Studies published between the beginning of 2013 and May 2015 on the neuropsychological functioning of patients with anorexia nervosa compared with healthy participants framed in the context of the Research Domain Criteria matrix identifies evidence for functional differences in three domains: Negative Valance Systems-negative attentional biases and lack of neural responsivity to hunger; Cognitive Systems-limited congruence between clinical and cognitive performance, poorer non-verbal than verbal performance, altered attentional styles to disorder related stimuli, perceptual processing impairment in discriminating body images, weaknesses in central coherence, set shifting weaknesses at low weight status, decision-making weaknesses, and greater neural resources required for working memory; Systems for Social Processes-patients appear to have a different attentional response to faces, and perception and understanding of self and others. Hence, there is evidence to suggest that patients with anorexia nervosa have a specific neuropsychological performance style across tasks in three domains of functioning. Some current controversies and areas for future development are identified.
AimsMutations in the KCNJ11 gene, which encodes the Kir6.2 subunit of the pancreatic KATP channel, cause neonatal diabetes. KCNJ11 is also expressed in the brain, and ~ 20% of those affected have neurological features, which may include features suggestive of psychiatric disorder. No previous studies have systematically characterized the psychiatric morbidity in people with KCNJ11 neonatal diabetes. We aimed to characterize the types of psychiatric disorders present in children with KCNJ11 mutations, and explore their impact on families.MethodsThe parents and teachers of 10 children with neonatal diabetes due to KCNJ11 mutations completed the Strengths and Difficulties Questionnaire and the Development and Wellbeing Assessment. Strengths and Difficulties Questionnaire scores were compared with normative data. Diagnoses from the Development and Wellbeing Assessment were compared with known clinical diagnoses.ResultsStrengths and Difficulties Questionnaire scores indicated high levels of psychopathology and impact. Psychiatric disorder(s) were present in all six children with the V59M or R201C mutation, and the presence of more than one psychiatric disorder was common. Only two children had received a formal clinical diagnosis, with a further one awaiting assessment, and the coexistence of more than one psychiatric disorder had been missed. Neurodevelopmental (attention deficit hyperactivity disorder and autism) and anxiety disorders predominated.ConclusionsSystematic assessment using standardized validated questionnaires reveals a range of psychiatric morbidity in children with KCNJ11 neonatal diabetes. This is under‐recognized clinically and has a significant impact on affected children and their families. An integrated collaborative approach to clinical care is needed to manage the complex needs of people with KCNJ11 neonatal diabetes.
An underlying neuropsychological heterogeneity may exist in AN. We encourage future studies to investigate whether the identified profiles and their association with clinical characteristics are replicable. We cautiously suggest that neuropsychological profiling may have potential to both inform future research and have possible clinical benefits through individually tailored treatment strategies.
Purpose-There is a lack of valid and reliable generic measures of Health Related Quality of Life(HRQoL) for children under eight. This was a preliminary study to assess the psychometric properties of the newly formulated Quality of Life Scale for Children (QoL-C), which uses a pictorial response format.Method-335 primary school children completed the QoL-C on two occasions, two weeks apart. Children aged 4-7 were interviewed one-to-one whilst children aged 8-9 completed the measure as a class activity. Test re-test reliability, convergent validity and child-parent concordance were assessed.Findings-Only one child refused to complete the QoL-C, which suggests the measure is userfriendly. Test re-test reliability was moderate for the measures total score (ICC=0.48, 95% CI 0.39, 0.57) but low to fair for individual items (K from 0.13 to 0.37). Internal consistency was moderate (α=0.42 time one, 0.53 time two). A small significant correlation was found between the QoL-C and Child Health Meter in the expected direction (r=-0.32) suggesting convergent validity. There was low concordance between the children's QoL-C responses and parents responses (r=0.19) to a parallel measure.Research implications-Our results suggest that further development of this measure is needed. However,our findings indicate that one-to-one support increases the reliability of very young children's responses. The use of pictures, emoticons and minimal text used in the QoL-C should be investigated further.Value-Low parent-child concordance underscores the importance that younger children get the opportunity to share their views about their HRQoL Keywords -QoL-C, quality of life, children, measure, health, Article Classification: Research paper A growing interest in the field of Quality of Life (QoL) research has led to an expansion in the use of Health Related Quality of Life (HRQoL) measures within health services (Varni et al., 2007a). The consensus is that measures of general HRQoL should be based on several domains that are necessary for healthy functioning (Wallander et al., 2001); namely physical, mental and social wellbeing (World Health Organisation (WHO) 1948; National Institute for Clinical Excellence (NICE), 2010). The aim of generic HRQoL measures is to gain an accurate representation of an individual's perception of their current health state (Hurst et al., 1997). There are also disease specific measures that assess the impact of clinical interventions for particular chronic illnesses (Brazier and Longworth, 2011) .These measures provide data that can be used to evaluate interventions on clinical trials across different health conditions (Food and Drug Administration (FDA), 2006), inform government and organisation policies, and improve patient healthcare experiences (Varni et al., 2007b;Robinson, 1993). There is a tension between generic measures that allow comparison across multiple conditions, versus disease specific measures, that may be more sensitive to change in the particular condition being measured, but make mean...
Weaknesses in planning by patients with anorexia nervosa (AN) have been noted (e.g., Zakzanis, Campbell, & Polsinelli, 2010 ) and are generally based on adults. This study explored D-KEFS Tower Test performance to better understand learning styles and strategies used by child and adolescent patients with AN compared to healthy controls. Overall, no significant differences were found in achievement; however, Item 5 predicted performance across harder items. The AN group was significantly faster to move their first disc suggesting patients with AN did not spend as much time planning their strategies for item completion. The findings of this study in conjunction with other studies investigating planning in AN may suggest the existence of subtle differences in learning style and strategy, such as faster initiation times, rather than gross planning differences. Further research is required to better understand the relationship between these subtle differences and clinical presentations.
Purpose – Community-based randomised control trials (RCTs) rely heavily on the involvement and collaboration of statutory and third-sector services and their employees. This paper seeks to explore the experiences of practitioners working within a statutory children and family service setting that delivered additional parenting programmes evaluated by an RCT. Design/methodology/approach – Practitioners completed a semi-structured interview about their experiences of the research trial based on a topic guide. Interviews were recorded, transcribed and analysed using thematic analysis. Findings – Results suggest that the experience of being involved in research was mostly positive for practitioners, but also produced additional stress. The research brought them the experience of being involved with national and international teams; and they valued the additional supervision and training that they received. They spoke about the skills that they developed and how they were able to continue to use these after the research trial had ended. Originality/value – Little is known about how services working alongside major research projects experience their involvement and what impact, if any, this has on them. This may be important as it could influence successful recruitment and retention of practitioners during RCTs, and the successful design and execution of other types of evaluation.
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