reactions. Conclusions These results suggest perturbed observational learning in social anxiety disorder. In addition, they further implicate the amygdala and dorsomedial prefrontal cortex in the disorder, and underscore their importance in future biomarker developments. PMID:27476529

Primary care-based multifaceted, interdisciplinary medical educational intervention for patients with systolic heart failure: lessons learned from a cluster randomised controlled trial.

PubMed

Peters-Klimm, Frank; Campbell, Stephen; Müller-Tasch, Thomas; Schellberg, Dieter; Gelbrich, Goetz; Herzog, Wolfgang; Szecsenyi, Joachim

2009-08-13

Chronic (systolic) heart failure (CHF) is a common and disabling condition. Adherence to evidence-based guidelines in primary care has been shown to improve health outcomes. The aim was to explore the impact of a multidisciplinary educational intervention for general practitioners (GPs) (Train the trainer = TTT) on patient and performance outcomes. This paper presents the key findings from the trial and discusses the lessons learned during the implementation of the TTT trial. Primary care practices were randomly assigned to the TTT intervention or to the control group. 37 GPs (18 TTT, 19 control) were randomised and 168 patients diagnosed with ascertained CHF (91 TTT, 77 control) were enrolled. GPs in the intervention group attended four meetings addressing clinical practice guidelines and pharmacotherapy feedback. The primary outcome was patient self-reported quality of life at seven months, using the SF-36 Physical Functioning scale. Secondary outcomes included other SF-36 scales, the Kansas City Cardiomyopathy Questionnaire (KCCQ), total mortality, heart failure hospital admissions, prescribing, depressive disorders (PHQ-9), behavioural change (European Heart Failure Self-Care Behaviour Scale), patient-perceived quality of care (EUROPEP) and improvement of heart failure using NT-proBNP-levels. Because recruitment targets were not achieved an exploratory analysis was conducted. There was high baseline achievement in both groups for many outcomes. At seven months, there were no significant mean difference between groups for the primary outcome measure (-3.3, 95%CI -9.7 to 3.1, p = 0.30). The only difference in secondary outcomes related to the prescribing of aldosterone antagonists by GPs in the intervention group, with significant between group differences at follow-up (42 vs. 24%, adjusted OR = 4.0, 95%CI 1.2-13; p = 0.02). The intervention did not change the primary outcome or most secondary outcomes. Recruitment targets were not achieved and the under-recruitment of practices and patients alongside a selection bias of participating GPs, prohibit definite conclusions, but the CI indicates a non-effectiveness of the intervention in this sample. We describe the lessons learned from conducting the trial for the future planning and conduct of confirmatory trials in primary care. ISRCTN08601529.

Primary care-based multifaceted, interdisciplinary medical educational intervention for patients with systolic heart failure: lessons learned from a cluster randomised controlled trial

PubMed Central

Peters-Klimm, Frank; Campbell, Stephen; Müller-Tasch, Thomas; Schellberg, Dieter; Gelbrich, Goetz; Herzog, Wolfgang; Szecsenyi, Joachim

2009-01-01

Background Chronic (systolic) heart failure (CHF) is a common and disabling condition. Adherence to evidence-based guidelines in primary care has been shown to improve health outcomes. The aim was to explore the impact of a multidisciplinary educational intervention for general practitioners (GPs) (Train the trainer = TTT) on patient and performance outcomes. Methods This paper presents the key findings from the trial and discusses the lessons learned during the implementation of the TTT trial. Primary care practices were randomly assigned to the TTT intervention or to the control group. 37 GPs (18 TTT, 19 control) were randomised and 168 patients diagnosed with ascertained CHF (91 TTT, 77 control) were enrolled. GPs in the intervention group attended four meetings addressing clinical practice guidelines and pharmacotherapy feedback. The primary outcome was patient self-reported quality of life at seven months, using the SF-36 Physical Functioning scale. Secondary outcomes included other SF-36 scales, the Kansas City Cardiomyopathy Questionnaire (KCCQ), total mortality, heart failure hospital admissions, prescribing, depressive disorders (PHQ-9), behavioural change (European Heart Failure Self-Care Behaviour Scale), patient-perceived quality of care (EUROPEP) and improvement of heart failure using NT-proBNP-levels. Because recruitment targets were not achieved an exploratory analysis was conducted. Results There was high baseline achievement in both groups for many outcomes. At seven months, there were no significant mean difference between groups for the primary outcome measure (-3.3, 95%CI -9.7 to 3.1, p = 0.30). The only difference in secondary outcomes related to the prescribing of aldosterone antagonists by GPs in the intervention group, with significant between group differences at follow-up (42 vs. 24%, adjusted OR = 4.0, 95%CI 1.2–13; p = 0.02). Conclusion The intervention did not change the primary outcome or most secondary outcomes. Recruitment targets were not achieved and the under-recruitment of practices and patients alongside a selection bias of participating GPs, prohibit definite conclusions, but the CI indicates a non-effectiveness of the intervention in this sample. We describe the lessons learned from conducting the trial for the future planning and conduct of confirmatory trials in primary care. Trial registration ISRCTN08601529. PMID:19678944

Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Interventions

ERIC Educational Resources Information Center

Matthys, Walter; Vanderschuren, Louk J. M. J.; Schutter, Dennis J. L. G.; Lochman, John E.

2012-01-01

In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive…

Understanding Cognitive Presence in an Online and Blended Community of Inquiry: Assessing Outcomes and Processes for Deep Approaches to Learning

ERIC Educational Resources Information Center

Akyol, Zehra; Garrison, D. Randy

2011-01-01

This paper focuses on deep and meaningful learning approaches and outcomes associated with online and blended communities of inquiry. Applying mixed methodology for the research design, the study used transcript analysis, learning outcomes, perceived learning, satisfaction, and interviews to assess learning processes and outcomes. The findings for…

Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for cognitive training☆

PubMed Central

Krause, Beatrix; Cohen Kadosh, Roi

2013-01-01

Learning difficulties in atypical brain development represent serious obstacles to an individual's future achievements and can have broad societal consequences. Cognitive training can improve learning impairments only to a certain degree. Recent evidence from normal and clinical adult populations suggests that transcranial electrical stimulation (TES), a portable, painless, inexpensive, and relatively safe neuroenhancement tool, applied in conjunction with cognitive training can enhance cognitive intervention outcomes. This includes, for instance, numerical processing, language skills and response inhibition deficits commonly associated with profound learning difficulties and attention-deficit hyperactivity disorder (ADHD). The current review introduces the functional principles, current applications and promising results, and potential pitfalls of TES. Unfortunately, research in child populations is limited at present. We suggest that TES has considerable promise as a tool for increasing neuroplasticity in atypically developing children and may be an effective adjunct to cognitive training in clinical settings if it proves safe. The efficacy and both short- and long-term effects of TES on the developing brain need to be critically assessed before it can be recommended for clinical settings. PMID:23770059

Desired Outcomes for Children and Adolescents with Autistic Spectrum Disorders

ERIC Educational Resources Information Center

Beresford, Bryony; Tozer, Rosemary; Rabiee, Parvaneh; Sloper, Patricia

2007-01-01

Within children's services, frameworks for assessing outcomes have been developed in the absence of consultation with children with autistic spectrum disorders and their parents. The research reported here worked with parents, other key adults and children with autistic spectrum disorders to identify desired outcomes. It found similarities with…

Predictors of outcome for cognitive behaviour therapy in binge eating disorder.

PubMed

Lammers, Mirjam W; Vroling, Maartje S; Ouwens, Machteld A; Engels, Rutger C M E; van Strien, Tatjana

2015-05-01

The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N = 304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6 months later (N = 190). We assessed eating disorder psychopathology, general psychopathology, personality characteristics and demographic variables using self-report questionnaires. Treatment outcome was measured using the bulimia subscale of the Eating Disorder Inventory 1. Predictors were determined using hierarchical linear regression analyses. Several variables significantly predicted outcome, four of which were found to be both baseline predictors of treatment outcome and end-of-treatment predictors of follow-up: Higher levels of drive for thinness, higher levels of interoceptive awareness, lower levels of binge eating pathology and, in women, lower levels of body dissatisfaction predicted better outcome in the short and longer term. Based on these results, several suggestions are made to improve treatment outcome for BED patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Mathematics intervention for children with fetal alcohol spectrum disorder: A replication and extension of the math interactive learning experience (MILE) program.

PubMed

Kully-Martens, Katrina; Pei, Jacqueline; Kable, Julie; Coles, Claire D; Andrew, Gail; Rasmussen, Carmen

2018-07-01

Individuals with fetal alcohol spectrum disorders (FASD) experience deficits in behavior, cognition, and academic functioning resulting from prenatal alcohol exposure (PAE). Although receiving intervention for developmental disabilities is a strong protective factor against negative outcomes in FASD, intervention research in this population is in its infancy. The purpose of this study was to replicate and extend a mathematics intervention, the Math Interactive Learning Experience (MILE) program, which was developed in the USA specifically for children with FASD. Twenty-eight Canadian children aged 4-10 years with confirmed PAE or an FASD diagnosis were assigned to either the MILE intervention or a contrast intervention. Following a relatively brief, individualized, one-on-one intervention, children in the MILE group demonstrated significantly greater changes in math achievement compared to the contrast group. Significant changes in other cognitive functions were not observed. Older age, lower IQ, and confirmed PAE but no FASD diagnosis were associated with greater math achievement change in the MILE group. The replication and extension of the math intervention appears to have significant, positive impact on mathematics achievement scores of children with PAE and FASD. Copyright © 2018 Elsevier Ltd. All rights reserved.

Automated Tracking and Quantification of Autistic Behavioral Symptoms Using Microsoft Kinect.

PubMed

Kang, Joon Young; Kim, Ryunhyung; Kim, Hyunsun; Kang, Yeonjune; Hahn, Susan; Fu, Zhengrui; Khalid, Mamoon I; Schenck, Enja; Thesen, Thomas

2016-01-01

The prevalence of autism spectrum disorder (ASD) has risen significantly in the last ten years, and today, roughly 1 in 68 children has been diagnosed. One hallmark set of symptoms in this disorder are stereotypical motor movements. These repetitive movements may include spinning, body-rocking, or hand-flapping, amongst others. Despite the growing number of individuals affected by autism, an effective, accurate method of automatically quantifying such movements remains unavailable. This has negative implications for assessing the outcome of ASD intervention and drug studies. Here we present a novel approach to detecting autistic symptoms using the Microsoft Kinect v.2 to objectively and automatically quantify autistic body movements. The Kinect camera was used to film 12 actors performing three separate stereotypical motor movements each. Visual Gesture Builder (VGB) was implemented to analyze the skeletal structures in these recordings using a machine learning approach. In addition, movement detection was hard-coded in Matlab. Manual grading was used to confirm the validity and reliability of VGB and Matlab analysis. We found that both methods were able to detect autistic body movements with high probability. The machine learning approach yielded highest detection rates, supporting its use in automatically quantifying complex autistic behaviors with multi-dimensional input.

Cognitive Enhancers for Facilitating Drug Cue Extinction: Insights from Animal Models

PubMed Central

Nic Dhonnchadha, Bríd Áine; Kantak, Kathleen M.

2011-01-01

Given the success of cue exposure (extinction) therapy combined with a cognitive enhancer for reducing anxiety, it is anticipated that this approach will prove more efficacious than exposure therapy alone in preventing relapse in individuals with substance use disorders. Several factors may undermine the efficacy of exposure therapy for substance use disorders, but we suspect that neurocognitive impairments associated with chronic drug use are an important contributing factor. Numerous insights on these issues are gained from research using animal models of addiction. In this review, the relationship between brain sites whose learning, memory and executive functions are impaired by chronic drug use and brain sites that are important for effective drug cue extinction learning is explored first. This is followed by an overview of animal research showing improved treatment outcome for drug addiction (e.g. alcohol, amphetamine, cocaine, heroin) when explicit extinction training is conducted in combination with acute dosing of a cognitive-enhancing drug. The mechanism by which cognitive enhancers are thought to exert their benefits is by facilitating consolidation of drug cue extinction memory after activation of glutamatergic receptors. Based on the encouraging work in animals, factors that may be important for the treatment of drug addiction are considered. PMID:21295059

The Feedback-related Negativity Codes Components of Abstract Inference during Reward-based Decision-making.

PubMed

Reiter, Andrea M F; Koch, Stefan P; Schröger, Erich; Hinrichs, Hermann; Heinze, Hans-Jochen; Deserno, Lorenz; Schlagenhauf, Florian

2016-08-01

Behavioral control is influenced not only by learning from the choices made and the rewards obtained but also by "what might have happened," that is, inference about unchosen options and their fictive outcomes. Substantial progress has been made in understanding the neural signatures of direct learning from choices that are actually made and their associated rewards via reward prediction errors (RPEs). However, electrophysiological correlates of abstract inference in decision-making are less clear. One seminal theory suggests that the so-called feedback-related negativity (FRN), an ERP peaking 200-300 msec after a feedback stimulus at frontocentral sites of the scalp, codes RPEs. Hitherto, the FRN has been predominantly related to a so-called "model-free" RPE: The difference between the observed outcome and what had been expected. Here, by means of computational modeling of choice behavior, we show that individuals employ abstract, "double-update" inference on the task structure by concurrently tracking values of chosen stimuli (associated with observed outcomes) and unchosen stimuli (linked to fictive outcomes). In a parametric analysis, model-free RPEs as well as their modification because of abstract inference were regressed against single-trial FRN amplitudes. We demonstrate that components related to abstract inference uniquely explain variance in the FRN beyond model-free RPEs. These findings advance our understanding of the FRN and its role in behavioral adaptation. This might further the investigation of disturbed abstract inference, as proposed, for example, for psychiatric disorders, and its underlying neural correlates.

Auditory and Visual Working Memory Functioning in College Students with Attention-Deficit/Hyperactivity Disorder and/or Learning Disabilities.

PubMed

Liebel, Spencer W; Nelson, Jason M

2017-12-01

We investigated the auditory and visual working memory functioning in college students with attention-deficit/hyperactivity disorder, learning disabilities, and clinical controls. We examined the role attention-deficit/hyperactivity disorder subtype status played in working memory functioning. The unique influence that both domains of working memory have on reading and math abilities was investigated. A sample of 268 individuals seeking postsecondary education comprise four groups of the present study: 110 had an attention-deficit/hyperactivity disorder diagnosis only, 72 had a learning disability diagnosis only, 35 had comorbid attention-deficit/hyperactivity disorder and learning disability diagnoses, and 60 individuals without either of these disorders comprise a clinical control group. Participants underwent a comprehensive neuropsychological evaluation, and licensed psychologists employed a multi-informant, multi-method approach in obtaining diagnoses. In the attention-deficit/hyperactivity disorder only group, there was no difference between auditory and visual working memory functioning, t(100) = -1.57, p = .12. In the learning disability group, however, auditory working memory functioning was significantly weaker compared with visual working memory, t(71) = -6.19, p < .001, d = -0.85. Within the attention-deficit/hyperactivity disorder only group, there were no auditory or visual working memory functioning differences between participants with either a predominantly inattentive type or a combined type diagnosis. Visual working memory did not incrementally contribute to the prediction of academic achievement skills. Individuals with attention-deficit/hyperactivity disorder did not demonstrate significant working memory differences compared with clinical controls. Individuals with a learning disability demonstrated weaker auditory working memory than individuals in either the attention-deficit/hyperactivity or clinical control groups. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Application of machine learning classification for structural brain MRI in mood disorders: Critical review from a clinical perspective.

PubMed

Kim, Yong-Ku; Na, Kyoung-Sae

2018-01-03

Mood disorders are a highly prevalent group of mental disorders causing substantial socioeconomic burden. There are various methodological approaches for identifying the underlying mechanisms of the etiology, symptomatology, and therapeutics of mood disorders; however, neuroimaging studies have provided the most direct evidence for mood disorder neural substrates by visualizing the brains of living individuals. The prefrontal cortex, hippocampus, amygdala, thalamus, ventral striatum, and corpus callosum are associated with depression and bipolar disorder. Identifying the distinct and common contributions of these anatomical regions to depression and bipolar disorder have broadened and deepened our understanding of mood disorders. However, the extent to which neuroimaging research findings contribute to clinical practice in the real-world setting is unclear. As traditional or non-machine learning MRI studies have analyzed group-level differences, it is not possible to directly translate findings from research to clinical practice; the knowledge gained pertains to the disorder, but not to individuals. On the other hand, a machine learning approach makes it possible to provide individual-level classifications. For the past two decades, many studies have reported on the classification accuracy of machine learning-based neuroimaging studies from the perspective of diagnosis and treatment response. However, for the application of a machine learning-based brain MRI approach in real world clinical settings, several major issues should be considered. Secondary changes due to illness duration and medication, clinical subtypes and heterogeneity, comorbidities, and cost-effectiveness restrict the generalization of the current machine learning findings. Sophisticated classification of clinical and diagnostic subtypes is needed. Additionally, as the approach is inevitably limited by sample size, multi-site participation and data-sharing are needed in the future. Copyright © 2017 Elsevier Inc. All rights reserved.

Quantifiable outcomes from corporate and higher education learning collaborations

NASA Astrophysics Data System (ADS)

Devine, Thomas G.

The study investigated the existence of measurable learning outcomes that emerged out of the shared strengths of collaborating sponsors. The study identified quantifiable learning outcomes that confirm corporate, academic and learner participation in learning collaborations. Each of the three hypotheses and the synergy indicator quantitatively and qualitatively confirmed learning outcomes benefiting participants. The academic-indicator quantitatively confirmed that learning outcomes attract learners to the institution. The corporate-indicator confirmed that learning outcomes include knowledge exchange and enhanced workforce talents for careers in the energy-utility industry. The learner-indicator confirmed that learning outcomes provide professional development opportunities for employment. The synergy-indicator confirmed that best learning practices in learning collaborations emanate out of the sponsors' shared strengths, and that partnerships can be elevated to strategic alliances, going beyond response to the desires of sponsors to create learner-centered cultures. The synergy-indicator confirmed the value of organizational processes that elevate sponsors' interactions to sharing strength, to create a learner-centered culture. The study's series of qualitative questions confirmed prior success factors, while verifying the hypothesis results and providing insight not available from quantitative data. The direct benefactors of the study are the energy-utility learning-collaboration participants of the study, and corporation, academic institutions, and learners of the collaboration. The indirect benefactors are the stakeholders of future learning collaborations, through improved knowledge of the existence or absence of quantifiable learning outcomes.

Analysing Learning Outcomes in an Electrical Engineering Curriculum Using Illustrative Verbs Derived from Bloom's Taxonomy

ERIC Educational Resources Information Center

Meda, Lawrence; Swart, Arthur James

2018-01-01

Learning outcomes are essential to any curriculum in education, where they need to be clear, observable and measurable. However, some academics structure learning outcomes in a way that does not promote student learning. The purpose of this article is to present the analyses of learning outcomes of an Electrical Engineering curriculum offered at a…

Adult Learning Disorders: Contemporary Issues

ERIC Educational Resources Information Center

Wolf, Lorraine E., Ed.; Schreiber, Hope E., Ed.; Wasserstein, Jeanette, Ed.

2008-01-01

Recent advances in neuroimaging and genetics technologies have enhanced our understanding of neurodevelopmental disorders in adults. The authors in this volume not only discuss such advances as they apply to adults with learning disorders, but also address their translation into clinical practice. One cluster of chapters addresses developmental…

Region-specific impairments in striatal synaptic transmission and impaired instrumental learning in a mouse model of Angelman syndrome

PubMed Central

Hayrapetyan, Volodya; Castro, Stephen; Sukharnikova, Tatyana; Yu, Chunxiu; Cao, Xinyu; Jiang, Yong-Hui; Yin, Henry H.

2018-01-01

Angelman syndrome (AS) is a neurodevelopmental disorder characterized by mental retardation and impaired speech. Because patients with this disorder often exhibit motor tremor and stereotypical behaviors, which are associated with basal ganglia pathology, we hypothesized that AS is accompanied by abnormal functioning of the striatum, the input nucleus of the basal ganglia. Using mutant mice with maternal deficiency of AS E6-AP ubiquitin protein ligase Ube3a (Ube3am−/p+), we assessed the effects of Ube3a deficiency on instrumental conditioning, a striatum-dependent task. We used whole-cell patch-clamp recording to measure glutamatergic transmission in the dorsomedial striatum (DMS) and dorsolateral striatum (DLS). Ube3am−/p+ mice were severely impaired in initial acquisition of lever pressing. Whereas the lever pressing of wild-type controls was reduced by outcome devaluation and instrumental contingency reversal, the performance of Ube3am−/p+ mice were more habitual, impervious to changes in outcome value and action–outcome contingency. In the DMS, but not the DLS, Ube3am−/p+ mice showed reduced amplitude and frequency of miniature excitatory postsynaptic currents. These results show for the first time a selective deficit in instrumental conditioning in the Ube3a deficient mouse model, and suggest a specific impairment in glutmatergic transmission in the associative corticostriatal circuit in AS. PMID:24329862

Postsecondary education and employment among youth with an autism spectrum disorder.

PubMed

Shattuck, Paul T; Narendorf, Sarah Carter; Cooper, Benjamin; Sterzing, Paul R; Wagner, Mary; Taylor, Julie Lounds

2012-06-01

We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD). Data were from a nationally representative survey of parents, guardians, and young adults with an ASD. Participation in postsecondary employment, college, or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in 3 other eligibility categories: speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome. For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first 6 years after high school. More than 50% of youth who had left high school in the past 2 years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared with youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education. Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school. Those from lower-income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning before high school exit can facilitate a better connection to productive postsecondary activities.

An investigation of habit learning in Anorexia Nervosa.

PubMed

Godier, Lauren R; de Wit, Sanne; Pinto, Anthony; Steinglass, Joanna E; Greene, Ashley L; Scaife, Jessica; Gillan, Claire M; Walsh, B Timothy; Simpson, Helen-Blair; Park, Rebecca J

2016-10-30

Anorexia Nervosa (AN) is a disorder characterised by compulsive behaviour, such as self-starvation and excessive exercise, which develop in the pursuit of weight-loss. Recent theory suggests that once established, compulsive weight-loss behaviours in AN may become habitual. In two parallel studies, we measured whether individuals with AN showed a bias toward habits using two outcome-devaluation tasks. In Study 1, 23 women with AN (restrictive and binge/purge subtypes), and 18 healthy controls (HC) completed the slips-of-action paradigm, designed to assess reward-based habits. In Study 2, 13 women with restrictive AN, 14 women recovered from restrictive AN, and 17 female HC participants completed the slips-of-action paradigm, and an avoidance paradigm, designed to assess aversive habits. AN participants showed no deficit relative to HCs in the ability to use feedback to respond correctly to stimuli. Following devaluation of outcomes, all groups in both studies were equally able to withhold inappropriate responses, suggesting no deficit in the balance between goal-directed and habitual control of behaviour in these tasks in AN. These results suggest that individuals with AN do not show a generalised tendency to rely on habits in two outcome-devaluation tasks. Future research is needed to investigate the potential role of disorder-specific habits in the maintenance of behaviour in AN. Copyright © 2016. Published by Elsevier Ireland Ltd.

Visual and Verbal Learning in a Genetic Metabolic Disorder

ERIC Educational Resources Information Center

Spilkin, Amy M.; Ballantyne, Angela O.; Trauner, Doris A.

2009-01-01

Visual and verbal learning in a genetic metabolic disorder (cystinosis) were examined in the following three studies. The goal of Study I was to provide a normative database and establish the reliability and validity of a new test of visual learning and memory (Visual Learning and Memory Test; VLMT) that was modeled after a widely used test of…

Support for Learning Goes beyond Academic Support: Voices of Students with Asperger's Disorder and Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Bolic Baric, Vedrana; Hellberg, Kristina; Kjellberg, Anette; Hemmingsson, Helena

2016-01-01

The purpose of this study was to describe and explore the experiences of support at school among young adults with Asperger's disorder and attention deficit hyperactivity disorder and also to examine what support they, in retrospect, described as influencing learning. Purposive sampling was used to enroll participants. Data were collected through…

A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism Spectrum Disorder.

PubMed

Whitehouse, Andrew J O; Granich, Joanna; Alvares, Gail; Busacca, Margherita; Cooper, Matthew N; Dass, Alena; Duong, Thi; Harper, Rajes; Marshall, Wendy; Richdale, Amanda; Rodwell, Tania; Trembath, David; Vellanki, Pratibha; Moore, Dennis W; Anderson, Angelika

2017-09-01

Technology-based interventions for Autism Spectrum Disorder (ASD) have proliferated, but few have been evaluated within the context of a randomised controlled trial (RCT). This RCT evaluated the efficacy of one technology-based early intervention programme (Therapy Outcomes By You; TOBY) in young children with ASD. TOBY is an app-based learning curriculum designed for children and parents as a complement to early behavioural intervention. Eighty children (16 female) were recruited to this RCT within 12 months of receiving a diagnosis of ASD (M age = 3.38; SD = 0.69) and randomised to receive either treatment-as-usual (community-based intervention, n = 39) or the TOBY therapy (at least 20 min/day) plus treatment-as-usual (n = 41) for a period of 6 months. Outcomes were assessed at 3 and 6 months postbaseline. (Australian New Zealand Clinical Trials Registry: ACTRN12614000738628; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365463). Children in the TOBY intervention group averaged 19 min/day engaging with the app in the first 3 months, but only 2 min/day during the second 3 months. There was no group difference in scores on the primary outcome, the Autism Treatment Evaluation Checklist, at either the 3- or 6-month follow-up. However, significant improvements at the 6-month follow-up were observed in the TOBY intervention group relative to the treatment-as-usual group on three secondary outcomes: the Fine Motor and Visual Reception subscales of the Mullen Scale of Early Learning and the Total Words Understood scale of the MacArthur-Bates Communicative Development Index. Statistical trends towards improvement in the TOBY intervention group were observed on measures of adaptive function, although these decreased in magnitude from the 3- to 6-month follow-up. This study provides evidence that technology-based interventions may provide a relatively low-cost addition to existing therapist-delivered interventions for children with ASD. However, sustained use of the app over the full 6-month period was a challenge for most families. © 2017 Association for Child and Adolescent Mental Health.

Secret Destinations

ERIC Educational Resources Information Center

Buss, David

2008-01-01

"All journeys have secret destinations of which the traveller is unaware" (Martin Buber). All learning results in learning outcomes of some form, planned or otherwise, but the term is now widely used to refer only to those learning outcomes that predetermine what those outcomes will be--the "intended" or "specified" learning outcomes of the…

Moderation of the Relationship Between Reward Expectancy and Prediction Error-Related Ventral Striatal Reactivity by Anhedonia in Unmedicated Major Depressive Disorder: Findings From the EMBARC Study

PubMed Central

Greenberg, Tsafrir; Chase, Henry W.; Almeida, Jorge R.; Stiffler, Richelle; Zevallos, Carlos R.; Aslam, Haris A.; Deckersbach, Thilo; Weyandt, Sarah; Cooper, Crystal; Toups, Marisa; Carmody, Thomas; Kurian, Benji; Peltier, Scott; Adams, Phillip; McInnis, Melvin G.; Oquendo, Maria A.; McGrath, Patrick J.; Fava, Maurizio; Weissman, Myrna; Parsey, Ramin; Trivedi, Madhukar H.; Phillips, Mary L.

2016-01-01

Objective Anhedonia, disrupted reward processing, is a core symptom of major depressive disorder. Recent findings demonstrate altered reward-related ventral striatal reactivity in depressed individuals, but the extent to which this is specific to anhedonia remains poorly understood. The authors examined the effect of anhedonia on reward expectancy (expected outcome value) and prediction error-(discrepancy between expected and actual outcome) related ventral striatal reactivity, as well as the relationship between these measures. Method A total of 148 unmedicated individuals with major depressive disorder and 31 healthy comparison individuals recruited for the multisite EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care) study underwent functional MRI during a well-validated reward task. Region of interest and whole-brain data were examined in the first- (N=78) and second- (N=70) recruited cohorts, as well as the total sample, of depressed individuals, and in healthy individuals. Results Healthy, but not depressed, individuals showed a significant inverse relationship between reward expectancy and prediction error-related right ventral striatal reactivity. Across all participants, and in depressed individuals only, greater anhedonia severity was associated with a reduced reward expectancy-prediction error inverse relationship, even after controlling for other symptoms. Conclusions The normal reward expectancy and prediction error-related ventral striatal reactivity inverse relationship concords with conditioning models, predicting a shift in ventral striatal responding from reward outcomes to reward cues. This study shows, for the first time, an absence of this relationship in two cohorts of unmedicated depressed individuals and a moderation of this relationship by anhedonia, suggesting reduced reward-contingency learning with greater anhedonia. These findings help elucidate neural mechanisms of anhedonia, as a step toward identifying potential biosignatures of treatment response. PMID:26183698

Moderation of the Relationship Between Reward Expectancy and Prediction Error-Related Ventral Striatal Reactivity by Anhedonia in Unmedicated Major Depressive Disorder: Findings From the EMBARC Study.

PubMed

Greenberg, Tsafrir; Chase, Henry W; Almeida, Jorge R; Stiffler, Richelle; Zevallos, Carlos R; Aslam, Haris A; Deckersbach, Thilo; Weyandt, Sarah; Cooper, Crystal; Toups, Marisa; Carmody, Thomas; Kurian, Benji; Peltier, Scott; Adams, Phillip; McInnis, Melvin G; Oquendo, Maria A; McGrath, Patrick J; Fava, Maurizio; Weissman, Myrna; Parsey, Ramin; Trivedi, Madhukar H; Phillips, Mary L

2015-09-01

Anhedonia, disrupted reward processing, is a core symptom of major depressive disorder. Recent findings demonstrate altered reward-related ventral striatal reactivity in depressed individuals, but the extent to which this is specific to anhedonia remains poorly understood. The authors examined the effect of anhedonia on reward expectancy (expected outcome value) and prediction error- (discrepancy between expected and actual outcome) related ventral striatal reactivity, as well as the relationship between these measures. A total of 148 unmedicated individuals with major depressive disorder and 31 healthy comparison individuals recruited for the multisite EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care) study underwent functional MRI during a well-validated reward task. Region of interest and whole-brain data were examined in the first- (N=78) and second- (N=70) recruited cohorts, as well as the total sample, of depressed individuals, and in healthy individuals. Healthy, but not depressed, individuals showed a significant inverse relationship between reward expectancy and prediction error-related right ventral striatal reactivity. Across all participants, and in depressed individuals only, greater anhedonia severity was associated with a reduced reward expectancy-prediction error inverse relationship, even after controlling for other symptoms. The normal reward expectancy and prediction error-related ventral striatal reactivity inverse relationship concords with conditioning models, predicting a shift in ventral striatal responding from reward outcomes to reward cues. This study shows, for the first time, an absence of this relationship in two cohorts of unmedicated depressed individuals and a moderation of this relationship by anhedonia, suggesting reduced reward-contingency learning with greater anhedonia. These findings help elucidate neural mechanisms of anhedonia, as a step toward identifying potential biosignatures of treatment response.

Valence and agency influence striatal response to feedback in patients with major depressive disorder

PubMed Central

Späti, Jakub; Chumbley, Justin; Doerig, Nadja; Brakowski, Janis; Holtforth, Martin Grosse; Seifritz, Erich; Spinelli, Simona

2015-01-01

Background Reduced sensitivity to positive feedback is common in patients with major depressive disorder (MDD). However, findings regarding negative feedback are ambiguous, with both exaggerated and blunted responses being reported. The ventral striatum (VS) plays a major role in processing valenced feedback, and previous imaging studies have shown that the locus of controls (self agency v. external agency) over the outcome influences VS response to feedback. We investigated whether attributing the outcome to one’s own action or to an external agent influences feedback processing in patients with MDD. We hypothesized that depressed participants would be less sensitive to the feedback attribution reflected by an altered VS response to self-attributed gains and losses. Methods Using functional MRI and a motion prediction task, we investigated the neural responses to self-attributed (SA) and externally attributed (EA) monetary gains and losses in unmedicated patients with MDD and healthy controls. Results We included 21 patients and 25 controls in our study. Consistent with our prediction, healthy controls showed a VS response influenced by feedback valence and attribution, whereas in depressed patients striatal activity was modulated by valence but was insensitive to attribution. This attribution insensitivity led to an altered ventral putamen response for SA – EA losses in patients with MDD compared with healthy controls. Limitations Depressed patients with comorbid anxiety disorder were included. Conclusion These results suggest an altered assignment of motivational salience to SA losses in patients with MDD. Altered striatal response to SA negative events may reinforce the belief of not being in control of negative outcomes contributing to a cycle of learned helplessness. PMID:26107160

Post-traumatic stress disorder in the perinatal period: A concept analysis.

PubMed

Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D

2017-12-01

To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley & Sons Ltd.

Psychiatric disorders and the labor market: an analysis by disorder profiles.

PubMed

Cowell, Alexander J; Luo, Zhehui; Masuda, Yuta J

2009-03-01

A key societal cost of mental illness is its impact on the labor market. In examining the relationship between psychiatric disorders and the labor market, the literature to date either examines psychiatric disorders in broad classes or focuses on the impact of specific conditions. The aim is to examine the relationships among meaningful profiles of concurrent past year disorders and labor market outcomes by gender. Data are from the National Epidemiologic Survey on Alcohol and Related Conditions for 2001/2002 (NESARC), a representative sample of the noninstitutionalized population aged 18 or older residing in the United States. The analysis sample contains 18,429 women and 16,426 men (unweighted). We examined the relationship between profiles of psychiatric disorders and three labor market outcomes: labor force participation; employment, conditional on labor force participation; and working full-time conditional on being employed. Because no attempt was made to control for potential endogeneity between the labor market outcomes and the psychiatric profiles, we are unable to establish the causal direction of the associations estimated. First, anxiety disorders among women appear to be associated with labor market outcomes (e.g., anxiety profile in employment outcome: OR=0.76, p<.05). Second, for employment among women large effects were seen for mood disorder and mood and anxiety; in contrast for men, these disorder profiles had significant associations with working full-time rather than employment. Third, for women, of the three labor market outcomes, employment status is particularly sensitive to the profiles of disorders. For men, no such pattern was found for any single labor market outcome. Concurrent psychiatric disorder profiles affect men and women differently in the labor market. The greatest differences are in (i) the relationship between labor market outcomes and profiles exhibiting anxiety disorders, and (ii) which labor market outcomes are influenced. The main methodological limitation is that the approach does not attempt to assert a direction of causation between mental health conditions and the labor market outcomes. Unobserved heterogeneity and endogeneity are both possible and likely to some degree. Other limitations pertain to the data, which are cross-sectional and exclude some relatively rare disorders (e.g., schizophrenia). The results may have significant implications for access to appropriate treatment, which may vary greatly by psychiatric disorder profile and by gender. In the United States, private third-party coverage for treatment is obtained either directly through working full-time at a medium to large firm or through a spouse being employed. The findings thus suggest that mental health policy may need to account for labor market policy. Additional research is needed to disentangle the findings presented. For example, it is important to separate the influence of substance use disorders from mood disorder and uncover the pathways by which the different conditions in substance use disorders may influence the job market.

Predictors, Moderators, and Mediators of Treatment Outcome Following Manualised Cognitive-Behavioural Therapy for Eating Disorders: A Systematic Review.

PubMed

Linardon, Jake; de la Piedad Garcia, Xochitl; Brennan, Leah

2017-01-01

This systematic review synthesised the literature on predictors, moderators, and mediators of outcome following Fairburn's CBT for eating disorders. Sixty-five articles were included. The relationship between individual variables and outcome was synthesised separately across diagnoses and treatment format. Early change was found to be a consistent mediator of better outcomes across all eating disorders. Moderators were mostly tested in binge eating disorder, and most moderators did not affect cognitive-behavioural treatment outcome relative to other treatments. No consistent predictors emerged. Findings suggest that it is unclear how and for whom this treatment works. More research testing mediators and moderators is needed, and variables selected for analyses need to be empirically and theoretically driven. Future recommendations include the need for authors to (i) interpret the clinical and statistical significance of findings; (ii) use a consistent definition of outcome so that studies can be directly compared; and (iii) report null and statistically significant findings. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Disorders of compulsivity: a common bias towards learning habits

PubMed Central

Voon, V; Derbyshire, K; Rück, C; Irvine, M A; Worbe, Y; Enander, J; Schreiber, L R N; Gillan, C; Fineberg, N A; Sahakian, B J; Robbins, T W; Harrison, N A; Wood, J; Daw, N D; Dayan, P; Grant, J E; Bullmore, E T

2015-01-01

Why do we repeat choices that we know are bad for us? Decision making is characterized by the parallel engagement of two distinct systems, goal-directed and habitual, thought to arise from two computational learning mechanisms, model-based and model-free. The habitual system is a candidate source of pathological fixedness. Using a decision task that measures the contribution to learning of either mechanism, we show a bias towards model-free (habit) acquisition in disorders involving both natural (binge eating) and artificial (methamphetamine) rewards, and obsessive-compulsive disorder. This favoring of model-free learning may underlie the repetitive behaviors that ultimately dominate in these disorders. Further, we show that the habit formation bias is associated with lower gray matter volumes in caudate and medial orbitofrontal cortex. Our findings suggest that the dysfunction in a common neurocomputational mechanism may underlie diverse disorders involving compulsion. PMID:24840709

Disorders of compulsivity: a common bias towards learning habits.

PubMed

Voon, V; Derbyshire, K; Rück, C; Irvine, M A; Worbe, Y; Enander, J; Schreiber, L R N; Gillan, C; Fineberg, N A; Sahakian, B J; Robbins, T W; Harrison, N A; Wood, J; Daw, N D; Dayan, P; Grant, J E; Bullmore, E T

2015-03-01

Why do we repeat choices that we know are bad for us? Decision making is characterized by the parallel engagement of two distinct systems, goal-directed and habitual, thought to arise from two computational learning mechanisms, model-based and model-free. The habitual system is a candidate source of pathological fixedness. Using a decision task that measures the contribution to learning of either mechanism, we show a bias towards model-free (habit) acquisition in disorders involving both natural (binge eating) and artificial (methamphetamine) rewards, and obsessive-compulsive disorder. This favoring of model-free learning may underlie the repetitive behaviors that ultimately dominate in these disorders. Further, we show that the habit formation bias is associated with lower gray matter volumes in caudate and medial orbitofrontal cortex. Our findings suggest that the dysfunction in a common neurocomputational mechanism may underlie diverse disorders involving compulsion.

The Effectiveness of Inquiry Learning Method to Enhance Students' Learning Outcome: A Theoritical and Empirical Review

ERIC Educational Resources Information Center

Andrini, Vera Septi

2016-01-01

The necessities of the 21st century requires education to continue creating the young generation to have life skills. Life skills are trained through the learning process and identified through the learning outcomes of students. One of the affecting factors for low learning outcomes is learning models. The learning model is a design study that…

Blended Learning Based on Schoology: Effort of Improvement Learning Outcome and Practicum Chance in Vocational High School

ERIC Educational Resources Information Center

Irawan, Vincentius Tjandra; Sutadji, Eddy; Widiyanti

2017-01-01

The aims of this study were to determine: (1) the differences in learning outcome between Blended Learning based on Schoology and Problem-Based Learning, (2) the differences in learning outcome between students with prior knowledge of high, medium, and low, and (3) the interaction between Blended Learning based on Schoology and prior knowledge to…

Teaching Social Studies to High School Students with Learning Problems

ERIC Educational Resources Information Center

Steele, Marcee M.

2007-01-01

Because of recent legislation, many students with mild disabilities enroll in high school social studies courses in general education rather than special education settings. Therefore, teachers may have students with learning disabilities, behavioral disorders, communication disorders, and attention deficit/hyperactivity disorder in their history,…

Institutional Narcissism, Arrogant Organization Disorder and Interruptions in Organizational Learning

ERIC Educational Resources Information Center

Godkin, Lynn; Allcorn, Seth

2009-01-01

Purpose: This article aims to present an alternative approach to diagnosing behavioral barriers to organizational learning. Design/methodology/approach: The paper juxtaposes interruptions in organizational learning with characteristics of narcissism and arrogant organization disorder. Psychoanalytically informed theory and DSM-IV criteria are…

Differential pattern of semantic memory organization between bipolar I and II disorders.

PubMed

Chang, Jae Seung; Choi, Sungwon; Ha, Kyooseob; Ha, Tae Hyon; Cho, Hyun Sang; Choi, Jung Eun; Cha, Boseok; Moon, Eunsoo

2011-06-01

Semantic cognition is one of the key factors in psychosocial functioning. The aim of this study was to explore the differences in pattern of semantic memory organization between euthymic patients with bipolar I and II disorders using the category fluency task. Study participants included 23 euthymic subjects with bipolar I disorder, 23 matched euthymic subjects with bipolar II disorder and 23 matched control subjects. All participants were assessed for verbal learning, recall, learning strategies, and fluency. The combined methods of hierarchical clustering and multidimensional scaling were used to compare the pattern of semantic memory organization among the three groups. Quantitative measures of verbal learning, recall, learning strategies, and fluency did not differ between the three groups. A two-cluster structure of semantic memory organization was identified for the three groups. Semantic structure was more disorganized in the bipolar I disorder group compared to the bipolar II disorder. In addition, patients with bipolar II disorder used less elaborate strategies of semantic memory organization than those of controls. Compared to healthy controls, strategies for categorization in semantic memory appear to be less knowledge-based in patients with bipolar disorders. A differential pattern of semantic memory organization between bipolar I and II disorders indicates a higher risk of cognitive abnormalities in patients with bipolar I disorder compared to patients with bipolar II disorder. Exploring qualitative nature of neuropsychological domains may provide an explanatory insight into the characteristic behaviors of patients with bipolar disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

Road Testing Graduate Attributes and Course Learning Outcomes of an Environmental Science Degree via a Work-Integrated Learning Placement

ERIC Educational Resources Information Center

Whelan, Michael

2017-01-01

Graduate attributes and course learning outcomes are an integral part of higher education in Australia. Testing the performance of graduates in the workplace with regard to graduate attributes and course learning outcomes is a not a common occurrence. This study has road tested the graduate attributes and course learning outcomes of a bachelor…

Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data.

PubMed

Maj, M; Pirozzi, R; Formicola, A M; Bartoli, L; Bucci, P

2000-01-01

Concerns have been expressed about the reliability and validity of the DSM-IV criteria for schizoaffective disorder, but no systematic study has been published up to now. The Cohen's kappa for the individual items of the DSM-IV definition of schizoaffective disorder, manic episode and major depressive episode was evaluated in 150 patients independently interviewed by two psychiatrists using the Composite International Diagnostic Interview. The two-year outcome of patients with a consensus DSM-IV diagnosis of schizoaffective disorder was compared to that of patients with DSM-IV schizophrenia and schizophreniform disorder, using the Strauss-Carpenter Outcome Scale. The Cohen's kappa was 0.22 for the diagnosis of schizoaffective disorder, 0.71 for that of manic episode, and 0.82 for that of major depressive episode. Schizoaffective patients had a significantly better outcome than those with schizophrenia but a worse outcome than those with schizophreniform disorder. The inter-rater reliability of the DSM-IV criteria for schizoaffective disorder is not satisfactory. The better outcome of DSM-IV schizoaffective disorder compared with schizophrenia seems to depend more on the inclusion, in the definition of schizophrenia but not in that of schizoaffective disorder, of the six-month duration and functional impairment criteria than on the different symptomatological patterns of the two conditions. The size of the sample of patients fulfilling DSM-IV criteria for schizoaffective disorder was small. The study suggests that the clinical implications of the currently problematic diagnosis of schizoaffective disorder may be modest.

Internet-Based Self-Help Intervention for ICD-11 Adjustment Disorder: Preliminary Findings.

PubMed

Eimontas, Jonas; Rimsaite, Zivile; Gegieckaite, Goda; Zelviene, Paulina; Kazlauskas, Evaldas

2018-06-01

Adjustment disorder is one of the most diagnosed mental disorders. However, there is a lack of studies of specialized internet-based psychosocial interventions for adjustment disorder. We aimed to analyze the outcomes of an internet-based unguided self-help psychosocial intervention BADI for adjustment disorder in a two armed randomized controlled trial with a waiting list control group. In total 284 adult participants were randomized in this study. We measured adjustment disorder as a primary outcome, and psychological well-being as a secondary outcome at pre-intervention (T1) and one month after the intervention (T2). We found medium effect size of the intervention for the completer sample on adjustment disorder symptoms. Intervention was effective for those participants who used it at least one time in 30-day period. Our results revealed the potential of unguided internet-based self-help intervention for adjustment disorder. However, high dropout rates in the study limits the generalization of the outcomes of the intervention only to completers.

Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology–Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial

PubMed Central

Lee, Li-Ang; Wang, Shu-Ling; Chao, Yi-Ping; Tsai, Ming-Shao; Hsin, Li-Jen; Kang, Chung-Jan; Fu, Chia-Hsiang; Chao, Wei-Chieh; Huang, Chung-Guei; Li, Hsueh-Yu

2018-01-01

Background The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology–head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown. Objective The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience. Methods This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules. Results Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI −75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change −41, 95% CI −67 to −20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants’ attention but that the nonlinearly arranged materials affected their learning. Conclusions Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group. Trial Registration ClinicalTrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) PMID:29519776

Hypnotherapy for Esophageal Disorders.

PubMed

Riehl, Megan E; Keefer, Laurie

2015-07-01

Hypnotherapy is an evidence based intervention for the treatment of functional bowel disorders, particularly irritable bowel syndrome. While similar in pathophysiology, less is known about the utility of hypnotherapy in the upper gastrointestinal tract. Esophageal disorders, most of which are functional in nature, cause painful and uncomfortable symptoms that impact patient quality of life and are difficult to treat from a medical perspective. After a thorough medical workup and a failed trial of proton pump inhibitor therapy, options for treatment are significantly limited. While the pathophysiology is likely multifactorial, two critical factors are believed to drive esophageal symptoms--visceral hypersensitivity and symptom hypervigilance. The goal of esophageal directed hypnotherapy is to promote a deep state of relaxation with focused attention allowing the patient to learn to modulate physiological sensations and symptoms that are not easily addressed with conventional medical intervention. Currently, the use of hypnosis is suitable for dysphagia, globus, functional chest pain/non-cardiac chest pain, dyspepsia, and functional heartburn. In this article the authors will provide a rationale for the use of hypnosis in these disorders, presenting the science whenever available, describing their approach with these patients, and sharing a case study representing a successful outcome.

Hypnotherapy for Esophageal Disorders

PubMed Central

Riehl, Megan E.; Keefer, Laurie

2015-01-01

Hypnotherapy is an evidence based intervention for the treatment of functional bowel disorders, particularly irritable bowel syndrome. While similar in pathophysiology, less is known about the utility of hypnotherapy in the upper gastrointestinal tract. Esophageal disorders, most of which are functional in nature, cause painful and uncomfortable symptoms that impact patient quality of life and are difficult to treat from a medical perspective. After a thorough medical workup and a failed trial of proton pump inhibitor therapy, options for treatment are significantly limited. While the pathophysiology is likely multifactorial, two critical factors are believed to drive esophageal symptoms—visceral hypersensitivity and symptom hypervigilance. The goal of esophageal directed hypnotherapy is to promote a deep state of relaxation with focused attention allowing the patient to learn to modulate physiological sensations and symptoms that are not easily addressed with conventional medical intervention. Currently, the use of hypnosis is suitable for dysphagia, globus, functional chest pain/non-cardiac chest pain, dyspepsia, and functional heartburn. In this article the authors will provide a rationale for the use of hypnosis in these disorders, presenting the science whenever available, describing their approach with these patients, and sharing a case study representing a successful outcome. PMID:26046715

Theory-based processes that promote the remission of substance use disorders.

PubMed

Moos, Rudolf H

2007-06-01

Four related theories about the personal and social resources that shield individuals from developing substance use disorders and foster the process of remission from these disorders are described. These theories are social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. Next, the social processes specified by these theories are highlighted, including the provision of support, goal direction, and monitoring; engagement in rewarding activities other than substance use, exposure to abstinence-oriented norms and models, and attempts to build self-efficacy and coping skills. Then, a review of the literature considers evidence about the association between the personal and social resources specified by the four theories and remission from substance use disorders. The discussion highlights several issues that need to be addressed to enhance our understanding of the protective resources involved in stable remission, such as how to develop integrated measures of the key resources and specify their associations with substance use outcomes, the extent to which the resources amplify or compensate for the influence of treatment, and how treatment and continuing care can be tailored to strengthen the protective resources that promote remission.

Theory-Based Processes that Promote the Remission of Substance Use Disorders

PubMed Central

Moos, Rudolf H.

2007-01-01

Four related theories about the personal and social resources that shield individuals from developing substance use disorders and foster the process of remission from these disorders are described. These theories are social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. Next, the social processes specified by these theories are highlighted, including the provision of support, goal direction, and monitoring; engagement in rewarding activities other than substance use, exposure to abstinence-oriented norms and models, and attempts to build self-efficacy and coping skills. Then, a review of the literature considers evidence about the association between the personal and social resources specified by the four theories and remission from substance use disorders. The discussion highlights several issues that need to be addressed to enhance our understanding of the protective resources involved in stable remission, such as how to develop integrated measures of the key resources and specify their associations with substance use outcomes, the extent to which the resources amplify or compensate for the influence of treatment, and how treatment and continuing care can be tailored to strengthen the protective resources that promote remission. PMID:17254686

Development of fine motor skills is associated with expressive language outcomes in infants at high and low risk for autism spectrum disorder.

PubMed

Choi, Boin; Leech, Kathryn A; Tager-Flusberg, Helen; Nelson, Charles A

2018-04-12

A growing body of research suggests that fine motor abilities are associated with skills in a variety of domains in both typical and atypical development. In this study, we investigated developmental trajectories of fine motor skills between 6 and 24 months in relation to expressive language outcomes at 36 months in infants at high and low familial risk for autism spectrum disorder (ASD). Participants included 71 high-risk infants without ASD diagnoses, 30 high-risk infants later diagnosed with ASD, and 69 low-risk infants without ASD diagnoses. As part of a prospective, longitudinal study, fine motor skills were assessed at 6, 12, 18, and 24 months of age and expressive language outcomes at 36 months using the Mullen Scales of Early Learning. Diagnosis of ASD was determined at the infant's last visit to the lab (18, 24, or 36 months) using the Autism Diagnostic Observation Schedule. Hierarchical linear modeling revealed that high-risk infants who later developed ASD showed significantly slower growth in fine motor skills between 6 and 24 months, compared to their typically developing peers. In contrast to group differences in growth from age 6 months, cross-sectional group differences emerged only in the second year of life. Also, fine motor skills at 6 months predicted expressive language outcomes at 3 years of age. These results highlight the importance of utilizing longitudinal approaches in measuring early fine motor skills to reveal subtle group differences in infancy between ASD high-risk and low-risk infant populations and to predict their subsequent language outcomes.

Differentiating children with attention-deficit/hyperactivity disorder, conduct disorder, learning disabilities and autistic spectrum disorders by means of their motor behavior characteristics.

PubMed

Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan

2012-01-01

The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N=22), Conduct Disorder (CD; N=17), Learning Disabilities (LD; N=24) and Autistic Spectrum Disorders (ASD; N=20). Physical education teachers used the MBC for children to rate their pupils based on their motor related behaviors. A multivariate analysis revealed significant differences among the groups on different problem scales. The results indicated that the MBC for children may be effective in discriminating children with similar disruptive behaviors (e.g., ADHD, CD) and autistic disorders, based on their motor behavior characteristics, but not children with Learning Disabilities (LD), when used by physical education teachers in school settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using AMLO to Improve the Quality of Teacher Education Outcomes

ERIC Educational Resources Information Center

Al-Shammari, Zaid

2012-01-01

This study aims to find ways to improve learning outcomes in teacher education courses by using an Analysis Model for Learning Outcomes (AMLO). It addresses the improvement of the quality of teacher education by analyzing learning outcomes and implementing curriculum modifications related to specific learning objectives and their effects on…

Cognitive Style and Mobile E-Learning in Emergent Otorhinolaryngology-Head and Neck Surgery Disorders for Millennial Undergraduate Medical Students: Randomized Controlled Trial

PubMed Central

Chao, Yi-Ping; Huang, Chung-Guei; Fang, Ji-Tseng; Wang, Shu-Ling; Chuang, Cheng-Keng; Kang, Chung-Jan; Hsin, Li-Jen; Lin, Wan-Ni; Fang, Tuan-Jen; Li, Hsueh-Yu

2018-01-01

Background Electronic learning (e-learning) through mobile technology represents a novel way to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders to undergraduate medical students. Whether a cognitive style of education combined with learning modules can impact learning outcomes and satisfaction in millennial medical students is unknown. Objective The aim of this study was to assess the impact of cognitive styles and learning modules using mobile e-learning on knowledge gain, competence gain, and satisfaction for emergent ORL-HNS disorders. Methods This randomized controlled trial included 60 undergraduate medical students who were novices in ORL-HNS at an academic teaching hospital. The cognitive style of the participants was assessed using the group embedded figures test. The students were randomly assigned (1:1) to a novel interactive multimedia (IM) group and conventional Microsoft PowerPoint show (PPS) group matched by age, sex, and cognitive style. The content for the gamified IM module was derived from and corresponded to the textbook-based learning material of the PPS module (video lectures). The participants were unblinded and used fully automated courseware containing the IM or PPS module on a 7-inch tablet for 100 min. Knowledge and competence were assessed using multiple-choice questions and multimedia situation tests, respectively. Each participant also rated their global satisfaction. Results All of the participants (median age 23 years, range 22-26 years; 36 males and 24 females) received the intended intervention after randomization. Overall, the participants had significant gains in knowledge (median 50%, interquartile range [IQR]=17%-80%, P<.001) and competence (median 13%, IQR=0%-33%, P=.006). There were no significant differences in knowledge gain (40%, IQR=13%-76% vs 60%, IQR=20%-100%, P=.42) and competence gain (0%, IQR= −21% to 38% vs 25%, IQR=0%-33%, P=.16) between the IM and PPS groups. However, the IM group had a higher satisfaction score (8, IQR=6-9 vs 6, IQR=4-7, P=.01) compared with the PPS group. Using Friedman’s two-way nonparametric analysis of variance, cognitive styles (field-independent, field-intermediate, or field-dependent classification) and learning modules (IM or PPS) had significant effects on both knowledge gain (both adjusted P<.001) and satisfaction (both adjusted P<.001). Conclusions Mobile e-learning is an effective modality to improve knowledge of emergent ORL-HNS in millennial undergraduate medical students. Our findings suggest the necessity of developing various modules for undergraduate medical students with different cognitive styles. Trial Registration Clinicaltrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) PMID:29439943

Assisted reproductive technology treatment in women with severe eating disorders: a national cohort study.

PubMed

Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja; Schmidt, Lone; Hougaard, Charlotte O; Hageman, Ida

2015-11-01

This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. Hospital-diagnosed eating disorders among 42,915 women in the Danish National ART cohort (DANAC), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42,644 women and an age-matched background population of 215,290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders, frequency distribution of diagnoses before/during/after ART treatment, as well as ART treatment and obstetric outcomes. In the ART cohort, 271 women (0.63%) had an eating disorder diagnosis compared with 0.73% in the background population (p = 0.025). The prevalence of ovulatory disorder was significantly higher in women with a severe eating disorder compared with the ART cohort without eating disorders. Obstetric outcomes were similar in ART-treated women with and without an eating disorder. Women with severe eating disorders were identified in the ART cohort, although significantly less often than in the age-matched background population. Women with severe eating disorders suffered more often from anovulatory infertility than the ART comparison cohort without this disease. Obstetric outcomes appeared reassuring in the ART cohort with eating disorders. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood

PubMed Central

Micali, Nadia; Solmi, Francesca; Horton, Nicholas J.; Crosby, Ross D.; Eddy, Kamryn T.; Calzo, Jerel P.; Sonneville, Kendrin R.; Swanson, Sonja A.; Field, Alison E.

2015-01-01

Objective To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Method Eating disorders were ascertained at 14 and 16 years of age in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years following predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. Results All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]=1.39 [95% CIs: 1.00-1.94]; BN: OR=3.39[1.25-9.20]; BED: OR=2.00 [1.06-3.75]; PD: OR=2.56 [1.38-4.74]). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR=5.72[2.22-14.72], PD: OR=4.88[2.78-8.57], subthreshold BN: OR=3.97[1.44-10.98], subthreshold BED: OR=2.32[1.43-3.75]). Whilst BED and BN predicted obesity (respectively OR=3.58 [1.06-12.14] and OR=6.42 [1.69-24.30]), AN was prospectively associated with underweight. Conclusions Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents. PMID:26210334

Online and Blended Learning: The Advantages and the Challenges for Students with Learning Disabilities and Attention Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Madaus, Joseph W.; Banerjee, Manju; McKeown, Kimberly; Gelbar, Nicholas

2011-01-01

As students with learning disabilities and attention deficit/hyperactivity disorder (ADHD) participate in postsecondary education, they are likely to encounter a new learning medium that will need to be mastered--online and blended courses. Although many college-aged students have grown up using the Internet and other information technologies,…

Victimization by Bullying and Attachment to Parents and Teachers among Students Who Report Learning Disorders and/or Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Klomek, A. Brunstein; Kopelman-Rubin, D.; Al-Yagon, M.; Berkowitz, Ruth; Apter, A.; Mikulincer, M.

2016-01-01

This is the first study examining the association between victimization by bullying and attachment to both parents and teachers among students who report Learning Disorders (LD) and/or Attention Deficit Hyperactivity Disorder (ADHD). A total of 1,691 seventh- and eighth-grade students in six junior high schools completed questionnaires about…

Community College Students with Psychological Disorders and Their Perceptions of Online Learning

ERIC Educational Resources Information Center

Warren, Gretchen Winifred Langford

2014-01-01

Research focusing on students with learning disabilities is abundant for secondary and higher education. Studies utilizing data on students with psychological disorders cover secondary and 4-year university education. However, community college students with psychological disorders and their perception of online classes is an area of educational…

Organic Determinants of Learning and Behavioral Disorders.

ERIC Educational Resources Information Center

Philpott, William H.; And Others

Theories regarding organic determinants of learning and behavior disorders are reviewed historically. Cases illustrating how a bio-ecologic examination can isolate the substances to which a person reacts and some of the reasons for those reactions are presented; and the role of various disorders in relation to the central nervous system is…

Early clinical experience: do students learn what we expect?

PubMed

Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Koopmans, Raymond

2011-07-01

Early clinical experience is thought to contribute to the professional development of medical students, but little is known about the kind of learning processes that actually take place. Learning in practice is highly informal and may be difficult to direct by predefined learning outcomes. Learning in medical practice includes a socialisation process in which some learning outcomes may be valued, but others neglected or discouraged. This study describes students' learning goals (prior to a Year 1 nursing attachment) and learning outcomes (after the attachment) in relation to institutional educational goals, and evaluates associations between learning outcomes, student characteristics and place of attachment. A questionnaire containing open-ended questions about learning goals and learning outcomes was administered to all Year 1 medical students (n = 347) before and directly after a 4-week nursing attachment in either a hospital or a nursing home. Two confirmatory focus group interviews were conducted and data were analysed using qualitative and quantitative content analyses. Students' learning goals corresponded with educational goals with a main emphasis on communication and empathy. Other learning goals included gaining insight into the organisation of health care and learning to deal with emotions. Self-reported learning outcomes were the same, but students additionally mentioned reflection on professional behaviour and their own future development. Women and younger students mentioned communication and empathy more often than men and older students. Individual learning goals, with the exception of communicating and empathising with patients, did not predict learning outcomes. Students' learning goals closely match educational goals, which are adequately met in early nursing attachments in both hospitals and nursing homes. Learning to deal with emotions was under-represented as a learning goal and learning outcome, which may indicate that emotional aspects of medical students' professional development are neglected in the first year of medical education. © Blackwell Publishing Ltd 2011.

Allergies and Learning/Behavioral Disorders.

ERIC Educational Resources Information Center

McLoughlin, James A.; Nall, Michael

1994-01-01

This article describes various types of allergies, how they are diagnosed medically, and the different forms of medical treatment. It also considers how allergies may affect school learning and behavior, the connection between allergies and learning and behavioral disorders, the impact of allergy medications upon classroom performance, and various…

Relationship between personality traits and panic disorder.

PubMed

Navarro, Bárbara; Sánchez, Mónica; Herrán, Andrés; Sierra-Biddle, Deirdre

2013-01-01

Panic disorder is a chronic course disorder that causes important distress and impaired social function. The relationship between personality disorders and panic disorder has been studied, and determines its severity, course and treatment, but it has not been studied the relationship between personality traits and outcome of panic disorder. 82 patients with a first episode of panic disorder are selected and followed during 1 year, to analyze the existence and kind of relationship between their personality traits and the outcome of their disorder.

A narrative review of schemas and schema therapy outcomes in the eating disorders.

PubMed

Pugh, Matthew

2015-07-01

Whilst cognitive-behavioural therapy has demonstrated efficacy in the treatment of eating disorders, therapy outcomes and current conceptualizations still remain inadequate. In light of these shortcomings there has been growing interest in the utility of schema therapy applied to eating pathology. The present article first provides a narrative review of empirical literature exploring schemas and schema processes in eating disorders. Secondly, it critically evaluates outcome studies assessing schema therapy applied to eating disorders. Current evidence lends support to schema-focused conceptualizations of eating pathology and confirms that eating disorders are characterised by pronounced maladaptive schemas. Treatment outcomes also indicate that schema therapy, the schema-mode approach, and associated techniques are promising interventions for complex eating disorders. Implications for clinical practice and future directions for research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neurocomputational mechanisms of prosocial learning and links to empathy

PubMed Central

Apps, Matthew A. J.; Valton, Vincent; Viding, Essi; Roiser, Jonathan P.

2016-01-01

Reinforcement learning theory powerfully characterizes how we learn to benefit ourselves. In this theory, prediction errors—the difference between a predicted and actual outcome of a choice—drive learning. However, we do not operate in a social vacuum. To behave prosocially we must learn the consequences of our actions for other people. Empathy, the ability to vicariously experience and understand the affect of others, is hypothesized to be a critical facilitator of prosocial behaviors, but the link between empathy and prosocial behavior is still unclear. During functional magnetic resonance imaging (fMRI) participants chose between different stimuli that were probabilistically associated with rewards for themselves (self), another person (prosocial), or no one (control). Using computational modeling, we show that people can learn to obtain rewards for others but do so more slowly than when learning to obtain rewards for themselves. fMRI revealed that activity in a posterior portion of the subgenual anterior cingulate cortex/basal forebrain (sgACC) drives learning only when we are acting in a prosocial context and signals a prosocial prediction error conforming to classical principles of reinforcement learning theory. However, there is also substantial variability in the neural and behavioral efficiency of prosocial learning, which is predicted by trait empathy. More empathic people learn more quickly when benefitting others, and their sgACC response is the most selective for prosocial learning. We thus reveal a computational mechanism driving prosocial learning in humans. This framework could provide insights into atypical prosocial behavior in those with disorders of social cognition. PMID:27528669

Long-term outcome of hypochondriacal personality disorder.

PubMed

Tyrer, P; Seivewright, N; Seivewright, H

1999-02-01

Hypochondriacal personality disorder diagnosed according to the Personality Assessment Schedule, a structured clinical interview, was related to outcome after 2 years and 5 years in a randomized, controlled trial of treatment of generalized anxiety, panic, and dysthymic disorders. Seventeen individuals (9%) from a population of 181 patients had hypochondriacal personality disorder and they experienced a significantly worse outcome than other patients, including those with other personality disorders, in terms of symptomatic change and health service utilization. This lack of improvement was associated with persistent somatization in hypochondriacal personality disorder. The results give further support to the belief that hypochondriacal personality disorder is a valid clinical diagnosis that has important clinical correlates, but further work is needed to establish the extent of its overlap with hypochondriasis as a mental state disorder.

Influence of personality on the outcome of treatment in depression: systematic review and meta-analysis.

PubMed

Newton-Howes, Giles; Tyrer, Peter; Johnson, Tony; Mulder, Roger; Kool, Simone; Dekker, Jack; Schoevers, Robert

2014-08-01

There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with depressive disorders and whether this is influenced by type of treatment, a systematic electronic search of MEDLINE, CINAHL, and PsycINFO from 1966, 1982, and 1882, respectively, until February 2007 was undertaken. The keyword terms depression, mental illness, and personality disorder were used. All references were reviewed and personal correspondence was undertaken. Only English language papers were considered. Any English language paper studying a depressed adult population was considered for inclusion. Studies needed to clearly define depression and personality disorder using peer-reviewed instruments or International Classification of Disease/Diagnostic Statistical Manual criteria. Outcome assessment at greater than 3 weeks was necessary. Final inclusion papers were agreed on by consensus by at least two reviewers. All data were extracted using predetermined criteria for depression by at least two reviewers in parallel. Disagreement was settled by consensus. Complex data extraction was confirmed within the study group. Data were synthesized using log odds ratios in the Cochrane RevMan 5 program. The finding of comorbid personality disorder and depression was associated with a more than double the odds of a poor outcome for depression compared with those with no personality disorder (OR 2.16, CI 1.83-2.56). This effect was not ameliorated by the treatment modality used for the depressive disorder. This finding led to the conclusion that personality disorder has a negative impact on the outcome of depression. This finding is important in considering prognosis in depressive disorders.

Homework Adherence and Cognitive Behaviour Treatment Outcome for Children and Adolescents with Anxiety Disorders.

PubMed

Arendt, Kristian; Thastum, Mikael; Hougaard, Esben

2016-03-01

Homework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders. The study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents. The treatment program was completed by 98 children and adolescents (ages 7-16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up. Results did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity. The study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.

Symptoms of Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, and Callous-Unemotional Traits as Unique Predictors of Psychosocial Maladjustment in Boys: Advancing an Evidence Base for DSM-V

ERIC Educational Resources Information Center

Pardini, Dustin A.; Fite, Paula J.

2010-01-01

Objective: The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Method: Several outcomes were assessed…

Exposing Clinicians to Exposure: A Randomized Controlled Dissemination Trial of Exposure Therapy for Anxiety Disorders

PubMed Central

Harned, Melanie S.; Dimeff, Linda A.; Woodcock, Eric A.; Kelly, Tim; Zavertnik, Jake; Contreras, Ignacio; Danner, Sankirtana M.

2014-01-01

Objective The present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training. Method Clinicians naïve to ET (N=181, Mage = 37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to: 1) an interactive, multimedia online training (OLT), 2) OLT plus a brief, computerized motivational enhancement intervention (OLT+ME), or 3) OLT + ME plus a web-based learning community (OLT+ME+LC). Assessments were completed at baseline, post-training, and 6 and 12 weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency. Results All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT+ME+LC condition was superior to both other conditions in increasing knowledge of ET. Conclusions Multi-component trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET. PMID:25311284

Detection and Prevention of Learning Disorders.

ERIC Educational Resources Information Center

Yahraes, Herbert; Prestwich, Sherry

The document provides an overview of learning disabilities and described are various approaches to the detection and prevention of these handicapping conditions. Discussed in the introduction are definitions of learning disorders, the multiple nature of the handicap, and maturational lag as a cause. A section on clinical approaches covers research…

Service-Learning in Higher Education: Focus on Eating Disorder Prevention

ERIC Educational Resources Information Center

Roofe, Nina; Brinegar, Jennifer; Seymour, Gayle

2015-01-01

Interdisciplinary service-learning projects are mutually beneficial for communities and students. This service-learning project focused on eating disorder prevention and involved students majoring in nutrition, art, and psychology at a public Southern university. The nutrition majors completed the Eating Attitudes Test before and after the…

Learning Problems and Classroom Instruction.

ERIC Educational Resources Information Center

Adelman, Howard S.

Defined are categories of learning disabilities (LD) that can be remediated in regular public school classes, and offered are remedial approaches. Stressed in four studies is the heterogeneity of LD problems. Suggested is grouping LD children into three categories: no disorder (problem is from the learning environment); minor disorder (problem is…

The Readiness of Adults with Attention Deficit Hyperactivity Disorder for Self-Directed Learning

ERIC Educational Resources Information Center

Wright, Melissa Sue

2011-01-01

This study investigated the readiness for self-directed learning of adults with Attention Deficit Hyperactivity Disorder (ADHD), as well as their overall educational experiences. Using Guglielmino's Self-Directed Learning Readiness Scale for Adults (SDLRS-A), the researcher investigated whether the following factors were significantly related to…

Training with Differential Outcomes Enhances Discriminative Learning and Visuospatial Recognition Memory in Children Born Prematurely

ERIC Educational Resources Information Center

Martinez, Lourdes; Mari-Beffa, Paloma; Roldan-Tapia, Dolores; Ramos-Lizana, Julio; Fuentes, Luis J.; Estevez, Angeles F.

2012-01-01

Previous studies have demonstrated that discriminative learning is facilitated when a particular outcome is associated with each relation to be learned. When this training procedure is applied (the differential outcome procedure; DOP), learning is faster and more accurate than when the more common non-differential outcome procedure is used. This…

Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

ERIC Educational Resources Information Center

Zainuba, Mohamed; Rahal, Ahmad

2012-01-01

This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

[Multilingualism and child psychiatry: on differential diagnoses of language disorder, specific learning disorder, and selective mutism].

PubMed

Tamiya, Satoshi

2014-01-01

Multilingualism poses unique psychiatric problems, especially in the field of child psychiatry. The author discusses several linguistic and transcultural issues in relation to Language Disorder, Specific Learning Disorder and Selective Mutism. Linguistic characteristics of multiple language development, including so-called profile effects and code-switching, need to be understood for differential diagnosis. It is also emphasized that Language Disorder in a bilingual person is not different or worse than that in a monolingual person. Second language proficiency, cultural background and transfer from the first language all need to be considered in an evaluation for Specific Learning Disorder. Selective Mutism has to be differentiated from the silent period observed in the normal successive bilingual development. The author concludes the review by remarking on some caveats around methods of language evaluation in a multilingual person.

Mobile Phone Apps for Smoking Cessation: Quality and Usability Among Smokers With Psychosis.

PubMed

Ferron, Joelle C; Brunette, Mary F; Geiger, Pamela; Marsch, Lisa A; Adachi-Mejia, Anna M; Bartels, Stephen J

2017-03-03

Smoking is one of the top preventable causes of mortality in people with psychotic disorders such as schizophrenia. Cessation treatment improves abstinence outcomes, but access is a barrier. Mobile phone apps are one way to increase access to cessation treatment; however, whether they are usable by people with psychotic disorders, who often have special learning needs, is not known. Researchers reviewed 100 randomly selected apps for smoking cessation to rate them based on US guidelines for nicotine addiction treatment and to categorize them based on app functions. We aimed to test the usability and usefulness of the top-rated apps in 21 smokers with psychotic disorders. We identified 766 smoking cessation apps and randomly selected 100 for review. Two independent reviewers rated each app with the Adherence Index to US Clinical Practice Guideline for Treating Tobacco Use and Dependence. Then, smokers with psychotic disorders evaluated the top 9 apps within a usability testing protocol. We analyzed quantitative results using descriptive statistics and t tests. Qualitative data were open-coded and analyzed for themes. Regarding adherence to practice guidelines, most of the randomly sampled smoking cessation apps scored poorly-66% rated lower than 10 out of 100 on the Adherence Index (Mean 11.47, SD 11.8). Regarding usability, three common usability problems emerged: text-dense content, abstract symbols on the homepage, and subtle directions to edit features. In order for apps to be effective and usable for this population, developers should utilize a balance of text and simple design that facilitate ease of navigation and content comprehension that will help people learn quit smoking skills. ©Joelle C Ferron, Mary F Brunette, Pamela Geiger, Lisa A Marsch, Anna M Adachi-Mejia, Stephen J Bartels. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 03.03.2017.

Mobile Phone Apps for Smoking Cessation: Quality and Usability Among Smokers With Psychosis

PubMed Central

Brunette, Mary F; Geiger, Pamela; Marsch, Lisa A; Adachi-Mejia, Anna M; Bartels, Stephen J

2017-01-01

Background Smoking is one of the top preventable causes of mortality in people with psychotic disorders such as schizophrenia. Cessation treatment improves abstinence outcomes, but access is a barrier. Mobile phone apps are one way to increase access to cessation treatment; however, whether they are usable by people with psychotic disorders, who often have special learning needs, is not known. Objective Researchers reviewed 100 randomly selected apps for smoking cessation to rate them based on US guidelines for nicotine addiction treatment and to categorize them based on app functions. We aimed to test the usability and usefulness of the top-rated apps in 21 smokers with psychotic disorders. Methods We identified 766 smoking cessation apps and randomly selected 100 for review. Two independent reviewers rated each app with the Adherence Index to US Clinical Practice Guideline for Treating Tobacco Use and Dependence. Then, smokers with psychotic disorders evaluated the top 9 apps within a usability testing protocol. We analyzed quantitative results using descriptive statistics and t tests. Qualitative data were open-coded and analyzed for themes. Results Regarding adherence to practice guidelines, most of the randomly sampled smoking cessation apps scored poorly—66% rated lower than 10 out of 100 on the Adherence Index (Mean 11.47, SD 11.8). Regarding usability, three common usability problems emerged: text-dense content, abstract symbols on the homepage, and subtle directions to edit features. Conclusions In order for apps to be effective and usable for this population, developers should utilize a balance of text and simple design that facilitate ease of navigation and content comprehension that will help people learn quit smoking skills. PMID:28258047

The Effect of Integrated Learning Model and Critical Thinking Skill of Science Learning Outcomes

NASA Astrophysics Data System (ADS)

Fazriyah, N.; Supriyati, Y.; Rahayu, W.

2017-02-01

This study aimed to determine the effect of integrated learning model and critical thinking skill toward science learning outcomes. The study was conducted in SDN Kemiri Muka 1 Depok in fifth grade school year 2014/2015 using cluster random sampling was done to 80 students. Retrieval of data obtained through tests and analysis by Variance (ANOVA) and two lines with the design treatment by level 2x2. The results showed that: (1) science learning outcomes students that given thematic integrated learning model is higher than in the group of students given fragmented learning model, (2) there is an interaction effect between critical thinking skills with integrated learning model, (3) for students who have high critical thinking skills, science learning outcomes students who given by thematic integrated learning model higher than fragmented learning model and (4) for students who have the ability to think critically low yield higher learning science fragmented model. The results of this study indicate that thematic learning model with critical thinking skills can improve science learning outcomes of students.

Using computer-assisted learning to engage diverse learning styles in understanding business management principles.

PubMed

Frost, Mary E; Derby, Dustin C; Haan, Andrea G

2013-01-01

Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

Using computer-assisted learning to engage diverse learning styles in understanding business management principles.

PubMed

Frost, Mary E; Derby, Dustin C; Haan, Andrea G

2013-06-27

Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

When Service-Learning Is Not a "Border-Crossing" Experience: Outcomes of a Graduate Spanish Online Course

ERIC Educational Resources Information Center

Carracelas-Juncal, Carmen

2013-01-01

Research on Spanish service-learning has focused mainly on the outcomes of service-learning for undergraduate students learning Spanish as a second language. This article examines the role of service-learning in a graduate online course for practicing Spanish teachers and the outcomes of the service-learning experience for three participants who…

The Biggs and Moore Model in E-Learning: The Role of Motivation and Collaboration as Moderators

ERIC Educational Resources Information Center

Haverila, Matti J.

2012-01-01

The purpose of this paper is to report the findings of a research conducted to evaluate the effect of e-learning experience on students' perceived learning outcomes, and more specifically the role of motivation and collaboration as moderators between the e-learning experience and the learning outcome. The perceived learning outcome was measured…

Teaching Quality and Learning Creativity in Technical and Vocational Schools

NASA Astrophysics Data System (ADS)

Kembuan, D. R. E.; Rompas, P. T. D.; Mintjelungan, M.; Pantondate, T.; Kilis, B. M. H.

2018-02-01

The purpose of this study is to obtain information about the teacher quality of teaching and learning creativity with the outcomes of student learning in a vocational high school in Indonesia. This research is a survey research. The sample used in this research is 50 teachers, selected by simple random sampling. Data were analyzed by using correlation analysis. The findings of this study are as follows: (1) There is a significant and positive correlation between teacher quality of teaching with the outcomes of student learning at the vocational high school; (2) There is a significant and positive correlation between learning creativity with the outcomes of student learning at the vocational high school, and (3) there is a significant and positive correlation between the teacher quality of teaching and learning creativity with the outcomes of student learning at the school. That is, if the use of appropriate the teacher quality of teaching and learning creativity, then the outcomes of student learning at the school. Finally it can be concluded that to improve the outcomes of student learning, it has to be followed by an improvement of teacher quality of teaching and learning creativity.

Predictors of treatment outcome in an effectiveness trial of cognitive behavioral therapy for children with anxiety disorders.

PubMed

Wergeland, Gro Janne H; Fjermestad, Krister W; Marin, Carla E; Bjelland, Ingvar; Haugland, Bente Storm Mowatt; Silverman, Wendy K; Öst, Lars-Göran; Bjaastad, Jon Fauskanger; Oeding, Kristin; Havik, Odd E; Heiervang, Einar R

2016-01-01

A substantial number of children with anxiety disorders do not improve following cognitive behavioral therapy (CBT). Recent effectiveness studies have found poorer outcome for CBT programs than what is typically found in efficacy studies. The present study examined predictors of treatment outcome among 181 children (aged 8-15 years), with separation anxiety, social phobia, or generalized anxiety disorder, who participated in a randomized, controlled effectiveness trial of a 10-session CBT program in community clinics. Potential predictors included baseline demographic, child, and parent factors. Outcomes were as follows: a) remission from all inclusion anxiety disorders; b) remission from the primary anxiety disorder; and c) child- and parent-rated reduction of anxiety symptoms at post-treatment and at 1-year follow-up. The most consistent findings across outcome measures and informants were that child-rated anxiety symptoms, functional impairment, a primary diagnosis of social phobia or separation anxiety disorder, and parent internalizing symptoms predicted poorer outcome at post-treatment. Child-rated anxiety symptoms, lower family social class, lower pretreatment child motivation, and parent internalizing symptoms predicted poorer outcome at 1-year follow-up. These results suggest that anxious children with more severe problems, and children of parents with elevated internalizing symptom levels, may be in need of modified, additional, or alternative interventions to achieve a positive treatment outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are lifetime affective disorders predictive of long-term outcome in severe adolescent anorexia nervosa?

PubMed

Carrot, B; Radon, L; Hubert, T; Vibert, S; Duclos, J; Curt, F; Godart, N

2017-08-01

Depression and anxiety are commonly associated with anorexia nervosa (AN) and contribute to difficulties in social integration, a negative factor for outcome in AN. The link between those disorders and AN has been poorly studied. Thus, our objective was to investigate (1) the link between outcome nine years after hospitalisation for AN and the occurrence of lifetime anxious or depressive comorbidities; (2) the prognostic value of these comorbidities on patient outcome; 181 female patients were hospitalised for AN (between 13 and 22 years old), and were re-evaluated for their psychological, dietary, physical and social outcomes, from 6 to 12 years after their hospitalisation. The link between anxious and depressive disorders (premorbid to AN and lifetime) and the outcome assessment criteria were tested through multivariate analyses; 63% of the participants had good or intermediate outcome, 83% had presented at least one anxiety or depression disorder in the course of their lives, half of them before the onset of AN. Premorbid obsessive compulsive disorders (OCD), BMI at admission, and premenarchal AN all contribute to poor prognosis. Social phobia and agoraphobia affect the subjects' quality of life and increase eating disorder symptoms. These results encourage a systematic assessment of, and care for, anxiety and depression comorbidities among female adolescent patients with a particular focus on premorbid OCD.

Landau-Kleffner Syndrome

MedlinePlus

... difficult to diagnose and may be misdiagnosed as autism, pervasive developmental disorder, hearing impairment, learning disability, auditory/ ... difficult to diagnose and may be misdiagnosed as autism, pervasive developmental disorder, hearing impairment, learning disability, auditory/ ...

Dysgraphia

MedlinePlus

... instruction. Children with the disorder may have other learning disabilities; however, they usually have no social or other ... instruction. Children with the disorder may have other learning disabilities; however, they usually have no social or other ...

Neurocognitive accounts of developmental dyscalculia and its remediation.

PubMed

Iuculano, T

2016-01-01

Numbers are one of the most pervasive stimulus categories in our environment and an integral foundation of modern society. Yet, up to 20% of individuals fail to understand, represent, and manipulate numbers and form the basis of arithmetic, a condition termed developmental dyscalculia (DD). Multiple cognitive and neural systems including those that serve numerical, mnemonic, visuospatial, and cognitive control functions have independently been implicated in the etiology of DD, yet most studies have not taken a comprehensive or dynamic view of the disorder. This chapter supports the view of DD as a multifaceted neurodevelopmental disorder that is the result of multiple aberrancies at one or multiple levels of the information processing hierarchy, which supports successful arithmetic learning, and suggests that interventions should target all these systems to achieve successful outcomes, at the behavioral and neural levels. © 2016 Elsevier B.V. All rights reserved.

How fear-relevant illusory correlations might develop and persist in anxiety disorders: A model of contributing factors.

PubMed

Wiemer, Julian; Pauli, Paul

2016-12-01

Fear-relevant illusory correlations (ICs) are defined as the overestimation of the relationship between a fear-relevant stimulus and aversive consequences. ICs reflect biased cognitions affecting the learning and unlearning of fear in anxiety disorders, and a deeper understanding might help to improve treatment. A model for the maintenance of ICs is proposed that highlights the importance of amplified aversiveness and salience of fear-relevant outcomes, impaired executive contingency monitoring and an availability heuristic. The model explains why ICs are enhanced in high fearful individuals and allows for some implications that might be applied to augment the effectiveness of cognitive behavior therapy, such as emotion regulation and the direction of attention to non-aversive experiences. Finally, we suggest possible future research directions and an alternative measure of ICs. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Psychological Effects of Climate Change on Children.

PubMed

Burke, Susie E L; Sanson, Ann V; Van Hoorn, Judith

2018-04-11

We review recent evidence on the psychological effects of climate change on children, covering both direct and indirect impacts, and discuss children's psychological adaptation to climate change. Both the direct and flow-on effects of climate change place children at risk of mental health consequences including PTSD, depression, anxiety, phobias, sleep disorders, attachment disorders, and substance abuse. These in turn can lead to problems with emotion regulation, cognition, learning, behavior, language development, and academic performance. Together, these create predispositions to adverse adult mental health outcomes. Children also exhibit high levels of concern over climate change. Meaning-focused coping promotes well-being and environmental engagement. Both direct and indirect climate change impacts affect children's psychological well-being. Children in the developing world will suffer the worst impacts. Mental health professionals have important roles in helping mitigate climate change, and researching and implementing approaches to helping children cope with its impacts.

Violence risk prediction. Clinical and actuarial measures and the role of the Psychopathy Checklist.

PubMed

Dolan, M; Doyle, M

2000-10-01

Violence risk prediction is a priority issue for clinicians working with mentally disordered offenders. To review the current status of violence risk prediction research. Literature search (Medline). Key words: violence, risk prediction, mental disorder. Systematic/structured risk assessment approaches may enhance the accuracy of clinical prediction of violent outcomes. Data on the predictive validity of available clinical risk assessment tools are based largely on American and North American studies and further validation is required in British samples. The Psychopathy Checklist appears to be a key predictor of violent recidivism in a variety of settings. Violence risk prediction is an inexact science and as such will continue to provoke debate. Clinicians clearly need to be able to demonstrate the rationale behind their decisions on violence risk and much can be learned from recent developments in research on violence risk prediction.

Child-Directed Interaction Training for Young Children With Autism Spectrum Disorders: Parent and Child Outcomes.

PubMed

Ginn, Nicole C; Clionsky, Leah N; Eyberg, Sheila M; Warner-Metzger, Christina; Abner, John-Paul

2017-01-01

This study examined the efficacy of the Child-Directed Interaction Training (CDIT) phase of Parent-Child Interaction Therapy for children with an Autism Spectrum Disorder (ASD). Thirty mother-child dyads with children ages 3-7 years with a diagnosis of ASD participated in this randomized controlled study. Following manualized CDIT, statistically significant and meaningful improvements in child disruptive behavior and social awareness as well as maternal distress associated with child disruptive behavior occurred. Across 8 sessions, mothers learned to provide positive attention to their children's appropriate social and play behaviors. Both child and parent changes were maintained at 6-week follow-up. A relatively brief, time-limited, and accessible intervention may be efficacious for improving child and parent behaviors in families of young children with ASD. By decreasing child disruptive behaviors, CDIT may also help to prepare children to benefit further from future interventions.

The use of behavior modeling training in a mobile app parent training program to improve functional communication of young children with autism spectrum disorder.

PubMed

Law, Gloria C; Neihart, Maureen; Dutt, Anuradha

2018-05-01

Communication intervention in early life can significantly impact long-term outcomes for young children with autism. Parents can be vital resources in the midst of the current manpower shortage. Map4speech is a new mobile application developed for parents of children with autism spectrum disorder. It is specially designed to provide high-quality, interactive learning, coupled with frequent feedback and live coaching to train parents in a naturalistic language intervention. A multiple-baseline single-case experimental design was conducted across three parent-child dyads. Results indicate that procedural integrity of parents' intervention techniques was above 85% during post-training intervention, and their respective children showed increases in spontaneous word/gesture use. The results show that mobile applications with feedback can be a promising means for improving efficiency and effectiveness in disseminating evidence-based practices for autism intervention.

Different Verbal Learning Strategies in Autism Spectrum Disorder: Evidence from the Rey Auditory Verbal Learning Test

ERIC Educational Resources Information Center

Bowler, Dermot M.; Limoges, Elyse; Mottron, Laurent

2009-01-01

The Rey Auditory Verbal Learning Test, which requires the free recall of the same list of 15 unrelated words over 5 trials, was administered to 21 high-functioning adolescents and adults with autism spectrum disorder (ASD) and 21 matched typical individuals. The groups showed similar overall levels of free recall, rates of learning over trials and…

Evidence of Deeper Learning Outcomes. Findings from the Study of Deeper Learning Opportunities and Outcomes: Report 3

ERIC Educational Resources Information Center

Zeiser, Kristina L.; Taylor, James; Rickles, Jordan; Garet, Michael S.; Segeritz, Michael

2014-01-01

The "Study of Deeper Learning: Opportunities and Outcomes"--funded by the William and Flora Hewlett Foundation--aimed to determine whether students attending high schools with a mature and at least moderately well implemented approach to promoting deeper learning actually experienced greater deeper learning opportunities and outcomes…

Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

PubMed Central

Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

2014-01-01

Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

Translational Rodent Models of Korsakoff Syndrome Reveal the Critical Neuroanatomical Substrates of Memory Dysfunction and Recovery

PubMed Central

Hall, Joseph M.; Resende, Leticia S.

2016-01-01

Investigation of the amnesic disorder Korsakoff Syndrome (KS) has been vital in elucidating the critical brain regions involved in learning and memory. Although the thalamus and mammillary bodies are the primary sites of neuropathology in KS, functional deactivation of the hippocampus and certain cortical regions also contributes to the chronic cognitive dysfunction reported in KS. The rodent pyrithiamine-induced thiamine deficiency (PTD) model has been used to study the extent of hippocampal and cortical neuroadaptations in KS. In the PTD model, the hippocampus, frontal and retrosplenial cortical regions display loss of cholinergic innervation, decreases in behaviorally stimulated acetylcholine release and reductions in neurotrophins. While PTD treatment results in significant impairment in measures of spatial learning and memory, other cognitive processes are left intact and may be recruited to improve cognitive outcome. In addition, behavioral recovery can be stimulated in the PTD model by increasing acetylcholine levels in the medial septum, hippocampus and frontal cortex, but not in the retrosplenial cortex. These data indicate that although the hippocampus and frontal cortex are involved in the pathogenesis of KS, these regions retain neuroplasticity and may be critical targets for improving cognitive outcome in KS. PMID:22528861

Translational rodent models of Korsakoff syndrome reveal the critical neuroanatomical substrates of memory dysfunction and recovery.

PubMed

Savage, Lisa M; Hall, Joseph M; Resende, Leticia S

2012-06-01

Investigation of the amnesic disorder Korsakoff Syndrome (KS) has been vital in elucidating the critical brain regions involved in learning and memory. Although the thalamus and mammillary bodies are the primary sites of neuropathology in KS, functional deactivation of the hippocampus and certain cortical regions also contributes to the chronic cognitive dysfunction reported in KS. The rodent pyrithiamine-induced thiamine deficiency (PTD) model has been used to study the extent of hippocampal and cortical neuroadaptations in KS. In the PTD model, the hippocampus, frontal and retrosplenial cortical regions display loss of cholinergic innervation, decreases in behaviorally stimulated acetylcholine release and reductions in neurotrophins. While PTD treatment results in significant impairment in measures of spatial learning and memory, other cognitive processes are left intact and may be recruited to improve cognitive outcome. In addition, behavioral recovery can be stimulated in the PTD model by increasing acetylcholine levels in the medial septum, hippocampus and frontal cortex, but not in the retrosplenial cortex. These data indicate that although the hippocampus and frontal cortex are involved in the pathogenesis of KS, these regions retain neuroplasticity and may be critical targets for improving cognitive outcome in KS.

Impairments in action-outcome learning in schizophrenia.

PubMed

Morris, Richard W; Cyrzon, Chad; Green, Melissa J; Le Pelley, Mike E; Balleine, Bernard W

2018-03-03

Learning the causal relation between actions and their outcomes (AO learning) is critical for goal-directed behavior when actions are guided by desire for the outcome. This can be contrasted with habits that are acquired by reinforcement and primed by prevailing stimuli, in which causal learning plays no part. Recently, we demonstrated that goal-directed actions are impaired in schizophrenia; however, whether this deficit exists alongside impairments in habit or reinforcement learning is unknown. The present study distinguished deficits in causal learning from reinforcement learning in schizophrenia. We tested people with schizophrenia (SZ, n = 25) and healthy adults (HA, n = 25) in a vending machine task. Participants learned two action-outcome contingencies (e.g., push left to get a chocolate M&M, push right to get a cracker), and they also learned one contingency was degraded by delivery of noncontingent outcomes (e.g., free M&Ms), as well as changes in value by outcome devaluation. Both groups learned the best action to obtain rewards; however, SZ did not distinguish the more causal action when one AO contingency was degraded. Moreover, action selection in SZ was insensitive to changes in outcome value unless feedback was provided, and this was related to the deficit in AO learning. The failure to encode the causal relation between action and outcome in schizophrenia occurred without any apparent deficit in reinforcement learning. This implies that poor goal-directed behavior in schizophrenia cannot be explained by a more primary deficit in reward learning such as insensitivity to reward value or reward prediction errors.

Suicide Attempts among Individuals with Specific Learning Disorders: An Underrecognized Issue

ERIC Educational Resources Information Center

Fuller-Thomson, Esme; Carroll, Samara Z.; Yang, Wook

2018-01-01

Several studies have linked specific learning disorders (SLDs) with suicidal ideation, but less is known about the disorders' association with suicide attempts. This gap in the literature is addressed via the 2012 nationally representative Canadian Community Health Survey (n = 21,744). The prevalence of lifetime suicide attempts among those with…

Role of learning potential in cognitive remediation: Construct and predictive validity.

PubMed

Davidson, Charlie A; Johannesen, Jason K; Fiszdon, Joanna M

2016-03-01

The construct, convergent, discriminant, and predictive validity of Learning Potential (LP) was evaluated in a trial of cognitive remediation for adults with schizophrenia-spectrum disorders. LP utilizes a dynamic assessment approach to prospectively estimate an individual's learning capacity if provided the opportunity for specific related learning. LP was assessed in 75 participants at study entry, of whom 41 completed an eight-week cognitive remediation (CR) intervention, and 22 received treatment-as-usual (TAU). LP was assessed in a "test-train-test" verbal learning paradigm. Incremental predictive validity was assessed as the degree to which LP predicted memory skill acquisition above and beyond prediction by static verbal learning ability. Examination of construct validity confirmed that LP scores reflected use of trained semantic clustering strategy. LP scores correlated with executive functioning and education history, but not other demographics or symptom severity. Following the eight-week active phase, TAU evidenced little substantial change in skill acquisition outcomes, which related to static baseline verbal learning ability but not LP. For the CR group, LP significantly predicted skill acquisition in domains of verbal and visuospatial memory, but not auditory working memory. Furthermore, LP predicted skill acquisition incrementally beyond relevant background characteristics, symptoms, and neurocognitive abilities. Results suggest that LP assessment can significantly improve prediction of specific skill acquisition with cognitive training, particularly for the domain assessed, and thereby may prove useful in individualization of treatment. Published by Elsevier B.V.

[Adaptive behaviour and learning in children with neurodevelopmental disorders (autism spectrum disorders and attention deficit hyperactivity disorder). Effects of executive functioning].

PubMed

Rosello-Miranda, B; Berenguer-Forner, C; Miranda-Casas, A

2018-03-01

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) present difficulties in adaptive functioning and learning, possibly associated with failures in executive functioning characteristic of both disorders. To analyze the impact of executive functioning in the adaptive behaviors of socialization and daily life and in learning behaviors in children with ASD and children with ADHD. The participants were 124 children matched in age and intellectual quotient: 37 children with typical development, 52 children with ASD and 35 children with ADHD. Parents reported on their children's adaptive behaviors, while teachers provided information on learning behaviors and executive functioning in daily life. There are significant differences between the groups with ASD and ADHD with the typical development group in all domains evaluated. In addition, the group with ASD had worse socialization skills while persistence in learning was more affected in children with ADHD. Finally, the metacognitive index of executive functioning predicted the socialization and persistence of children with ASD. On the other hand, the index of behavioral regulation and the educational level of the parents predicted the socialization skills in children with ADHD. The results highlight the need to include differentiated executive strategies in the intervention of children with ASD and children with ADHD.

Neurobiological Basis of Language Learning Difficulties.

PubMed

Krishnan, Saloni; Watkins, Kate E; Bishop, Dorothy V M

2016-09-01

In this paper we highlight why there is a need to examine subcortical learning systems in children with language impairment and dyslexia, rather than focusing solely on cortical areas relevant for language. First, behavioural studies find that children with these neurodevelopmental disorders perform less well than peers on procedural learning tasks that depend on corticostriatal learning circuits. Second, fMRI studies in neurotypical adults implicate corticostriatal and hippocampal systems in language learning. Finally, structural and functional abnormalities are seen in the striatum in children with language disorders. Studying corticostriatal networks in developmental language disorders could offer us insights into their neurobiological basis and elucidate possible modes of compensation for intervention. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Detecting Abnormal Word Utterances in Children With Autism Spectrum Disorders: Machine-Learning-Based Voice Analysis Versus Speech Therapists.

PubMed

Nakai, Yasushi; Takiguchi, Tetsuya; Matsui, Gakuyo; Yamaoka, Noriko; Takada, Satoshi

2017-10-01

Abnormal prosody is often evident in the voice intonations of individuals with autism spectrum disorders. We compared a machine-learning-based voice analysis with human hearing judgments made by 10 speech therapists for classifying children with autism spectrum disorders ( n = 30) and typical development ( n = 51). Using stimuli limited to single-word utterances, machine-learning-based voice analysis was superior to speech therapist judgments. There was a significantly higher true-positive than false-negative rate for machine-learning-based voice analysis but not for speech therapists. Results are discussed in terms of some artificiality of clinician judgments based on single-word utterances, and the objectivity machine-learning-based voice analysis adds to judging abnormal prosody.

Contribution of Group Therapeutic Factors to the Outcome of Cognitive-Behavioral Therapy for Patients with Panic Disorder.

PubMed

Behenck, Andressa; Wesner, Ana Cristina; Finkler, Débora; Heldt, Elizeth

2017-04-01

Investigating the contribution of therapeutic factors arising from the collective nature or group therapy to treat mental disorders may help therapists maximize the outcome of therapy. Studies about the role of therapeutic factors in cognitive-behavioral group therapy (CBGT) for panic disorder (PD) patients are still scarce. To identify the therapeutic factors rated as the most useful by patients during CBGT. Also, we aimed to investigate the relationship between patient rating of therapeutic factors and specific stages of CBGT. Non-controlled clinical trial. A 12-session CBGT protocol was set up, covering psychoeducation, techniques for anxiety coping, cognitive restructuring, interoceptive and naturalistic exposure, and live exposure to avoidant behavior. PD symptom severity was assessed before and after the CBGT protocol. Yalom's Curative Factors Questionnaire was self-administered at the end of each session to evaluate the 12 therapeutic factors. The sample consisted of 16 patients, who produced 192 assessments of therapeutic factors. Severity of symptoms improved at the end of CBGT, with a large effect size (>1.0). Different ratings were attributed to therapeutic factors at different phases of CBGT. Seven factors were rated as significantly helpful: altruism, interpersonal learning/input, guidance, identification, family reenactment, self-understanding, and existential factors. Therapeutic factors are dynamic and interdependent. Therefore, recognizing the impact of these factors during CBGT may potentially contribute to a better understanding of the therapeutic process. Copyright © 2016 Elsevier Inc. All rights reserved.

Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

ERIC Educational Resources Information Center

Olino, Thomas M.; Seeley, John R.; Lewinsohn, Peter M.

2010-01-01

Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar…

Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

ERIC Educational Resources Information Center

Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

2014-01-01

Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

Developmental coordination disorder

MedlinePlus

Physical causes and other types of learning disabilities must be ruled out before the diagnosis can be confirmed. ... Elsevier; 2016:chap 90. Szklut SE, Philibert DB. Learning disabilities and developmental coordination disorder. In: Umphred DA, Burton ...

Stepped care versus face-to-face cognitive behavior therapy for panic disorder and social anxiety disorder: Predictors and moderators of outcome.

PubMed

Haug, Thomas; Nordgreen, Tine; Öst, Lars-Göran; Kvale, Gerd; Tangen, Tone; Andersson, Gerhard; Carlbring, Per; Heiervang, Einar R; Havik, Odd E

2015-08-01

To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD). Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses. Lower social functioning, higher impairment from the anxiety disorder, and a comorbid cluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help. In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment. CLINICALTRIALS.GOV: Identifier: NCT00619138. Copyright © 2015 Elsevier Ltd. All rights reserved.

No Effects of D-Cycloserine Enhancement in Exposure With Response Prevention Therapy in Panic Disorder With Agoraphobia: A Double-Blind, Randomized Controlled Trial.

PubMed

Hofmeijer-Sevink, Mieke Klein; Duits, Puck; Rijkeboer, Marleen M; Hoogendoorn, Adriaan W; van Megen, Harold J; Vulink, Nienke C; Denys, Damiaan A; van den Hout, Marcel A; van Balkom, Anton J; Cath, Danielle C

2017-10-01

D-cycloserine (DCS) is a partial N-methyl-D-aspartate receptor agonist that potentially augments response to exposure therapy in anxiety disorders by enhancing extinction learning. This randomized, double-blinded, placebo-controlled augmentation trial examined (1) the effectiveness of adding 125 mg of DCS to exposure therapy (before or directly after the first 6 treatment sessions) in patients with panic disorder with agoraphobia and (2) the effectiveness of DCS augmentation preceding exposure relative to DCS augmentation directly postexposure. Fifty-seven patients were allocated to 1 of 3 medication conditions (placebo and pre-exposure and postexposure DCS) as an addition to 6 exposure sessions within a 12-session exposure and response prevention protocol. The primary outcome measure was the mean score on the "alone" subscale of the Mobility Inventory (MI). No differences were found in treatment outcome between DCS and placebo, administered either pre-exposure or postexposure therapy, although at 3-month follow-up, the DCS postexposure group compared with DCS pre-exposure, exhibited greater symptom reduction on the MI-alone subscale. Ancillary analyses in specific subgroups (responders vs nonresponders, early vs late responders, severely vs mildly affected patients) did not reveal any between-group DCS versus placebo differences. Finally, the study did not find an effect of DCS relative to placebo to be specific for successful exposure sessions. This study does not find an effect of augmentation with DCS in patients with severe panic disorder and agoraphobia administered either pretreatment or directly posttreatment sessions. Moreover, no preferential effects are revealed in specific subgroups nor in successful exposure sessions. Yet, a small effect of DCS administration postexposure therapy cannot be ruled out, given the relatively small sample size of this study.

Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications

PubMed Central

Vavken, Patrick; Ganal-Antonio, Anne Kathleen B.; Quidde, Julia; Shen, Francis H.; Chapman, Jens R.; Samartzis, Dino

2015-01-01

Study Design A broad narrative review. Objectives Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of “personalized spine care.” PMID:26225283

The roles of dopamine and serotonin in decision making: evidence from pharmacological experiments in humans.

PubMed

Rogers, Robert D

2011-01-01

Neurophysiological experiments in primates, alongside neuropsychological and functional magnetic resonance investigations in humans, have significantly enhanced our understanding of the neural architecture of decision making. In this review, I consider the more limited database of experiments that have investigated how dopamine and serotonin activity influences the choices of human adults. These include those experiments that have involved the administration of drugs to healthy controls, experiments that have tested genotypic influences upon dopamine and serotonin function, and, finally, some of those experiments that have examined the effects of drugs on the decision making of clinical samples. Pharmacological experiments in humans are few in number and face considerable methodological challenges in terms of drug specificity, uncertainties about pre- vs post-synaptic modes of action, and interactions with baseline cognitive performance. However, the available data are broadly consistent with current computational models of dopamine function in decision making and highlight the dissociable roles of dopamine receptor systems in the learning about outcomes that underpins value-based decision making. Moreover, genotypic influences on (interacting) prefrontal and striatal dopamine activity are associated with changes in choice behavior that might be relevant to understanding exploratory behaviors and vulnerability to addictive disorders. Manipulations of serotonin in laboratory tests of decision making in human participants have provided less consistent results, but the information gathered to date indicates a role for serotonin in learning about bad decision outcomes, non-normative aspects of risk-seeking behavior, and social choices involving affiliation and notions of fairness. Finally, I suggest that the role played by serotonin in the regulation of cognitive biases, and representation of context in learning, point toward a role in the cortically mediated cognitive appraisal of reinforcers when selecting between actions, potentially accounting for its influence upon the processing salient aversive outcomes and social choice.

Semantic Richness and Word Learning in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gladfelter, Allison; Goffman, Lisa

2018-01-01

Semantically rich learning contexts facilitate semantic, phonological, and articulatory aspects of word learning in children with typical development (TD). However, because children with autism spectrum disorder (ASD) show differences at each of these processing levels, it is unclear whether they will benefit from semantic cues in the same manner…

A Self-Regulated Learning Approach for Children with Learning/Behavior Disorders

ERIC Educational Resources Information Center

Benevento, Joan A.

2004-01-01

This book is designed to be an intervention model based on the concepts of Piaget's study of constructivism. The application of this approach will help children with learning/ behavioral disorders actively participate in a fuller integration of their own psychomotor, affective, and cognitive information processing skills and adaptation. The work…

Learning Styles of Students with Attention Deficit Hyperactivity Disorder: Who Are They and How Can We Teach Them?

ERIC Educational Resources Information Center

Brand, Susan; Dunn, Rita; Greb, Fran

2002-01-01

Proposes that students with Attention Deficit Hyperactivity Disorder (ADHD) learn differently than other students. Discusses two studies of ADHD students. Concludes such students may learn better in the afternoon instead of the morning; with tactile and kinesthetic instructional resources; in soft illumination; with Multisensory Instructional…

Factors of Learner-Instructor Interaction Which Predict Perceived Learning Outcomes in Online Learning Environment

ERIC Educational Resources Information Center

Kang, M.; Im, T.

2013-01-01

Interaction in the online learning environment has been regarded as one of the most critical elements that affect learning outcomes. This study examined what factors in learner-instructor interaction can predict the learner's outcomes in the online learning environment. Learners in K Online University participated by answering the survey, and data…

The Effects of Different Computer-Supported Collaboration Scripts on Students' Learning Processes and Outcome in a Simulation-Based Collaborative Learning Environment

ERIC Educational Resources Information Center

Wieland, Kristina

2010-01-01

Students benefit from collaborative learning activities, but they do not automatically reach desired learning outcomes when working together (Fischer, Kollar, Mandl, & Haake, 2007; King, 2007). Learners need instructional support to increase the quality of collaborative processes and individual learning outcomes. The core challenge is to find…

Effects of Cooperative E-Learning on Learning Outcomes

ERIC Educational Resources Information Center

Yeh, Shang-Pao; Fu, Hsin-Wei

2014-01-01

This study aims to discuss the effects of E-Learning and cooperative learning on learning outcomes. E-Learning covers the dimensions of Interpersonal communication, abundant resources, Dynamic instruction, and Learning community; and, cooperative learning contains three dimensions of Cooperative motive, Social interaction, and Cognition…

Symptoms versus neurocognition as predictors of change in life skills in schizophrenia after outpatient rehabilitation.

PubMed

Kurtz, Matthew M; Wexler, Bruce E; Fujimoto, Marco; Shagan, Dana S; Seltzer, James C

2008-07-01

A growing body of literature has shown that neurocognitive deficits in schizophrenia account for 20-60% of the variance in measures of outcome, and in many studies are more closely related to outcome than symptoms [Green, M.F., Kern, R.S., Braff, D.L., Mintz, J., 2000. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr. Bull. 26(1), 119-136; Green, M.F., Kern, R.S., Heaton, R.K., 2004. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr. Res. 72(1), 41-51]. Most of these studies have been cross-sectional, few longitudinal studies have investigated the degree to which neurocognition and symptoms predict ability to benefit from outpatient rehabilitation, and no longitudinal studies use measures of everyday life skills that are performance-based. In the current study we investigated the relationship between five measures of neurocognitive function, crystallized verbal ability, visual sustained vigilance, verbal learning, problem-solving, and processing speed, and two measures of symptoms, total positive and negative symptoms, and change on a performance-based measure of everyday life skills after a year of outpatient rehabilitation. Rehabilitation consisted of both psychosocial and cognitive interventions. Forty-six patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that verbal learning predicted a significant amount of the variance in change in performance-based measures of everyday life skills after outpatient rehabilitation, even when variance for all other variables in the model was accounted for. Measures of crystallized verbal ability, sustained visual vigilance, problem-solving, processing speed and symptoms were not linked to functional status change. These findings emphasize the importance of verbal learning for benefiting from psychosocial and cognitive rehabilitation interventions, and suggest the development of alternative rehabilitation strategies for those who do not benefit.

Learn About GI Motility

MedlinePlus

... eNewsletter Sidebar × MOBILE MENU About Us Learn About GI Motility Digestive Tract Disorders of the Esophagus Disorders ... Floor Motility Testing Personal Stories Contact Search About GI Motility Twitter Facebook YouTube Search Search ... About Us ...

Intact implicit statistical learning in borderline personality disorder.

PubMed

Unoka, Zsolt; Vizin, Gabriella; Bjelik, Anna; Radics, Dóra; Nemeth, Dezso; Janacsek, Karolina

2017-09-01

Wide-spread neuropsychological deficits have been identified in borderline personality disorder (BPD). Previous research found impairments in decision making, declarative memory, working memory and executive functions; however, no studies have focused on implicit learning in BPD yet. The aim of our study was to investigate implicit statistical learning by comparing learning performance of 19 BPD patients and 19 healthy, age-, education- and gender-matched controls on a probabilistic sequence learning task. Moreover, we also tested whether participants retain the acquired knowledge after a delay period. To this end, participants were retested on a shorter version of the same task 24h after the learning phase. We found intact implicit statistical learning as well as retention of the acquired knowledge in this personality disorder. BPD patients seem to be able to extract and represent regularities implicitly, which is in line with the notion that implicit learning is less susceptible to illness compared to the more explicit processes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Translation and validation of the Spanish version of the Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD).

PubMed

Esteba-Castillo, Susanna; Torrents-Rodas, David; García-Alba, Javier; Ribas-Vidal, Núria; Novell-Alsina, Ramon

2016-12-21

The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is a brief instrument that assesses functioning in people with intellectual development disorder and mental health problems/behaviour disorders. The aim of the present study was to examine the evidence on the validity of the scores based on the Spanish version of the HoNOS-LD. The study included 111 participants that were assessed by the Spanish version of the HoNOS-LD and other questionnaires that measured different variables related to the scale. Thirty-three participants were assessed by 2 examiners, and retested 7 days later, in order to study inter-examiner reliability and test-retest reliabilities. Based on clinical and conceptual criteria, and on the results of the parallel analysis, a factorial solution with one factor was selected. Internal consistency was good (Omega coefficient of 0.87). Inter-examiner and test-retest reliabilities were excellent (intraclass correlation coefficients of 0.95 and 0.98, respectively). Correlations between sections of the HoNOS-LD and the related instruments showed the expected direction, and were highly significant (P<.001), and the HoNOS-LD score increased with the intensity of the support required by the participants. These results showed evidence of the validity of association with other external variables. The Spanish version of the HoNOS-LD is a brief, valid and reliable instrument, which will enable a routine assessment of functioning for different uses, including diagnosis and intervention. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans.

PubMed

Rothbaum, Barbara Olasov; Price, Matthew; Jovanovic, Tanja; Norrholm, Seth D; Gerardi, Maryrose; Dunlop, Boadie; Davis, Michael; Bradley, Bekh; Duncan, Erica J; Rizzo, Albert; Ressler, Kerry J

2014-06-01

The authors examined the effectiveness of virtual reality exposure augmented with D-cycloserine or alprazolam, compared with placebo, in reducing posttraumatic stress disorder (PTSD) due to military trauma. After an introductory session, five sessions of virtual reality exposure were augmented with D-cycloserine (50 mg) or alprazolam (0.25 mg) in a double-blind, placebo-controlled randomized clinical trial for 156 Iraq and Afghanistan war veterans with PTSD. PTSD symptoms significantly improved from pre- to posttreatment across all conditions and were maintained at 3, 6, and 12 months. There were no overall differences in symptoms between D-cycloserine and placebo at any time. Alprazolam and placebo differed significantly on the Clinician-Administered PTSD Scale score at posttreatment and PTSD diagnosis at 3 months posttreatment; the alprazolam group showed a higher rate of PTSD (82.8%) than the placebo group (47.8%). Between-session extinction learning was a treatment-specific enhancer of outcome for the D-cycloserine group only. At posttreatment, the D-cycloserine group had the lowest cortisol reactivity and smallest startle response during virtual reality scenes. A six-session virtual reality treatment was associated with reduction in PTSD diagnoses and symptoms in Iraq and Afghanistan veterans, although there was no control condition for the virtual reality exposure. There was no advantage of D-cycloserine for PTSD symptoms in primary analyses. In secondary analyses, alprazolam impaired recovery and D-cycloserine enhanced virtual reality outcome in patients who demonstrated within-session learning. D-cycloserine augmentation reduced cortisol and startle reactivity more than did alprazolam or placebo, findings that are consistent with those in the animal literature.

Testing a machine-learning algorithm to predict the persistence and severity of major depressive disorder from baseline self-reports.

PubMed

Kessler, R C; van Loo, H M; Wardenaar, K J; Bossarte, R M; Brenner, L A; Cai, T; Ebert, D D; Hwang, I; Li, J; de Jonge, P; Nierenberg, A A; Petukhova, M V; Rosellini, A J; Sampson, N A; Schoevers, R A; Wilcox, M A; Zaslavsky, A M

2016-10-01

Heterogeneity of major depressive disorder (MDD) illness course complicates clinical decision-making. Although efforts to use symptom profiles or biomarkers to develop clinically useful prognostic subtypes have had limited success, a recent report showed that machine-learning (ML) models developed from self-reports about incident episode characteristics and comorbidities among respondents with lifetime MDD in the World Health Organization World Mental Health (WMH) Surveys predicted MDD persistence, chronicity and severity with good accuracy. We report results of model validation in an independent prospective national household sample of 1056 respondents with lifetime MDD at baseline. The WMH ML models were applied to these baseline data to generate predicted outcome scores that were compared with observed scores assessed 10-12 years after baseline. ML model prediction accuracy was also compared with that of conventional logistic regression models. Area under the receiver operating characteristic curve based on ML (0.63 for high chronicity and 0.71-0.76 for the other prospective outcomes) was consistently higher than for the logistic models (0.62-0.70) despite the latter models including more predictors. A total of 34.6-38.1% of respondents with subsequent high persistence chronicity and 40.8-55.8% with the severity indicators were in the top 20% of the baseline ML-predicted risk distribution, while only 0.9% of respondents with subsequent hospitalizations and 1.5% with suicide attempts were in the lowest 20% of the ML-predicted risk distribution. These results confirm that clinically useful MDD risk-stratification models can be generated from baseline patient self-reports and that ML methods improve on conventional methods in developing such models.

Testing a machine-learning algorithm to predict the persistence and severity of major depressive disorder from baseline self-reports

PubMed Central

Kessler, Ronald C.; van Loo, Hanna M.; Wardenaar, Klaas J.; Bossarte, Robert M.; Brenner, Lisa A.; Cai, Tianxi; Ebert, David Daniel; Hwang, Irving; Li, Junlong; de Jonge, Peter; Nierenberg, Andrew A.; Petukhova, Maria V.; Rosellini, Anthony J.; Sampson, Nancy A.; Schoevers, Robert A.; Wilcox, Marsha A.; Zaslavsky, Alan M.

2015-01-01

Heterogeneity of major depressive disorder (MDD) illness course complicates clinical decision-making. While efforts to use symptom profiles or biomarkers to develop clinically useful prognostic subtypes have had limited success, a recent report showed that machine learning (ML) models developed from self-reports about incident episode characteristics and comorbidities among respondents with lifetime MDD in the World Health Organization World Mental Health (WMH) Surveys predicted MDD persistence, chronicity, and severity with good accuracy. We report results of model validation in an independent prospective national household sample of 1,056 respondents with lifetime MDD at baseline. The WMH ML models were applied to these baseline data to generate predicted outcome scores that were compared to observed scores assessed 10–12 years after baseline. ML model prediction accuracy was also compared to that of conventional logistic regression models. Area under the receiver operating characteristic curve (AUC) based on ML (.63 for high chronicity and .71–.76 for the other prospective outcomes) was consistently higher than for the logistic models (.62–.70) despite the latter models including more predictors. 34.6–38.1% of respondents with subsequent high persistence-chronicity and 40.8–55.8% with the severity indicators were in the top 20% of the baseline ML predicted risk distribution, while only 0.9% of respondents with subsequent hospitalizations and 1.5% with suicide attempts were in the lowest 20% of the ML predicted risk distribution. These results confirm that clinically useful MDD risk stratification models can be generated from baseline patient self-reports and that ML methods improve on conventional methods in developing such models. PMID:26728563

Eicosapentaenoic and docosahexaenoic acids, cognition, and behavior in children with attention-deficit/hyperactivity disorder: a randomized controlled trial.

PubMed

Milte, Catherine M; Parletta, Natalie; Buckley, Jonathan D; Coates, Alison M; Young, Ross M; Howe, Peter R C

2012-06-01

To determine the effects of an eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acid (DHA)-rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil (control) on literacy and behavior in children with attention-deficit/hyperactivity disorder (ADHD) in a randomized controlled trial. Supplements rich in EPA, DHA, or safflower oil were randomly allocated for 4 mo to 90 Australian children 7 to 12 y old with ADHD symptoms higher than the 90th percentile on the Conners Rating Scales. The effect of supplementation on cognition, literacy, and parent-rated behavior was assessed by linear mixed modeling. Pearson correlations determined associations between the changes in outcome measurements and the erythrocyte fatty acid content (percentage of total) from baseline to 4 mo. There were no significant differences between the supplement groups in the primary outcomes after 4 mo. However, the erythrocyte fatty acid profiles indicated that an increased proportion of DHA was associated with improved word reading (r = 0.394) and lower parent ratings of oppositional behavior (r = 0.392). These effects were more evident in a subgroup of 17 children with learning difficulties: an increased erythrocyte DHA was associated with improved word reading (r = 0.683), improved spelling (r = 0.556), an improved ability to divide attention (r = 0.676), and lower parent ratings of oppositional behavior (r = 0.777), hyperactivity (r = 0.702), restlessness (r = 0.705), and overall ADHD symptoms (r = 0.665). Increases in erythrocyte ω-3 polyunsaturated fatty acids, specifically DHA, may improve literacy and behavior in children with ADHD. The greatest benefit may be observed in children who have comorbid learning difficulties. Copyright © 2012 Elsevier Inc. All rights reserved.

Per-oral Endoscopic Myotomy (POEM) After the Learning Curve: Durable Long-term Results With a Low Complication Rate.

PubMed

Hungness, Eric S; Sternbach, Joel M; Teitelbaum, Ezra N; Kahrilas, Peter J; Pandolfino, John E; Soper, Nathaniel J

2016-09-01

We aimed to report long-term outcomes for patients undergoing per-oral endoscopic myotomy (POEM) after our initial 15-case learning curve. POEM has become an established, natural-orifice surgical approach for treating esophageal motility disorders. To date, published outcomes and comparative-effectiveness studies have included patients from the early POEM experience. Consecutive patients undergoing POEM after our initial 15 cases, with a minimum of 1-year postoperative follow-up, were included. Treatment success was defined as an Eckardt score ≤3 without reintervention. Gastroesophageal reflux was defined by abnormal pH-testing or reflux esophagitis >Los Angeles grade A. Between January 2012 and March 2015, 115 patients underwent POEM at a single, high-volume center. Operative time was 101 ± 29 minutes, with 95% (109/115) of patients discharged on postoperative day 1. Clavien-Dindo grade III complications occurred in 2.7%, one of which required diagnostic laparoscopy to rule out Veress needle injury to the gall bladder. The rate of grade I complications was 15.2%. At an average of 2.4 years post-POEM (range 12-52 months), the overall success rate was 92%. Objective evidence of reflux was present in 40% for all patients and 33% for patients with a body mass index <35 kg/m and no hiatal hernia. POEM performed by experienced surgeons provided durable symptomatic relief in 94% of patients with nonspastic achalasia and 90% of patients with type 3 achalasia/spastic esophageal motility disorders, with a low rate of complications. The rate of gastroesophageal reflux was comparable with prior studies of both POEM and laparoscopic Heller myotomy.

Student outcomes of distance learning in nursing education: an integrative review.

PubMed

Patterson, Barbara J; Krouse, Anne M; Roy, Linda

2012-09-01

Distance learning offers a distinctive environment to educate nursing students. While there is a significant body of evidence in the literature related to course, program, and faculty outcomes of distance education, little attention has been given by researchers to evaluate student outcomes, with the exception of student satisfaction. There is a need to evaluate and translate findings related to student outcomes in distance learning into educational practice. Integrative reviews offer one strategy to contribute to evidence-based teaching practice initiatives. A search of available published qualitative and quantitative research on student outcomes of distance learning from 1999 to 2009 was conducted using a number of databases. Astin's Input-Environment-Output conceptual model provided a framework for this review. Thirty-three studies met the inclusion criteria. Bothcognitive and affective student outcomes emerged. The cognitive outcomes were student learning, learning process, and technology proficiency. Affective outcomes included personal and professional growth, satisfaction, and connectedness. Implications, recommendations, and future research are discussed.

Alcohol and drug use disorders among homeless veterans: prevalence and association with supported housing outcomes.

PubMed

Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

2014-02-01

This study examines the prevalence of alcohol and drug disorders among homeless veterans entering the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program and its association with both housing and clinical outcomes. A total of 29,143 homeless veterans were categorized as either having: no substance use disorder, only an alcohol use disorder, only a drug use disorder, or both alcohol and drug use disorders. Veterans were compared on housing and clinical status prior to admission to HUD-VASH and a smaller sample of 14,086 HUD-VASH clients were compared on their outcomes 6 months after program entry. Prior to HUD-VASH, 60% of program entrants had a substance use disorder and 54% of those with a substance use disorder had both alcohol and drug use disorders. Homeless veterans with both alcohol and drug use disorders had more extensive homeless histories than others, and those with any substance use disorder stayed more nights in transitional housing or residential treatment in the previous month. After six months in HUD-VASH, clients with substance use disorders continued to report more problems with substance use, even after adjusting for baseline differences, but there were no differences in housing outcomes. These findings suggest that despite strong associations between substance use disorders and homelessness, the HUD-VASH program is able to successfully house homeless veterans with substance use disorders although additional services may be needed to address their substance abuse after they become housed. Published by Elsevier Ltd.

The Role of Informative and Ambiguous Feedback in Avoidance Behavior: Empirical and Computational Findings

PubMed Central

Moustafa, Ahmed A.; Sheynin, Jony; Myers, Catherine E.

2015-01-01

Avoidance behavior is a critical component of many psychiatric disorders, and as such, it is important to understand how avoidance behavior arises, and whether it can be modified. In this study, we used empirical and computational methods to assess the role of informational feedback and ambiguous outcome in avoidance behavior. We adapted a computer-based probabilistic classification learning task, which includes positive, negative and no-feedback outcomes; the latter outcome is ambiguous as it might signal either a successful outcome (missed punishment) or a failure (missed reward). Prior work with this task suggested that most healthy subjects viewed the no-feedback outcome as strongly positive. Interestingly, in a later version of the classification task, when healthy subjects were allowed to opt out of (i.e. avoid) responding, some subjects (“avoiders”) reliably avoided trials where there was a risk of punishment, but other subjects (“non-avoiders”) never made any avoidance responses at all. One possible interpretation is that the “non-avoiders” valued the no-feedback outcome so positively on punishment-based trials that they had little incentive to avoid. Another possible interpretation is that the outcome of an avoided trial is unspecified and that lack of information is aversive, decreasing subjects’ tendency to avoid. To examine these ideas, we here tested healthy young adults on versions of the task where avoidance responses either did or did not generate informational feedback about the optimal response. Results showed that provision of informational feedback decreased avoidance responses and also decreased categorization performance, without significantly affecting the percentage of subjects classified as “avoiders.” To better understand these results, we used a modified Q-learning model to fit individual subject data. Simulation results suggest that subjects in the feedback condition adjusted their behavior faster following better-than-expected outcomes, compared to subjects in the no-feedback condition. Additionally, in both task conditions, “avoiders” adjusted their behavior faster following worse-than-expected outcomes, and treated the ambiguous no-feedback outcome as less rewarding, compared to non-avoiders. Together, results shed light on the important role of ambiguous and informative feedback in avoidance behavior. PMID:26630279

Motor learning characterization in people with autism spectrum disorder: A systematic review

PubMed Central

de Moraes, Íbis Ariana Peña; Massetti, Thais; Crocetta, Tânia Brusque; da Silva, Talita Dias; de Menezes, Lilian Del Ciello; Monteiro, Carlos Bandeira de Mello; Magalhães, Fernando Henrique

2017-01-01

ABSTRACT Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily characterized by deficits in social interaction, communication and implicit skill learning. OBJECTIVE: To analyse the results of research on "motor learning" and the means used for measuring "autistic disorder". METHODS: A systematic literature search was done using Medline/PubMed, Web of Science, BVS (virtual health library), and PsycINFO. We included articles that contained the keywords "autism" and "motor learning". The variables considered were the methodological aspects; results presented, and the methodological quality of the studies. RESULTS: A total of 42 studies were identified; 33 articles were excluded because they did not meet the inclusion criteria. Data were extracted from nine eligible studies and summarized. CONCLUSION: We concluded that although individuals with ASD showed performance difficulties in different memory and motor learning tasks, acquisition of skills still takes place in this population; however, this skill acquisition is related to heterogeneous events, occurring without the awareness of the individual. PMID:29213525

Procedural Learning in Children With Developmental Coordination, Reading, and Attention Disorders.

PubMed

Magallón, Sara; Crespo-Eguílaz, Nerea; Narbona, Juan

2015-10-01

The aim is to assess repetition-based learning of procedures in children with developmental coordination disorder (DCD), reading disorder (RD) and attention-deficit hyperactivity disorder (ADHD). Participants included 187 children, studied in 4 groups: (a) DCD comorbid with RD and ADHD (DCD+RD+ADHD) (n = 30); (b) RD comorbid with ADHD (RD+ADHD) (n = 48); (c) ADHD (n = 19); and typically developing children (control group) (n = 90). Two procedural learning tasks were used: Assembly learning and Mirror drawing. Children were tested on 4 occasions for each task: 3 trials were consecutive and the fourth trial was performed after an interference task. Task performance by DCD+RD+ADHD children improved with training (P < .05); however, the improvement was significantly lower than that achieved by the other groups (RD+ADHD, ADHD and controls) (P < .05). In conclusion, children with DCD+RD+ADHD improve in their use of cognitive-motor procedures over a short training period. Aims of intervention in DCD+RD+ADHD should be based on individual learning abilities. © The Author(s) 2015.

Effect of Chemistry Triangle Oriented Learning Media on Cooperative, Individual and Conventional Method on Chemistry Learning Result

NASA Astrophysics Data System (ADS)

Latisma D, L.; Kurniawan, W.; Seprima, S.; Nirbayani, E. S.; Ellizar, E.; Hardeli, H.

2018-04-01

The purpose of this study was to see which method are well used with the Chemistry Triangle-oriented learning media. This quasi experimental research involves first grade of senior high school students in six schools namely each two SMA N in Solok city, in Pasaman and two SMKN in Pariaman. The sampling technique was done by Cluster Random Sampling. Data were collected by test and analyzed by one-way anova and Kruskall Wallish test. The results showed that the high school students in Solok learning taught by cooperative method is better than the results of student learning taught by conventional and Individual methods, both for students who have high initial ability and low-ability. Research in SMK showed that the overall student learning outcomes taught by conventional method is better than the student learning outcomes taught by cooperative and individual methods. Student learning outcomes that have high initial ability taught by individual method is better than student learning outcomes that are taught by cooperative method and for students who have low initial ability, there is no difference in student learning outcomes taught by cooperative, individual and conventional methods. Learning in high school in Pasaman showed no significant difference in learning outcomes of the three methods undertaken.

Teaching Sam to Read: An Integrated Team Approach with One Child with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Coulter, Gail; Sasnett, Roger

2016-01-01

Few evidence-based practices are available to guide educators in teaching reading to children with Autism Spectrum Disorder who have complex learning and behavioral needs associated with the symptoms of ASD and common co-occurring conditions, such as Attention Deficit/Hyperactive Disorder and Specific Learning Disability. Some researchers have…

Learning Processes Associated with Panic-Related Symptoms in Families with and without Panic Disordered Mothers

ERIC Educational Resources Information Center

de Albuquerque, Jiske E. G.; Munsch, Simone; Margraf, Jurgen; Schneider, Silvia

2013-01-01

The present study compared learning processes associated with panic-related symptoms in families with and without panic disordered mothers. Using a multi-informant approach, 86 mothers [of whom 58 had a primary diagnosis of panic disorder (PD)], their partners and teenage children (mean age, 16.67 years) reported about parents' behavior (modeling…

Deviant Behavior in Learning Disabled and Behaviorally Disordered Students as a Function of Level and Placement.

ERIC Educational Resources Information Center

Sindelar, Paul T.; And Others

1985-01-01

Resource and special class teachers of learning disabled (LD) and behaviorally disordered elementary and secondary students rated behaviorally disordered Ss as exhibiting more of five patterns of deviant behavior than LD Ss. Secondary Ss exhibited more rule breaking than elementary Ss; and special class Ss, more anxious, fearful behavior than…

Tic Disorders and Learning Disability: Clinical Characteristics, Cognitive Performance and Comorbidity

ERIC Educational Resources Information Center

Eapen, Valsamma; Crncec, Rudi; McPherson, Sarah; Snedden, Corina

2013-01-01

Tics are involuntary movements or sounds. Tourette syndrome is one of a family of tic disorders that affect around 1% of the population but which remains underrecognised in the community. In paediatric special education learning disability classes, the prevalence of individuals with tic disorders is around 20-45%--higher still in special education…

Design Approach of Mathematics Learning Activities in a Digital Environment for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Santos, Maria Isabel; Breda, Ana; Almeida, Ana Margarida

2017-01-01

Learning environment on mathematics for autistic children is a prototype of a digital environment with dynamic adaptation features designed to offer activities towards the development of mathematical reasoning in children aged 6-12 years, diagnosed with autism spectrum disorders (ASD), a neurodevelopmental disorder characterized by deficits in…

Outcome Studies in the Treatment of Panic Disorder: A Review.

ERIC Educational Resources Information Center

Beamish, Patricia M.; And Others

1996-01-01

Reviews outcome studies in the treatment of panic disorder without agoraphobia for adults. Presents evidence supporting the efficacy of psychopharmacological and cognitive-behavioral interventions. Addresses the need for standards of care in counseling persons with panic disorder. (RB)

Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood.

PubMed

Micali, Nadia; Solmi, Francesca; Horton, Nicholas J; Crosby, Ross D; Eddy, Kamryn T; Calzo, Jerel P; Sonneville, Kendrin R; Swanson, Sonja A; Field, Alison E

2015-08-01

To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16 years, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Eating disorders were ascertained at ages 14 and 16 years in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years after predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR] = 1.39, 95% CI = 1.00-1.94; BN: OR = 3.39, 95% CI = 1.25-9.20; BED: OR = 2.00, 95% CI = 1.06-3.75; and PD: OR = 2.56, 95% CI = 1.38-4.74). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR = 5.72, 95% CI = 2.22-14.72; PD: OR = 4.88, 95% CI = 2.78-8.57; subthreshold BN: OR = 3.97, 95% CI = 1.44-10.98; and subthreshold BED: OR = 2.32, 95% CI = 1.43-3.75). Although BED and BN predicted obesity (respectively OR = 3.58, 95% CI = 1.06-12.14 and OR = 6.42, 95% CI = 1.69-24.30), AN was prospectively associated with underweight. Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Annual Research Review: Optimal outcomes of child and adolescent mental illness

PubMed Central

Costello, E. Jane; Maughan, Barbara

2015-01-01

Background ‘Optimal outcomes’ of child and adolescent psychiatric disorders may mean the best possible outcome, or the best considering a child’s history. Most research into the outcomes of child and adolescent psychiatric disorder concentrates on the likelihood of adult illness and disability given an earlier history of psychopathology. Methods In this article we review the research literature (based on a literature search using PubMed, RePORT and Google Advanced Scholar databases) on optimal outcomes for young people with a history of anxiety, depression, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, or substance use disorders in childhood or adolescence. We consider three types of risks that these children may run later in development: future episodes of the same disorder, future episodes of a different disorder, and functional impairment. The impact of treatment or preventative interventions on early adult functioning is briefly reviewed. Results We found that very few studies enabled us to answer our questions with certainty, but that in general about half of adults with a psychiatric history were disorder-free and functioning quite well in their 20s or 30s. However, their chance of functioning well was less than that of adults without a psychiatric history, even in the absence of a current disorder. Conclusions Among adults who had a psychiatric disorder as a child or adolescent, about half can be expected to be disorder-free as young adults, and of these about half will be free of significant difficulties in the areas of work, health, relationships, and crime. Optimal outcomes are predicted by a mixture of personal characteristics and environmental supports. PMID:25496295

Eating disorders in individuals with type 1 diabetes: case series and day hospital treatment outcome.

PubMed

Colton, Patricia Anne; Olmsted, Marion Patricia; Wong, Harmonie; Rodin, Gary Michael

2015-07-01

Women with type 1 diabetes are at high risk for eating disorders (ED), a combination that can increase medical complications and mortality. As little is known about treatment response in this population, clinical presentation and treatment outcome in an extended case series were assessed. A chart review at the Eating Disorders Day Hospital Program at Toronto General Hospital identified a total of 100 individuals with type 1 diabetes assessed 1990-2012. Of 37 who attended day hospital, most experienced improvement in ED symptoms, but only 18.8% had a good immediate treatment outcome, while 43.8% had an intermediate outcome and 37.5% had a poor outcome (meeting diagnostic criteria at discharge). This is poorer than program outcomes in individuals without diabetes (χ(2)  = 12.2, df = 2; p = 0.002). Factors influencing treatment engagement and outcome must be further studied and used to improve treatment results in this high-risk group. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Patient Outcomes in Varying Length Post Traumatic Stress Disorder Programs at the Denver VA Medical Center

DTIC Science & Technology

1998-06-16

Post Traumatic Stress Disorder ( PTSD ...Outcomes 2 Abstract The Department of Veterans Affairs (DVA) has provided a number of treatment programs for Post Traumatic Stress Disorder ( PTSD ) including...D.C. Department of Veterans Affairs (1991). A Program Evaluation of the Department of Veterans Affairs Post Traumatic Stress Disorder ( PTSD )

Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

ERIC Educational Resources Information Center

McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

2006-01-01

Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

Physical Therapy for Neurological Conditions in Geriatric Populations.

PubMed

Carmeli, Eli

2017-01-01

With more of the world's population surviving longer, individuals often face age-related neurology disorders and decline of function that can affect lifestyle and well-being. Despite neurophysiological changes affecting the brain function and structure, the aged brain, in some degree, can learn and relearn due to neuroplasticity. Recent advances in rehabilitation techniques have produced better functional outcomes in age-related neurological conditions. Physical therapy (PT) of the elderly individual focuses in particular on sensory-motor impairments, postural control coordination, and prevention of sarcopenia. Geriatric PT has a significant influence on quality of life, independent living, and life expectancy. However, in many developed and developing countries, the profession of PT is underfunded and understaffed. This article provides a brief overview on (a) age-related disease of central nervous system and (b) the principles, approaches, and doctrines of motor skill learning and point out the most common treatment models that PTs use for neurological patients.

Enhanced Primary Care Treatment of Behavioral Disorders With ECHO Case-Based Learning.

PubMed

Komaromy, Miriam; Bartlett, Judy; Manis, Kathryn; Arora, Sanjeev

2017-09-01

The Extension for Community Healthcare Outcomes (ECHO) model offers a way for primary care providers to develop expertise in addressing behavioral health issues of primary care patients. It provides an alternative to traditional continuing medical education (CME) for ongoing training and support for health care providers. ECHO uses videoconferencing to connect multiple primary care teams simultaneously with academic specialists and builds capacity via mentorship and case-based learning. ECHO aims to expand access to care by developing capacity to treat common, complex conditions in underserved areas. Participants in an integrated addictions and psychiatry teleECHO program reported that when they presented a patient case, the feedback they received was highly valuable and led them to change their care plans more than 75% of the time. ECHO is an effective model for teaching primary care teams about behavioral health and may be more effective than traditional CME approaches.

Physical Therapy for Neurological Conditions in Geriatric Populations

PubMed Central

Carmeli, Eli

2017-01-01

With more of the world’s population surviving longer, individuals often face age-related neurology disorders and decline of function that can affect lifestyle and well-being. Despite neurophysiological changes affecting the brain function and structure, the aged brain, in some degree, can learn and relearn due to neuroplasticity. Recent advances in rehabilitation techniques have produced better functional outcomes in age-related neurological conditions. Physical therapy (PT) of the elderly individual focuses in particular on sensory–motor impairments, postural control coordination, and prevention of sarcopenia. Geriatric PT has a significant influence on quality of life, independent living, and life expectancy. However, in many developed and developing countries, the profession of PT is underfunded and understaffed. This article provides a brief overview on (a) age-related disease of central nervous system and (b) the principles, approaches, and doctrines of motor skill learning and point out the most common treatment models that PTs use for neurological patients. PMID:29270402

Conceptualizing impact assessment as a learning process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sánchez, Luis E., E-mail: lsanchez@usp.br; Mitchell, Ross, E-mail: ross.mitchell@ualberta.net

This paper explores how project developers and their consultants, government regulators and stakeholders can learn from the impact assessment (IA) process, thus potentially improving its effectiveness and enhancing project sustainability. Despite the benefits that learning can bring to an organization, failure to learn appears commonplace both within the IA process and, once approved, subsequent industrial development. To nurture organizational learning through IA, enabling structures that foster information sharing and interpretation and enhance organizational memory are needed. In this paper learning outcomes are grouped into three categories: acquisition of knowledge and skills, developing new behaviors and developing sustainability-oriented norms and values.more » Means to achieve such outcomes include education and training, experiential learning, learning through public participation (social learning) and a ‘learning organization approach’. Societal expectations increasingly demand not only projects that ‘pass’ the review criteria of regulators, financiers and the community, but IA processes capable of delivering sustainable outcomes that include learning and sharing of knowledge. It is proposed that learning be treated as a purposeful – not as an accidental – outcome of IA, and facilitated by adopting a ‘learning organization approach’ coupled with best practice such as early stakeholder engagement. - Highlights: • Proponents are challenged to develop projects that deliver sustainable outcomes. • Passing the test of government approval may be insufficient to obtain a social license. • Learning by all stakeholders is vital to meet these challenges. • Learning outcomes have to go beyond instrumental learning to reach new behaviors, norms and values. • A “learning organization approach” can promote mutual learning and improve project design.« less

Motivation Matters? The Relationship among Different Types of Learning Motivation, Engagement Behaviors and Learning Outcomes of Undergraduate Students in Taiwan

ERIC Educational Resources Information Center

Hsieh, Tzu-Ling

2014-01-01

The purpose of this study is to understand predictors of different learning outcomes among various student background characteristics, types of learning motivation and engagement behaviors. 178 junior students were surveyed at a 4-year research university in Taiwan. The scales of motivation, engagement and perceived learning outcomes were adapted…

Improving the Students' Activity and Learning Outcomes on Social Sciences Subject Using Round Table and Rally Coach of Cooperative Learning Model

ERIC Educational Resources Information Center

Ningsih; Soetjipto, Budi Eko; Sumarmi

2017-01-01

The purpose of this study was: (1) to analyze increasing students' learning activity and learning outcomes. Student activities which were observed include the visual, verbal, listening, writing and mental visual activity; (2) to analyze the improvement of student learning outcomes using "Round Table" and "Rally Coach" Model of…

Quality of Learning Outcomes in an Online Video-Based Learning Community: Potential and Challenges for Student Teachers

ERIC Educational Resources Information Center

So, Winnie Wing-mui

2012-01-01

This study investigates the learning outcomes of 25 student teachers in an online video-based learning community (VBLC). Data were drawn from the student teachers' written comments and feedback recorded in the VBLC and the post-course interviews. Based on Biggs and Collis's Structure of Observed Learning Outcomes (SOLO) taxonomy, the majority of…

Outcomes-Based Collaborative Teaching and Learning in Asian Higher Education

ERIC Educational Resources Information Center

van Schalkwyk, Gertina J.

2015-01-01

This chapter explores the background and development of outcomes-based collaborative teaching and learning, and provides guidance for writing learning outcomes and engaging students in the Asian higher education context.

Management of uncommon disorders in pregnancy: Von Hippel-Lindau disease, Gitelman syndrome, and Nutcracker syndrome.

PubMed

Merhi, Basma; Miller, Margaret; Lanis, Aviya; Katz, Brittany; Hsu, Tiffany; Tong, Iris

2017-09-01

Uncommon renal disorders in pregnancy can be challenging to manage given limited evidence in the literature to guide management. We present a series of three uncommon renal disorders in pregnancy: Von Hippel-Lindau disease, Gitelman syndrome, and Nutcracker syndrome. Previously published case reports with differing outcomes offer some guidance to the management of these disorders in pregnancy. In this case series, we address the management of these syndromes during pregnancy and discuss the maternal and fetal outcomes. All three of our patients had good maternal and fetal outcomes, which will contribute to current data on maternal and fetal outcomes in these rare diseases, which is limited.

Learning Disorders: Know the Signs, How to Help

MedlinePlus

... a child to read, write or do simple math. Understand the signs and what you can do. ... Dyscalculia. Dyscalculia is a learning disorder related to math concepts. Signs include difficulty solving even simple math ...

Individualized Education Plans (IEPs) (For Parents)

MedlinePlus

... in a special way, for reasons such as: learning disabilities attention deficit hyperactivity disorder (ADHD) emotional disorders cognitive ... the child would be tested for a specific learning disability or other impairment to help determine qualification for ...

Interactions and Learning Outcomes in Online Language Courses

ERIC Educational Resources Information Center

Lin, Chin-Hsi; Zheng, Binbin; Zhang, Yining

2017-01-01

Interactions are the central emphasis in language learning. An increasing number of K-12 students take courses online, leading some critics to comment that reduced opportunities for interaction may affect learning outcomes. This study examined the relationship between online interactions and learning outcomes for 466 students who were taking…

Students Talking about Assessment: Insights on Program Learning Outcomes

ERIC Educational Resources Information Center

Donohue, William J.

2017-01-01

This study examines the student writer perspective of a first-year composition program's student learning outcomes. Student descriptions of learning are a valuable, yet often overlooked data source. The student voice broadens a first-year composition program's outcomes-based, student learning assessment process as program assessment data is often…

Evaluating Learning Outcomes: In Search of Lost Knowledge

ERIC Educational Resources Information Center

O'Brien, Stephen; Brancaleone, David

2011-01-01

This paper examines the concept, pervasive policy and practice of learning outcomes, as increasingly adopted and officially supported in third-level educational institutions. It begins by outlining the context and development of learning outcomes from European and Irish educational policy perspectives. We go on to explore how learning outcomes…

A similarity based learning framework for interim analysis of outcome prediction of acupuncture for neck pain.

PubMed

Zhang, Gang; Liang, Zhaohui; Yin, Jian; Fu, Wenbin; Li, Guo-Zheng

2013-01-01

Chronic neck pain is a common morbid disorder in modern society. Acupuncture has been administered for treating chronic pain as an alternative therapy for a long time, with its effectiveness supported by the latest clinical evidence. However, the potential effective difference in different syndrome types is questioned due to the limits of sample size and statistical methods. We applied machine learning methods in an attempt to solve this problem. Through a multi-objective sorting of subjective measurements, outstanding samples are selected to form the base of our kernel-oriented model. With calculation of similarities between the concerned sample and base samples, we are able to make full use of information contained in the known samples, which is especially effective in the case of a small sample set. To tackle the parameters selection problem in similarity learning, we propose an ensemble version of slightly different parameter setting to obtain stronger learning. The experimental result on a real data set shows that compared to some previous well-known methods, the proposed algorithm is capable of discovering the underlying difference among different syndrome types and is feasible for predicting the effective tendency in clinical trials of large samples.

[Effects of an intensive therapy program for behaviorally disordered mentally handicapped patients on staff personnel in residential care].

PubMed

Elbing, U; Rohmann, U H

1994-03-01

This study evaluates the effects of an intensive therapy program designed for mentally handicapped persons with severely disturbed or autistic behavior on their staff personal which had an active role in the program. The staff members rated their professional competence, quality of interaction with the client, team culture and work satisfaction before and after being engaged in the program, with additional ratings of their personal aims at the beginning of the program. Three sets of data were obtained with the program being conducted three times in a row. The testings of the related as well as the independent samples show differentiated program effects. The main effect is an increase of the professional competence and quality of interaction, especially by the qualified staff members. Trainees put emphasis on the development of their personal relationship with the client. The results are discussed in terms of the impact of learning processes specific to the roles of the staff members and motivational factors on learning and therapy outcome, along with institutional conditions influencing successful learning. Thus the program facilitates the professional and interpersonal learning process of staff members in a specific way with success as well as with limitations.

Can transcranial electrical stimulation improve learning difficulties in atypical brain development? A future possibility for cognitive training.

PubMed

Krause, Beatrix; Cohen Kadosh, Roi

2013-10-01

Learning difficulties in atypical brain development represent serious obstacles to an individual's future achievements and can have broad societal consequences. Cognitive training can improve learning impairments only to a certain degree. Recent evidence from normal and clinical adult populations suggests that transcranial electrical stimulation (TES), a portable, painless, inexpensive, and relatively safe neuroenhancement tool, applied in conjunction with cognitive training can enhance cognitive intervention outcomes. This includes, for instance, numerical processing, language skills and response inhibition deficits commonly associated with profound learning difficulties and attention-deficit hyperactivity disorder (ADHD). The current review introduces the functional principles, current applications and promising results, and potential pitfalls of TES. Unfortunately, research in child populations is limited at present. We suggest that TES has considerable promise as a tool for increasing neuroplasticity in atypically developing children and may be an effective adjunct to cognitive training in clinical settings if it proves safe. The efficacy and both short- and long-term effects of TES on the developing brain need to be critically assessed before it can be recommended for clinical settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Learned predictiveness and outcome predictability effects are not simply two sides of the same coin.

PubMed

Thorwart, Anna; Livesey, Evan J; Wilhelm, Francisco; Liu, Wei; Lachnit, Harald

2017-10-01

The Learned Predictiveness effect refers to the observation that learning about the relationship between a cue and an outcome is influenced by the predictive relevance of the cue for other outcomes. Similarly, the Outcome Predictability effect refers to a recent observation that the previous predictability of an outcome affects learning about this outcome in new situations, too. We hypothesize that both effects may be two manifestations of the same phenomenon and stimuli that have been involved in highly predictive relationships may be learned about faster when they are involved in new relationships regardless of their functional role in predictive learning as cues and outcomes. Four experiments manipulated both the relationships and the function of the stimuli. While we were able to replicate the standard effects, they did not survive a transfer to situations where the functional role of the stimuli changed, that is the outcome of the first phase becomes a cue in the second learning phase or the cue of the first phase becomes the outcome of the second phase. Furthermore, unlike learned predictiveness, there was little indication that the distribution of overt attention in the second phase was influenced by previous predictability. The results suggest that these 2 very similar effects are not manifestations of a more general phenomenon but rather independent from each other. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

National Curricula in Norway and Finland: The Role of Learning Outcomes

ERIC Educational Resources Information Center

Mølstad, Christina Elde; Karseth, Berit

2016-01-01

The core curricular category of "learning outcomes" has entered the educational policy scene in Europe. While content-oriented curricula have dominated the Nordic countries, a shift towards outcomes can also be observed. In this article, we describe the fundamental distinctions between "Didaktik" and learning outcomes and…

Social learning in a high-risk environment: incomplete disregard for the 'minnow that cried pike' results in culturally transmitted neophobia.

PubMed

Crane, Adam L; Mathiron, Anthony G E; Ferrari, Maud C O

2015-08-07

Many prey species rely on conspecifics to gather information about unknown predation threats, but little is known about the role of varying environmental conditions on the efficacy of social learning. We examined predator-naive minnows that had the opportunity to learn about predators from experienced models that were raised in either a low- or high-risk environment. There were striking differences in behaviour among models; high-risk models showed a weaker response to the predator cue and became neophobic in response to the control cue (a novel odour, NO). Observers that were previously paired with low-risk models acquired a strong antipredator response only to the predator cue. However, observers that interacted with high-risk models, displayed a much weaker response to the predator odour and a weak neophobic response to the NO. This is the first study reporting such different outcomes of social learning under different environmental conditions, and suggests high-risk environments promote the cultural transmission of neophobia more so than social learning. If such a transfer can be considered similar to secondary traumatization in humans, culturally transmitted neophobia in minnows may provide a good model system for understanding more about the social ecology of fear disorders. © 2015 The Author(s).

Brief Report: Memory Performance on the California Verbal Learning Test-Children's Version in Autism Spectrum Disorder

ERIC Educational Resources Information Center

Phelan, Heather L.; Filliter, Jillian H.; Johnson, Shannon A.

2011-01-01

According to the Task Support Hypothesis (TSH; Bowler et al. in Neuropsychologia 35:65-70, 1997) individuals with autism spectrum disorder (ASD) perform more similarly to their typically developing peers on learning and memory tasks when provided with external support at retrieval. We administered the California Verbal Learning Test-Children's…

Encoding Deficits Impede Word Learning and Memory in Adults with Developmental Language Disorders

ERIC Educational Resources Information Center

McGregor, Karla K.; Gordon, Katherine; Eden, Nichole; Arbisi-Kelm, Tim; Oleson, Jacob

2017-01-01

Purpose: The aim of this study was to determine whether the word-learning challenges associated with developmental language disorder (DLD) result from encoding or retention deficits. Method In Study 1, 59 postsecondary students with DLD and 60 with normal development (ND) took the California Verbal Learning Test-Second Edition, Adult Version…

Effect of the Corrective Reading Program for Special Needs Students with Learning Disabilities and Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Mallory-Knight, Gwendolyn

2013-01-01

Implementing effective reading instruction is critical for schools. This study examined the effects of the Corrective Reading (CR) program on junior high students with learning disabilities (LD) and students with learning disabilities and attention deficit/hyperactivity disorder (LD/ADHD). The research questions were: What differences exist…

Enhancing the Motor Skills of Children with Autism Spectrum Disorders: A Pool-Based Approach

ERIC Educational Resources Information Center

Lee, Jihyun; Porretta, David L.

2013-01-01

Children with autism spectrum disorders (ASDs) often experience difficulties with motor skill learning and performance. The pool is a unique learning environment that can help children with ASDs learn or improve aquatic skills, fitness, and social skills. A pool-based approach is also aligned with the elements of dynamic systems theory, which…

Variables affecting learning in a simulation experience: a mixed methods study.

PubMed

Beischel, Kelly P

2013-02-01

The primary purpose of this study was to test a hypothesized model describing the direct effects of learning variables on anxiety and cognitive learning outcomes in a high-fidelity simulation (HFS) experience. The secondary purpose was to explain and explore student perceptions concerning the qualities and context of HFS affecting anxiety and learning. This study used a mixed methods quantitative-dominant explanatory design with concurrent qualitative data collection to examine variables affecting learning in undergraduate, beginning nursing students (N = 124). Being ready to learn, having a strong auditory-verbal learning style, and being prepared for simulation directly affected anxiety, whereas learning outcomes were directly affected by having strong auditory-verbal and hands-on learning styles. Anxiety did not quantitatively mediate cognitive learning outcomes as theorized, although students qualitatively reported debilitating levels of anxiety. This study advances nursing education science by providing evidence concerning variables affecting learning outcomes in HFS.

Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder

PubMed Central

Narendorf, Sarah Carter; Cooper, Benjamin; Sterzing, Paul R.; Wagner, Mary; Taylor, Julie Lounds

2012-01-01

OBJECTIVES: We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD). METHODS: Data were from a nationally representative survey of parents, guardians, and young adults with an ASD. Participation in postsecondary employment, college, or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in 3 other eligibility categories: speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome. RESULTS: For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first 6 years after high school. More than 50% of youth who had left high school in the past 2 years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared with youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education. CONCLUSIONS: Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school. Those from lower-income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning before high school exit can facilitate a better connection to productive postsecondary activities. PMID:22585766

Effects of sensory cueing in virtual motor rehabilitation. A review.

PubMed

Palacios-Navarro, Guillermo; Albiol-Pérez, Sergio; García-Magariño García, Iván

2016-04-01

To critically identify studies that evaluate the effects of cueing in virtual motor rehabilitation in patients having different neurological disorders and to make recommendations for future studies. Data from MEDLINE®, IEEExplore, Science Direct, Cochrane library and Web of Science was searched until February 2015. We included studies that investigate the effects of cueing in virtual motor rehabilitation related to interventions for upper or lower extremities using auditory, visual, and tactile cues on motor performance in non-immersive, semi-immersive, or fully immersive virtual environments. These studies compared virtual cueing with an alternative or no intervention. Ten studies with a total number of 153 patients were included in the review. All of them refer to the impact of cueing in virtual motor rehabilitation, regardless of the pathological condition. After selecting the articles, the following variables were extracted: year of publication, sample size, study design, type of cueing, intervention procedures, outcome measures, and main findings. The outcome evaluation was done at baseline and end of the treatment in most of the studies. All of studies except one showed improvements in some or all outcomes after intervention, or, in some cases, in favor of the virtual rehabilitation group compared to the control group. Virtual cueing seems to be a promising approach to improve motor learning, providing a channel for non-pharmacological therapeutic intervention in different neurological disorders. However, further studies using larger and more homogeneous groups of patients are required to confirm these findings. Copyright © 2016 Elsevier Inc. All rights reserved.

German battle casualties: the treatment of functional somatic disorders during World War I.

PubMed

Linden, Stefanie Caroline; Jones, Edgar

2013-10-01

World War I witnessed the admission of large numbers of German soldiers with neurological symptoms for which there was no obvious organic cause. This posed a considerable challenge for the military and medical authorities and resulted in an active discussion on the etiology and treatment of these disorders. Current historiography is reliant on published physician accounts, and this represents the first study of treatment approaches based on original case notes. We analyzed patient records from two leading departments of academic psychiatry in Germany, those at Berlin and Jena, in conjunction with the contemporaneous medical literature. Treatment, which can be broadly classified into reward and punishment, suggestion, affective shock, cognitive learning, and physiological methods, was developed in the context of the emerging fields of animal learning and neurophysiology. A further innovative feature was the use of quantitative methods to assess outcomes. These measures showed good response rates, though most cured patients were not sent back to battle because of their presumed psychopathic constitution. While some treatments appear unnecessarily harsh from today's perspective and were also criticized by leading psychiatrists of the time, the concentration of effort and involvement of so many senior doctors led to the development of psychotherapeutic methods that were to influence the field of psychiatric therapy for decades to come.

German Battle Casualties: The Treatment of Functional Somatic Disorders during World War I

PubMed Central

Linden, Stefanie Caroline; Jones, Edgar

2013-01-01

World War I witnessed the admission of large numbers of German soldiers with neurological symptoms for which there was no obvious organic cause. This posed a considerable challenge for the military and medical authorities and resulted in an active discussion on the etiology and treatment of these disorders. Current historiography is reliant on published physician accounts, and this represents the first study of treatment approaches based on original case notes. We analyzed patient records from two leading departments of academic psychiatry in Germany, those at Berlin and Jena, in conjunction with the contemporaneous medical literature. Treatment, which can be broadly classified into reward and punishment, suggestion, affective shock, cognitive learning, and physiological methods, was developed in the context of the emerging fields of animal learning and neurophysiology. A further innovative feature was the use of quantitative methods to assess outcomes. These measures showed good response rates, though most cured patients were not sent back to battle because of their presumed psychopathic constitution. While some treatments appear unnecessarily harsh from today's perspective and were also criticized by leading psychiatrists of the time, the concentration of effort and involvement of so many senior doctors led to the development of psychotherapeutic methods that were to influence the field of psychiatric therapy for decades to come. PMID:22492735

Cognitive enhancers for facilitating drug cue extinction: insights from animal models.

PubMed

Nic Dhonnchadha, Bríd Áine; Kantak, Kathleen M

2011-08-01

Given the success of cue exposure (extinction) therapy combined with a cognitive enhancer for reducing anxiety, it is anticipated that this approach will prove more efficacious than exposure therapy alone in preventing relapse in individuals with substance use disorders. Several factors may undermine the efficacy of exposure therapy for substance use disorders, but we suspect that neurocognitive impairments associated with chronic drug use are an important contributing factor. Numerous insights on these issues are gained from research using animal models of addiction. In this review, the relationship between brain sites whose learning, memory and executive functions are impaired by chronic drug use and brain sites that are important for effective drug cue extinction learning is explored first. This is followed by an overview of animal research showing improved treatment outcome for drug addiction (e.g. alcohol, amphetamine, cocaine, heroin) when explicit extinction training is conducted in combination with acute dosing of a cognitive-enhancing drug. The mechanism by which cognitive enhancers are thought to exert their benefits is by facilitating consolidation of drug cue extinction memory after activation of glutamatergic receptors. Based on the encouraging work in animals, factors that may be important for the treatment of drug addiction are considered. Copyright © 2011. Published by Elsevier Inc.

Long-term outcomes and predictors of internet-delivered cognitive behavioral therapy for childhood anxiety disorders.

PubMed

Vigerland, Sarah; Serlachius, Eva; Thulin, Ulrika; Andersson, Gerhard; Larsson, Jan-Olov; Ljótsson, Brjánn

2017-03-01

This study investigated the long-term outcomes of internet-delivered cognitive behavior therapy (ICBT) for children with anxiety disorders, and potential pre-treatment predictors of treatment outcome. The sample included eighty-four children (8-12 years old) with anxiety disorders, from both a treatment group and a waitlist control (after participants had crossed over to treatment) of a previous randomized controlled study. Participants were assessed at post-treatment and three- and twelve-months after treatment using a semi-structured interview and parent ratings. Pre-treatment data were used to investigate predictors of treatment outcome at three-month follow-up. Intention-to-treat analysis showed that treatment gains were maintained at twelve-month follow-up, including clinician rated severity of the principal anxiety disorder, parent rated anxiety symptoms and global functioning, with mainly large effect sizes (Cohen's d = 0.63-2.35). Completer analyses showed that suspected autism spectrum disorder was associated with less change in symptom severity. No other pre-treatment measures significantly predicted treatment outcome. This study suggests that internet-delivered CBT can have long-term beneficial effects for children with anxiety disorders. Predictors of treatment outcome need to be evaluated further. Clinicaltrials.gov; NCT01533402. Copyright © 2016 Elsevier Ltd. All rights reserved.

The association between interpersonal problems and treatment outcome in patients with eating disorders.

PubMed

Ung, Elise Meyn; Erichsen, Cecilie Birkmose; Poulsen, Stig; Lau, Marianne Engelbrecht; Simonsen, Sebastian; Davidsen, Annika Helgadóttir

2017-01-01

Interpersonal problems are thought to play an essential role in the development and maintenance of eating disorders. The aim of the current study was to investigate whether a specific interpersonal profile could be identified in a group of patients diagnosed with Bulimia Nervosa, Binge Eating Disorder, or Eating Disorders Not Otherwise Specified, and to explore if specific types of interpersonal problems were systematically related to treatment outcome in this group of patients. The participants were 159 patients who received systemic/narrative outpatient group psychotherapy. Interpersonal problems were measured at baseline, and eating disorder symptoms were measured pre- and post treatment. Data were analysed with the Structural Summary Method, a particular method for the analysis of the Inventory of Interpersonal Problems, and hierarchical regression analysis was conducted. The patients demonstrated a generally Non-assertive and Friendly-submissive interpersonal style. No significant association between the overall level of interpersonal problems and treatment outcome was identified. However, the results showed a correlation between being cold and hostile and poor treatment outcome, while being domineering showed a trend approaching significance in predicting better treatment outcome. The results indicate that patients with eating disorders show a specific interpersonal profile, and suggest that particular types of interpersonal problems are associated with treatment outcome.

One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting

PubMed Central

Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar

2016-01-01

Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care. PMID:26915921

One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting.

PubMed

Rosling, Agneta; Salonen Ros, Helena; Swenne, Ingemar

2016-01-01

Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care.

Behavioral and Electrophysiological Alterations for Reinforcement Learning in Manic and Euthymic Patients with Bipolar Disorder.

PubMed

Ryu, Vin; Ha, Ra Yeon; Lee, Su Jin; Ha, Kyooseob; Cho, Hyun-Sang

2017-03-01

Bipolar disorder is characterized by behavioral changes such as risk-taking and increasing goal-directed activities, which may result from altered reward processing. Patients with bipolar disorder show impaired reward learning in situations that require the integration of reinforced feedback over time. In this study, we examined the behavioral and electrophysiological characteristics of reward learning in manic and euthymic patients with bipolar disorder using a probabilistic reward task. Twenty-four manic and 20 euthymic patients with bipolar I disorder and 24 healthy control subjects performed the probabilistic reward task. We assessed response bias (RB) as a preference for the stimulus paired with the more frequent reward and feedback-related negativity (FRN) to correct identification of the rich stimulus. Both manic and euthymic patients showed significantly lower RB scores in the early learning stage (block 1) in comparison with the late learning stage (block 2 or block 3) of the task, as well as significantly lower RB scores in the early stage compared to healthy subjects. Relatively more negative FRN amplitude is elicited by no presentation of an expected reward, compared to that elicited by presentation of expected feedback. The FRN became significantly more negative from the early (block 1) to the later stages (blocks 2 and 3) in both manic and euthymic patients, but not in healthy subjects. Changes in RB scores and FRN amplitudes between blocks 2 and 3 and block 1 correlated positively in healthy controls, but correlated negatively in manic and euthymic patients. The severity of manic symptoms correlated positively with reward learning scores and negatively with the FRN. These findings suggest that patients with bipolar disorder during euthymic or manic states have behavioral and electrophysiological alterations in reward learning compared to healthy subjects. This dysfunctional reward processing may be related to the abnormal decision-making or altered goal-directed activities frequently seen in patients with bipolar disorder. © 2017 John Wiley & Sons Ltd.

An e-learning course in medical immunology: does it improve learning outcome?

PubMed

Boye, Sondre; Moen, Torolf; Vik, Torstein

2012-01-01

E-learning is used by most medical students almost daily and several studies have shown e-learning to improve learning outcome in small-scale interventions. However, few studies have explored the effects of e-learning in immunology. To study the effect of an e-learning package in immunology on learning outcomes in a written integrated examination and to examine student satisfaction with the e-learning package. All second-year students at a Norwegian medical school were offered an animated e-learning package in basic immunology as a supplement to the regular teaching. Each student's log-on-time was recorded and linked with the student's score on multiple choice questions included in an integrated end-of-the-year written examination. Student satisfaction was assessed through a questionnaire. The intermediate-range students (interquartile range) on average scored 3.6% better on the immunology part of the examination per hour they had used the e-learning package (p = 0.0046) and log-on-time explained 17% of the variance in immunology score. The best and the less skilled students' examination outcomes were not affected by the e-learning. The e-learning was well appreciated among the students. Use of an e-learning package in immunology in addition to regular teaching improved learning outcomes for intermediate-range students.

Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology-Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial.

PubMed

Lee, Li-Ang; Wang, Shu-Ling; Chao, Yi-Ping; Tsai, Ming-Shao; Hsin, Li-Jen; Kang, Chung-Jan; Fu, Chia-Hsiang; Chao, Wei-Chieh; Huang, Chung-Guei; Li, Hsueh-Yu; Chuang, Cheng-Keng

2018-03-08

The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown. The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience. This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules. Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI -75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change -41, 95% CI -67 to -20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants' attention but that the nonlinearly arranged materials affected their learning. Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group. ClinicalTrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV). ©Li-Ang Lee, Shu-Ling Wang, Yi-Ping Chao, Ming-Shao Tsai, Li-Jen Hsin, Chung-Jan Kang, Chia-Hsiang Fu, Wei-Chieh Chao, Chung-Guei Huang, Hsueh-Yu Li, Cheng-Keng Chuang. Originally published in JMIR Medical Education (http://mededu.jmir.org), 08.03.2018.

Food for thought: a pilot study of the pros and cons of changing eating patterns within cognitive-behavioural therapy for the eating disorders.

PubMed

Waller, Glenn; Evans, Jane; Pugh, Matthew

2013-09-01

Evidence-based cognitive-behavioural therapy (CBT) for the eating disorders has an early focus on behavioural changes around food intake. However, patients' anxiety around such change might account for why they often seem unmotivated in treatment. In order to determine the impact of changing intake, this pilot study of patients with bulimic disorders (N = 19) or anorexia nervosa (N = 9) used a mixed quantitative and qualitative design to retrospectively examine their perspectives of the short- and long-term pros and cons of such change. As expected, change was seen negatively in the short-term (with particularly high numbers reporting anxiety), but there were few reports of long-term negative outcomes. In contrast, there were both short- and long-term benefits of changing eating. The patients described what was helpful in making changes and what they had learned as a result. In both cases, their descriptions mapped closely onto the content and process of evidence-based CBT for the eating disorders. Although there is a need for more extensive research, these findings suggest that patients (and therapists) might benefit from being aware of the contrast between the short- and the long-term pros and cons of changing eating within CBT for the eating disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development of an IOS App Using Situated Learning, Communities of Practice, and Augmented Reality for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Clarkson, Jessica

2014-01-01

This paper presents the development process and framework used to construct a transportation app that uses situated learning, augmented reality, and communities of practice. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause social impairments as well as the limit the potential for the individual to achieve independence…

Attentional Learning Helps Language Acquisition Take Shape for Atypically Developing Children, Not Just Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Field, Charlotte; Allen, Melissa L.; Lewis, Charlie

2016-01-01

The shape bias--generalising labels to same shaped objects--has been linked to attentional learning or referential intent. We explore these origins in children with typical development (TD), autism spectrum disorders (ASD) and other developmental disorders (DD). In two conditions, a novel object was presented and either named or described.…

Oral Language Impairments in Developmental Disorders Characterized by Language Strengths: A Comparison of Asperger Syndrome and Nonverbal Learning Disabilities

ERIC Educational Resources Information Center

Stothers, M. E.; Cardy, J. Oram

2012-01-01

Asperger syndrome (AS) and nonverbal learning disabilities (NLD) are developmental disorders in which linguistic ability is reported to be stronger than in disorders from which they must be distinguished for diagnosis. Children and adults with AS and NLD share pragmatic weaknesses, atypical social behaviours, and some cognitive features. To date,…

Characterization of two familial cases presenting with a syndromic specific learning disorder and carrying (17q;21q) unbalanced translocations.

PubMed

Coton, Julie; Labalme, Audrey; Till, Marianne; Bussy, Gerald; Krifi Papoz, Sonia; Lesca, Gaetan; Heron, Delphine; Sanlaville, Damien; Edery, Patrick; des Portes, Vincent; Rossi, Massimiliano

2018-05-01

Chromosomal microarray (CMA) can detect pathogenic copy number variations in 15-20% of individuals with intellectual disability and in 10% of patients with autism spectrum disorders. The diagnostic rate in specific learning disorders (SLD) is unknown. Our study emphasizes the usefulness of CMA in the diagnostic workout assessment of familial SLD.

The Development of Learning Management System Using Edmodo

NASA Astrophysics Data System (ADS)

Joko; Septia Wulandari, Gayuh

2018-04-01

The development of Learning Management System (LMS) can be used as an online learning media by managing the teacher in delivering the material and giving a task. This study aims to: 1) to know the validity of learning devices using LMS with Edmodo, 2) know the student’s response to LMS implementation using Edmodo, and 3) to know the difference of the learning outcome that is students who learned by using LMS with Edmodo and Direct Learning Model (DLM). This research method is quasi experimental by using control group pretest-posttest design. The population of the study was the student at SMKN 1 Sidoarjo. Research sample X TITL 1 class as control goup, and X TITL 2 class as experimental group. The researcher used scale rating to analyze the data validity and students’ respon, and t-test was used to examine the difference of learning outcomes with significant 0.05. The result of the research shows: 1) the average learning device validity use Edmodo 88.14%, lesson plan validity is 92.45%, pretest-posttest validity is 89.15%, learning material validity is 84.64%, and affective and psychomotor-portfolio observation sheets validity is 86.33 included very good criteria or very suitable to be used for research; 2) the result of students’ response questionnaire after taught by using LMS with Edmodo 86.03% in very good category and students agreed that Edmodo can be used in learning; and 3) the learning outcome of LMS by using Edmodo with DLM are: a) there are significant difference of the student cognitive learning outcome which is taught by using Edmodo with the student who use DLM. The average of student learning outcome that is taught LMS using Edmodo is 81.69 compared to student with DLM outcome 76.39, b) there is difference of affective learning outcome that is taught LMS using Edmodo compared to student using DLM. The average of student learning outcomeof affective that is taught LMS by using Edmodo is 83.50 compared students who use DLM 80.34, and c) there is difference of student psychomotor learning outcome that is taught with LMS using Edmodo compared student who use DLM. The average of student learning outcome that is taught with LMS using Edmodo is 85.60 compared to student who uses DLM 82.31.

Managing attention deficit hyperactivity disorder in adults using illicit psychostimulants: A systematic review.

PubMed

Cook, Jon; Lloyd-Jones, Martyn; Arunogiri, Shalini; Ogden, Edward; Bonomo, Yvonne

2017-09-01

Attention deficit hyperactivity disorder and stimulant use disorder commonly co-exist, and appropriate treatments have not been well established. To provide guidance for treatment of co-existing attention deficit hyperactivity disorder and stimulant use disorder. A systematic review of published English articles using MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane, utilising consistent search terms. Randomised controlled trials, comparing any treatment arm with a control group, for participants meeting Diagnostic and Statistical Manual of Mental Disorders or equivalent criteria for both attention deficit hyperactivity disorder and stimulant use disorder. Eight trials were identified for inclusion in this review. Four of eight studies showed improvement in attention deficit hyperactivity disorder outcome measures compared with placebo. Two of six studies that reported substance use outcomes showed improvement in treatment arms compared with placebo. Studies to show effect tended to be those with the highest treatment dosage. Evidence for the efficacy of treatment of patients with comorbid stimulant use disorder and attention deficit hyperactivity disorder is limited. Promising outcomes need replication in further studies utilising higher treatment dosage.

Early-Onset Bipolar Disorder: Characteristics and Outcomes in the Clinic.

PubMed

Connor, Daniel F; Ford, Julian D; Pearson, Geraldine S; Scranton, Victoria L; Dusad, Asha

2017-12-01

To assess patient characteristics and clinician-rated outcomes for children diagnosed with early-onset bipolar disorder in comparison to a depressive disorders cohort from a single clinic site. To assess predictors of bipolar treatment response. Medical records from 714 consecutive pediatric patients evaluated and treated at an academic tertiary child and adolescent psychiatry clinic between 2006 and 2012 were reviewed. Charts of bipolar children (n = 49) and children with depressive disorders (n = 58) meeting study inclusion/exclusion criteria were compared on variables assessing clinical characteristics, treatments, and outcomes. Outcomes were assessed by using pre- and post-Clinical Global Impressions (CGI)-Severity and Children's Global Assessment Scale (CGAS) scores, and a CGI-Improvement score ≤2 at final visit determined responder status. Bipolar outcome predictors were assessed by using multiple linear regression. Clinic prevalence rates were 6.9% for early-onset bipolar disorder and 1.5% for very early-onset bipolar disorder. High rates of comorbid diagnoses, symptom severity, parental stress, and child high-risk behaviors were found in both groups. The bipolar cohort had higher rates of aggression and higher lifetime systems of care utilization. The final CGI and CGAS outcomes for unipolar depression patients differed statistically significantly from those for the bipolar cohort, reflecting better clinical status and more improvement at outcome for the depression patients. Both parent-reported Child Behavior Checklist total T-score at clinic admission and the number of lifetime systems-of-care for the child were significantly and inversely associated with improvement for the bipolar cohort. Early-onset bipolar disorder is a complex and heterogeneous psychiatric disorder. Evidence-based treatment should emphasize psychopharmacology with adjunctive family and individual psychotherapy. Strategies to improve engagement in treatment may be especially important. Given high rates of high-risk behaviors in these youth, regular mental health follow-up to assess safety is important. Additional evidence-based treatments for pediatric bipolar disorder are needed.

Science Learning Outcomes in Alignment with Learning Environment Preferences

NASA Astrophysics Data System (ADS)

Chang, Chun-Yen; Hsiao, Chien-Hua; Chang, Yueh-Hsia

2011-04-01

This study investigated students' learning environment preferences and compared the relative effectiveness of instructional approaches on students' learning outcomes in achievement and attitude among 10th grade earth science classes in Taiwan. Data collection instruments include the Earth Science Classroom Learning Environment Inventory and Earth Science Learning Outcomes Inventory. The results showed that most students preferred learning in a classroom environment where student-centered and teacher-centered instructional approaches coexisted over a teacher-centered learning environment. A multivariate analysis of covariance also revealed that the STBIM students' cognitive achievement and attitude toward earth science were enhanced when the learning environment was congruent with their learning environment preference.

Outcomes of an Academic Service-Learning Project on Four Urban Community Colleges

ERIC Educational Resources Information Center

Greenwood, Debra Abston

2015-01-01

Service-learning has a rich history in higher education, with a multitude of studies indicating positive learning, community engagement, and moral development outcomes of student participants. The majority of the research findings, however, have represented four-year colleges. And while there are limited outcome studies of service-learning in…

Addressing the Learning Outcomes and Assessment Methods Associated with Participation in Student Government Associations: A Qualitative Study of California Community Colleges

ERIC Educational Resources Information Center

Nevin, Miles J.

2017-01-01

This document analysis synthesized student learning outcomes (SLOs) and assessment methods from a sample of 36 student government associations in the California Community College system. Student learning outcomes were grouped according to "governance, ethical and civic behavior", and "experiential learning functions." Using…

Relationship between Learning Outcomes and Online Accesses

ERIC Educational Resources Information Center

Suanpang, Pannee; Petocz, Peter; Reid, Anna

2004-01-01

This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by…

Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

ERIC Educational Resources Information Center

Orinstein, Alyssa; Tyson, Katherine E.; Suh, Joyce; Troyb, Eva; Helt, Molly; Rosenthal, Michael; Barton, Marianne L.; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael C.; Fein, Deborah A.

2015-01-01

Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth,…

Agoraphobia With and Without Panic Disorder: A 20-Year Follow-up of Integrated Exposure and Psychodynamic Therapy.

PubMed

Hoffart, Asle; Hedley, Liv M; Svanøe, Karol; Langkaas, Tomas Formo; Sexton, Harold

2016-02-01

The aim of the current study was to compare the 20-year outcome in panic disorder with agoraphobia (PD with AG) and agoraphobia without panic disorder (AG without PD) patients after inpatient psychological treatment. Of 53 eligible patients having completed a medication-free integrated exposure and psychodynamic treatment, 38 (71.7%)-25 PD with AG and 13 AG without PD patients-attended 20-year follow-up. AG without PD patients improved less than PD with AG patients did on primary outcome measures. In the PD with AG group, there were large uncontrolled effect sizes (<-2.30). More of the AG without PD patients had avoidant personality disorder at pretreatment, but the presence of this disorder did not predict outcome. The follow-up results support that PD with AG and AG without PD are two different disorders. The results also suggest that the very long-term outcome in PD with AG patients is excellent for this integrated treatment.

Is ADHD a Risk Factor for High School Dropout? A Controlled Study.

PubMed

Fried, Ronna; Petty, Carter; Faraone, Stephen V; Hyder, Laran L; Day, Helen; Biederman, Joseph

2016-05-01

This study examined whether ADHD was an independent contributor to grade retention when adjusting for IQ, learning disorders, and social class. Outcome data was from participants in studies at Massachusetts General Hospital (n= 404 ADHD,n= 349 controls) who underwent psychiatric interviews, socioeconomic status measures, and IQ testing. 28% of individuals with ADHD repeated a grade compared with 7% of controls (p< .001). Among participants with ADHD, social class, and IQ were significant predictors of high school dropout or repeated grade. An interaction effect of ADHD and gender was also found with females with ADHD having a higher risk ratio for repeated grade/dropout compared with males with ADHD. Participants with ADHD were significantly more likely to repeat a grade, adjusting for all other variables indicating the critical importance of early identification of ADHD to help mitigate adverse educational outcomes. © The Author(s) 2013.

Teachers' Everyday Professional Development: Mapping Informal Learning Activities, Antecedents, and Learning Outcomes

ERIC Educational Resources Information Center

Kyndt, Eva; Gijbels, David; Grosemans, Ilke; Donche, Vincent

2016-01-01

Although a lot is known about teacher development by means of formal learning activities, research on teachers' everyday learning is limited. In the current systematic review, we analyzed 74 studies focusing on teachers' informal learning to identify teachers' learning activities, antecedents for informal learning, and learning outcomes. In…

Effects of congruence between preferred and perceived learning environments in nursing education in Taiwan: a cross-sectional study

PubMed Central

Yeh, Ting-Kuang; Huang, Hsiu-Mei; Chan, Wing P; Chang, Chun-Yen

2016-01-01

Objective To investigate the effects of congruence between preferred and perceived learning environments on learning outcomes of nursing students. Setting A nursing course at a university in central Taiwan. Participants 124 Taiwanese nursing students enrolled in a 13-week problem-based Fundamental Nursing curriculum. Design and methods Students' preferred learning environment, perceptions about the learning environment and learning outcomes (knowledge, self-efficacy and attitudes) were assessed. On the basis of test scores measuring their preferred and perceived learning environments, students were assigned to one of two groups: a ‘preferred environment aligned with perceived learning environment’ group and a ‘preferred environment discordant with perceived learning environment’ group. Learning outcomes were analysed by group. Outcome measures Most participants preferred learning in a classroom environment that combined problem-based and lecture-based instruction. However, a mismatch of problem-based instruction with students' perceptions occurred. Learning outcomes were significantly better when students' perceptions of their instructional activities were congruent with their preferred learning environment. Conclusions As problem-based learning becomes a focus of educational reform in nursing, teachers need to be aware of students' preferences and perceptions of the learning environment. Teachers may also need to improve the match between an individual student's perception and a teacher's intention in the learning environment, and between the student's preferred and actual perceptions of the learning environment. PMID:27207620

Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

DTIC Science & Technology

2008-12-01

the Student Learning Outcomes Assessment group (SLOAC) at California State University Dominguez Hills. She is an assessment expert and consultant...identified in the program-level outcomes (Essential Elements of Learning Outcomes Assessment, Indicators 4 & 5, University Student Learning Outcomes...A short 70-mile trip is changing the lives of O&P students and impacting future care of returning military service members. By Jennifer Hoydicz

A Pedagogical Alliance for Academic Achievement: Socio-Emotional Effects on Assessment Outcomes

ERIC Educational Resources Information Center

Leighton, Jacqueline P.; Guo, Qi; Chu, Man-Wai; Tang, Wei

2018-01-01

Assessment of student learning outcomes is often discussed in relation to curriculum, standards and even administration practices. However, assessment of learning outcomes is rarely discussed in light of students' socio-emotional contexts, which might help or hinder learning outcomes. For example, do students' perceptions of the teacher as…

The role of outcome inhibition in interference between outcomes: a contingency-learning analogue of retrieval-induced forgetting.

PubMed

Vadillo, Miguel A; Orgaz, Cristina; Luque, David; Cobos, Pedro L; López, Francisco J; Matute, Helena

2013-05-01

Current associative theories of contingency learning assume that inhibitory learning plays a part in the interference between outcomes. However, it is unclear whether this inhibitory learning results in the inhibition of the outcome representation or whether it simply counteracts previous excitatory learning so that the outcome representation is neither activated nor inhibited. Additionally, these models tend to conceptualize inhibition as a relatively transient and cue-dependent state. However, research on retrieval-induced forgetting suggests that the inhibition of representations is a real process that can be relatively independent of the retrieval cue used to access the inhibited information. Consistent with this alternative view, we found that interference between outcomes reduces the retrievability of the target outcome even when the outcome is associated with a novel (non-inhibitory) cue. This result has important theoretical implications for associative models of interference and shows that the empirical facts and theories developed in studies of retrieval-induced forgetting might be relevant in contingency learning and vice versa. © 2012 The British Psychological Society.

Adult Diagnostic and Functional Outcomes of DSM-5 Disruptive Mood Dysregulation Disorder

PubMed Central

Copeland, William E.; Shanahan, Lilly; Egger, Helen; Angold, Adrian; Costello, E. Jane

2014-01-01

Objective Disruptive mood dysregulation disorder is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders. Here, we test whether meeting diagnostic criteria for this disorder in childhood predicts adult diagnostic and functional outcomes. Methods In a prospective, population-based study, subjects were assessed with structured interviews up to 6 times in childhood and adolescence (ages 10 to 16; 5336 observations of 1420 subjects) for symptoms of disruptive mood dysregulation disorder and 3 times in young adulthood (ages 19, 21, and 24-26; 3215 observations of 1273 subjects) for psychiatric and functional outcomes (health, risky/illegal behavior, financial/educational and social functioning). Results Young adults with a history of childhood disruptive mood dysregulation disorders had elevated rates of anxiety and depression and were more likely to meet criteria for more than one adult disorder as compared to controls with no history of childhood psychiatric problems (noncases) or subjects meeting criteria for psychiatric disorders other than disruptive mood dysregulation disorder in childhood/adolescence (psychiatric controls). Participants with a history of disruptive mood dysregulation disorder also were more likely to have adverse health outcomes, be impoverished, have reported police contact, and have low educational attainment as adults compared to either psychiatric or noncase controls. Conclusions The long-term prognosis of children with disruptive mood dysregulation disorder cases is one of pervasive impaired functioning that in many cases is worse than that of other childhood psychiatric cases. PMID:24781389

Employment outcomes in people with bipolar disorder: a systematic review.

PubMed

Marwaha, S; Durrani, A; Singh, S

2013-09-01

Employment outcome in bipolar disorder is an under investigated, but important area. The aim of this study was to identify the long-term employment outcomes of people with bipolar disorder. A systematic review using the Medline, PsychInfo and Web of Science databases. Of 1962 abstracts retrieved, 151 full text papers were read. Data were extracted from 25 papers representing a sample of 4892 people with bipolar disorder and a mean length of follow-up of 4.9 years. Seventeen studies had follow-up periods of up to 4 years and eight follow-up of 5-15 years. Most studies with samples of people with established bipolar disorder suggest approximately 40-60% of people are in employment. Studies using work functioning measures mirrored this result. Bipolar disorder appears to lead to workplace underperformance and 40-50% of people may suffer a slide in their occupational status over time. Employment levels in early bipolar disorder were higher than in more established illness. Bipolar disorder damages employment outcome in the longer term, but up to 60% of people may be in employment. Whilst further studies are necessary, the current evidence provides support for extending the early intervention paradigm to bipolar disorder. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Outcome of dysthymic disorder at 5-year follow-up: the effect of familial psychopathology, early adversity, personality, comorbidity, and chronic stress.

PubMed

Hayden, E P; Klein, D N

2001-11-01

This study sought to identify predictors of course and outcome in dysthymic disorder. Eighty-six outpatients with early-onset dysthymic disorder (before age 21) participated in a prospective 5-year follow-up study. Family history of psychopathology, early home environment, axis I and II comorbidity, social support, and chronic stress were assessed at baseline. The Longitudinal Interval Follow-up Evaluation and the Hamilton Depression Rating Scale were used in the follow-up assessments conducted at 30 and 60 months. Comorbid anxiety disorder, cluster C and depressive personality features, and chronic stress were associated with a lower rate of recovery from dysthymic disorder, while family history of bipolar disorder was associated with a higher probability of recovery. Family history of dysthymic disorder, poor childhood maternal and paternal relationships, childhood sexual abuse, cluster C features, neuroticism, a history of anxiety and eating disorders, and chronic stress predicted higher levels of depression at follow-up. Multivariate models indicated that almost all domains contributed to the prediction of course and outcome. The course and outcome of dysthymic disorder is best conceptualized within a multifactorial framework, with family history of psychopathology, early adversity, axis I and II comorbidity, and chronic stress all making important contributions.

Brief report: Predictors of outcomes in the Early Start Denver Model delivered in a group setting.

PubMed

Vivanti, Giacomo; Dissanayake, Cheryl; Zierhut, Cynthia; Rogers, Sally J

2013-07-01

There is a paucity of studies that have looked at factors associated with responsiveness to interventions in preschoolers with autism spectrum disorder (ASD). We investigated learning profiles associated with response to the early start Denver model delivered in a group setting. Our preliminary results from 21 preschool children with an ASD aged 2- to 5-years suggest that the children with more advanced skills in functional use of objects, goal understanding and imitation made the best developmental gains after 1 year of treatment. Cognitive abilities, social attention, intensity of the treatment and chronological age were not associated with treatment gains.

Lessons to be learned: how a comprehensive neurobiological framework of atypical reading development can inform educational practice

PubMed Central

Ozernov-Palchik, Ola; Yu, Xi; Wang, Yingying; Gaab, Nadine

2016-01-01

Dyslexia is a heritable reading disorder with an estimated prevalence of 5–17%. A multiple deficit model has been proposed that illustrates dyslexia as an outcome of multiple risks and protective factors interacting at the genetic, neural, cognitive, and environmental levels. Here we review the evidence on each of these levels and discuss possible underlying mechanisms and their reciprocal interactions along a developmental timeline. Current and potential implications of neuroscientific findings for contemporary challenges in the field of dyslexia, as well as for reading development and education in general, are then discussed. PMID:27766284

Personalized Medication Response Prediction for Attention-Deficit Hyperactivity Disorder: Learning in the Model Space vs. Learning in the Data Space

PubMed Central

Wong, Hin K.; Tiffin, Paul A.; Chappell, Michael J.; Nichols, Thomas E.; Welsh, Patrick R.; Doyle, Orla M.; Lopez-Kolkovska, Boryana C.; Inglis, Sarah K.; Coghill, David; Shen, Yuan; Tiño, Peter

2017-01-01

Attention-Deficit Hyperactive Disorder (ADHD) is one of the most common mental health disorders amongst school-aged children with an estimated prevalence of 5% in the global population (American Psychiatric Association, 2013). Stimulants, particularly methylphenidate (MPH), are the first-line option in the treatment of ADHD (Reeves and Schweitzer, 2004; Dopheide and Pliszka, 2009) and are prescribed to an increasing number of children and adolescents in the US and the UK every year (Safer et al., 1996; McCarthy et al., 2009), though recent studies suggest that this is tailing off, e.g., Holden et al. (2013). Around 70% of children demonstrate a clinically significant treatment response to stimulant medication (Spencer et al., 1996; Schachter et al., 2001; Swanson et al., 2001; Barbaresi et al., 2006). However, it is unclear which patient characteristics may moderate treatment effectiveness. As such, most existing research has focused on investigating univariate or multivariate correlations between a set of patient characteristics and the treatment outcome, with respect to dosage of one or several types of medication. The results of such studies are often contradictory and inconclusive due to a combination of small sample sizes, low-quality data, or a lack of available information on covariates. In this paper, feature extraction techniques such as latent trait analysis were applied to reduce the dimension of on a large dataset of patient characteristics, including the responses to symptom-based questionnaires, developmental health factors, demographic variables such as age and gender, and socioeconomic factors such as parental income. We introduce a Bayesian modeling approach in a “learning in the model space” framework that combines existing knowledge in the literature on factors that may potentially affect treatment response, with constraints imposed by a treatment response model. The model is personalized such that the variability among subjects is accounted for by a set of subject-specific parameters. For remission classification, this approach compares favorably with conventional methods such as support vector machines and mixed effect models on a range of performance measures. For instance, the proposed approach achieved an area under receiver operator characteristic curve of 82–84%, compared to 75–77% obtained from conventional regression or machine learning (“learning in the data space”) methods. PMID:28443027

Enhancing Learning Environments for Students Affected by Fetal Alcohol Spectrum Disorders: An Exploratory Study of Canadian Pre-Service Teacher Knowledge and Conceptions

ERIC Educational Resources Information Center

Pei, Jacqueline; Job, Jenelle; Poth, Cheryl; O'Brien-Langer, Anna; Tang, Wei

2015-01-01

There is a pressing need for enhancing the learning environment for students affected by Fetal Alcohol Spectrum Disorders (FASDs). To develop relevant professional learning opportunities for teachers, a logical initial step is to explore the extent to which pre-service teachers accurately understand the unique neuropsychological functioning…

Integrating Case Topics in Medical School Curriculum to Enhance Multiple Skill Learning: Using Fetal Alcohol Spectrum Disorders as an Exemplary Case

ERIC Educational Resources Information Center

Paley, Blair; O'Connor, Mary J.; Baillie, Susan J.; Guiton, Gretchen; Stuber, Margaret L.

2009-01-01

Objectives: This article describes the use of fetal alcohol spectrum disorders (FASDs) as a theme to connect the learning of basic neurosciences with clinical applications across the age span within a systems-based, integrated curricular structure that emphasizes problem-based learning. Methods: In collaboration with the Centers for Disease…