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Unraveling the Longitudinal Relationship Between ADHD and Anxiety Disorders: The Contribution of Parenting
Year of Dissertation:
Background: The substantially elevated risk for anxiety disorders among children with attention-deficit/hyperactivity disorder (ADHD) is well documented, although a causal explanation for the high comorbidity has yet to be identified. Objective:To investigate the extent to which ADHD in young children affects parenting practices, which, in turn, place children at risk for anxiety disorders. Method: A sample of 200 children was assessed at ages 3-4 years (Baseline; BL) and at three follow-up time-points (ages 5, 6, and 8 years). Presence or absence of ADHD at BL and presence or absence of anxiety disorder at ages 6 and 8 were determined via semi-structured interview with parents. Parenting behaviors were ascertained at BL, age 5, and age 6, via parental self-report on the Alabama Parenting Questionnaire - Preschool Revision (APQ-PR) and observer-coded video recordings of parent-child interactions (PCI) within the lab. Results: (1) Age 3-4 ADHD predicted greater rates of anxiety disorders at age 8. (2) Early ADHD predicted less parent-rated positive parenting at ages 5-6 and more observer-rated parental negative emotionality and lack of respect for autonomy at ages 3-4 and 5; early ADHD also predicted poorer observer-rated quality of support in parents of 6 year-olds. (3) Lower parent-rated positive parenting between the ages of 3 and 5 years, and higher observer-rated parental negative expressions of emotion at ages 5 and 6, were predictive of child anxiety disorders at age 8, even after controlling for early temperament. (4) Mediation analyses found parenting, particularly that characterized by rejection, low warmth, and poor positive contingency management, to partially mediate the relationship between preschool ADHD and age 8 anxiety disorders. Conclusions: Parenting plays an important role in contributing to or alleviating risk for the development of anxiety disorders in children with ADHD. Implications for prevention and intervention are discussed.
TONIC AND PHASIC INHIBITORY MECHANISMS MEDIATING SENSORIMOTOR DECISION-MAKING IN THE GOLDFISH AUDITORY STARTLE CIRCUIT
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This work describes related studies of cellular and synaptic signaling mechanisms involved in the balance of excitation and inhibition in the goldfish auditory startle circuit. The general purpose of these experiments was to identify novel mechanisms that contribute to action selection at different stages of the motor control hierarchy. The methods applied to achieve this goal tested the effects of selective antagonists for target receptor systems on sound-evoked excitation and inhibition of startle. Chapter 2 describes a study of a poorly-understood serotonergic mechanism, the 5-HT5A receptor, that was not previously functionally characterized in native tissues or associated with neural or behavioral processes. Treatment with a selective 5-HT5A antagonist caused a 26.41 ± 3.98% reduction in sound-evoked excitation of startle. Subsequent experiments revealed that the 5-HT5A antagonist significantly reduced post-synaptic excitability in the Mauthner-cell (M-cell) neurons that initiate startle. Despite these effects, prepulse inhibition (PPI) of the startle response remained robustly intact after treatment with the 5-HT5A antagonist. The 5-HT5A receptor is thus not a likely mechanism for PPI, but does act as a selective modulator of startle excitability. A final series of experiments confirmed that the 5-HT5A antagonist reduced M-cell excitability by increasing Cl- conductance, likely by activating Cl- channels. Chapter 3 presents experiments focused on the inhibitory neurotransmitters that directly mediate the phasic inhibitory process elicited during PPI. Strychnine, a glycine receptor (GlyR) antagonist, caused an 87.43 ± 21.53% increase in sound-evoked excitation of startle, but PPI remained robustly intact, despite this. GlyRs thus likely mediate a tonic inhibitory process that was blocked by strychnine treatment, but glycinergic components of sound-evoked inhibition decayed too rapidly (<50 ms) to contribute to the prolonged time-course of PPI. In a parallel series of experiments, treatment with bicuculline, the GABAAR antagonist, caused similar increases in sound-evoked excitation (by 133.8 ± 10.3%) of startle, but the GABAAR antagonist also significantly reduced auditory PPI at inter-stimulus intervals of 100 ms and less. In sum, these findings indicate that glycine and GABA tonically inhibit the M-cell startle circuit, but GABA is also the primary effector mechanism for inhibitory signaling during PPI. In summary, three goals were accomplished. First, the thorough functional characterization of 5-HT5A provides a fully integrated serotonergic mechanism, and this appears to provide an ideal tool for selective potentiation of startle. Next, experiments with strychnine emphasize a short-lived role of GlyRs in sound-evoked (feed-forward) inhibition, and also act as mediators of a tonic inhibitory process that controls startle excitability. Last, experiments with bicuculline identify GABA as the inhibitory neurotransmitter that directly mediates PPI.
The Effects of Pre- and Post-Venire Publicity on Juror Decision Making
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Given the proliferation of the media in everyday life, finding jurors who have not been exposed to potentially biasing pretrial publicity (PTP) is somewhat of a challenge, especially in high profile cases. This has long been recognized by the courts, but some question the effectiveness of the remedies that have been put in place. Over the past 45 years, psychologists have studied these effects to understand whether and how PTP influences juror decision making. This research has shown that PTP effects do indeed exist and can jeopardize the defendant's right to a fair an impartial trial. At the same time, some have questioned the methodological rigor of these studies and their applicability to the trial setting. Additionally, some important questions remain, specifically the durability of PTP effects, the influence of quantity and type of PTP (pro-prosecution vs. pro-defense), the medium of exposure (print vs. television), and the influence of mid-trial publicity. This study was designed to address these questions by investigating the influence of pre- and post-venire publicity on juror decision making. The purpose of this study was (1) to examine the durability of PTP effects, (2) to examine the influence of pro-prosecution and pro-defense PTP on decision making, (3) to examine the influence of natural vs. experimentally manipulated PTP, (4) to examine the influence of amount of PTP exposure on decision making, (5) to examine the influence of medium of PTP, (6) to examine the influence of post-venire publicity, and (7) to add to the external validity of PTP effects. It was proposed that depending on the media slant jurors are exposed to - a pro-prosecution slant or a pro-defense slant -- their perceptions and inferences will be distorted in the direction of the favored party. This has significant legal implications as many news media sources are substantially biased in one direction or the other and this exposure could influence decision making. The results revealed that participants were significantly influenced by the slant of the PTP they were exposed to. Specifically, participants in the pro-defense condition were more likely to render not guilty verdicts as compared to those in the pro-prosecution condition, and this effect lasted throughout the duration of the trial. Additionally PTP exposure significantly distorted participants' perceptions of witnesses at all points in the trial. Secondly, a finding of no significant difference of the effect of exposure slant between the naturally exposed, and experimentally exposed samples provide support for the external validity of laboratory studies examining PTP effects. In addition, quantity of PTP influenced decision making, such that those exposed to greater quantities of PTP tended to be more biased. Finally, medium of PTP and post-venire publicity exposure had no significant influence on decision making. Results provide support for the pervasive and persistent nature of PTP effects on juror decision making.
EXAMINING SPATIAL RESOLUTION, STIMULUS PERCEPTION AND RELATIVE CONTRIBUTIONS OF THE OCTAVOLATERALIS SUB-SYSTEMS OF THE GOLDFISH (CARASSIUS AURATUS)
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In two separate series of behavioral experiments, spatial resolution and perceptual dimensions corresponding to physical stimulus attributes (frequency, amplitude and position) of a vibratory dipole source were assessed using classically conditioned respiratory suppression in goldfish (Carassius auratus).
Reflective Functioning and Differentiation-Relatedness During Pregnancy and Infant Attachment Outcomes at One Year
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This study compared maternal reflective functioning (RF) and differentiation-relatedness (DR) during pregnancy and examined how these processes relate to the quality of mother-infant attachment at one year. The subjects were 35 mother-infant pairs drawn from the control group of a longitudinal treatment study, "Minding the Baby (MTB)," a federally and privately funded home intervention program developed jointly by the Yale School of Nursing and Yale Child Study Center, led by Drs. Lois Sadler and Arietta Slade, and targeting a low socio-economic status area of New Haven, CT. The Pregnancy Interview (Slade, 2003) was administered to the women (ages 14-25 years) during the third trimester of pregnancy, and quality of attachment was assessed when infants were 14 months using the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978; Main & Solomon, 1990). The DR scoring system, the Differentiation-Relatedness Scale of Self and Object Representations (Diamond, Blatt, Stayner, & Kaslow, 2011), was adapted for use with the Pregnancy Interview to provide a manual for this study (Daley, 2012). Lowest, highest, and most typical DR ratings were captured for self, the woman's mother, the father of the baby, and the baby. The mean for the baby, at 3.03, was one DR point lower than other relationship means. Three composite scores were created, averaging across relationships: Low DR, High DR, and Overall DR. Results indicated that maternal RF was correlated with Overall DR and High DR; however, none of these variables distinguished between attachment outcomes. In contrast, Low DR distinguished, with a large effect size (d = .92), between disorganized and secure attachment outcomes (p = .026), and, in post-hoc analyses, between disorganized and all organized outcomes. For the disorganized group, Low DR often dropped to self-other boundary confusion (level 2) across relationships. This suggests that, for a population of women on the lower end of the RF Scale, transient regression to non-differentiated states during pregnancy is a risk factor for disorganized infant attachment outcomes at one year. Results have implications for early identification of high-risk dyads and refinement of intervention models.
Characterization of Somatosensory Processing in Relation to Schizotypal Traits in a Sample of Nonclinical Young Adults
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A core feature of schizophrenia spectrum disorders (SSDs) is a basic sensory (e.g., visual, auditory) processing disruption, yet few studies have examined somatosensation. The current dissertation project examined somatosensory processes among individuals at varying degrees of psychometric risk for psychosis using tactile texture and spatial discrimination and letter recognition tasks. Differential patterns of associations of somatosensory abilities with schizotypal trait dimensions (positive, negative, disorganized), independent of anxiety and depressive symptoms, and the relative contributions of bottom-up (peripheral and morphologic features) versus top-down (error types) processing were examined. It was hypothesized that: 1) performance on somatosensory tasks would account for significant variability in total schizotypal traits; 2) somatosensory performances would be differentially associated with schizotypal trait dimensions, and somatosensory performances would account for variability in schizotypal traits beyond mood symptoms; and, 3) central and peripheral mechanisms may contribute to somatosensory performance, but they were not expected to fully account for the associations between basic somatosensory processing and schizotypal traits. Participants were 125 (37 Male/88 Female) young adults (Mage = 20.55, SD = 3.27) recruited from the City University of New York human subjects pool. Participants were asked to complete somatosensory tasks and mood and personality self-report measures. Fingerprints were obtained to assess morphologic features. Anxiety and depressive symptoms were included as covariates, as they accounted for a significant proportion of variability schizotypal traits. Contrary to hypotheses, after accounting for the relative contributions of mood symptoms, better spatial discrimination and rough texture discrimination abilities were associated with more disorganized and negative schizotypal traits, respectively, at the trend level. Exploratory analyses demonstrated some differential contributions of dermatoglyphic features and letter recognition confusion errors in accounting for variability in schizotypal traits. Specifically, more isomorphic errors were significantly associated with fewer negative (and total) schizotypal traits, and, at trend level, more minutiae were associated with more positive schizotypal traits. Findings are discussed in the context of theories regarding neural substrates of somatosensory processing disruptions in SSDs. Implications for understanding SSD etiology and using somatosensory measures as possible indicators of risk for psychosis are posited.
THE EFFECTS OF CHILDHOOD MALTREATMENT ON CRIMINAL AND SUBSTANCE ABUSE OUTCOMES IN URBAN YOUTH DIAGNOSED WITH ADHD
Virginia De Sanctis
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Results from longitudinal studies of individuals diagnosed with attention-deficit/hyperactive disorder (ADHD) in childhood have clearly shown that these children are at heightened risk for poor outcomes as they enter into adolescence and early adulthood. Among poor outcomes criminality (Barkley, Fischer, Edelbrock, & Smallish, 1990; Hechtman & Weiss, 1986; Mannuzza, Klein, Konig, & Giampino, 1989; Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1993) and substance use disorders (SUDs; Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1998; Wilens, Biederman, & Mick, 1998; King, Iacono, & Mcgue, 2004) are particularly prevalent and cause significant hardship for the individual, their family, and society at large. While early conduct disorder (CD) has been shown to account for a substantial portion of the risk associated with later criminality and substance use in youth with ADHD (Armstrong & Costello, 2002; Brook, Whiteman, Cohen, Shapiro, & Balka, 1995; Disney, Elkins, Mcgue, & Iacono, 1999; Barkley, Fischer, Smallish, & Fletcher, 2004), the extent to which other factors, such as a history of childhood maltreatment, contribute to poor outcomes remain relatively unexplored. This is surprising given the fact that 1) there is a clear literature showing that childhood maltreatment confers considerable risk for later poor outcome in general population studies (Cicchetti & Manly, 2001; Widom, 1989a; Smith & Thornberry, 1995; Zingraff, Leiter, Myers, & Johnsen, 1993; Ireland, Smith, & Thornberry, 2002; Smith, Ireland, & Thornberry, 2005), and 2) children diagnosed with ADHD are at increased risk for maltreatment due to externalizing behaviors and dysfunctional parental relations (Briscoe-Smith & Hinshaw, 2006; Ford, Racusin, Daviss, Ellis,Thomas, Rogers, et al., 1999). To our knowledge, no study has examined the contributory role of childhood maltreatment on later poor outcome among children with ADHD. The identification of maltreatment as risk factor is important as it could 1) significantly change the way clinicians assess and treat children with ADHD, and 2) be instrumental in the development of more targeted treatment alternatives and interventions for this at risk population. The following series of studies investigated the role of childhood maltreatment in the development of later criminality and SUDs in adolescents and young adults in a referred sample of urban, ethnically and socio-economically diverse children recruited in childhood between the ages of seven and 11 years and diagnosed with ADHD (N = 183). This group was re-assessed in adolescence (n = 98), almost ten years later, and compared to a well-matched, never-ADHD comparison group (n = 85). Official criminal records for the sample were obtained approximately three years after commencement of the adolescent follow-up. The results of these studies clearly establish a history of childhood maltreatment as a potent and important risk factor for later poor outcome in ADHD youth. In addition, it appears from our results that at least some portion of the poor outcome that has been attributed to CD in ADHD studies may in fact be due to childhood maltreatment. These findings have important implications with regard to antisocial and substance use outcomes and emphasize the utility of assessing childhood maltreatment in ADHD populations.
Emotion Regulation and Aging: A Neurophysiological Study
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Cognitive emotion regulation (ER) pertains to the ability to change the way we attend to and experience emotional information and events. Older and younger adults, however, differ in the way that they attend to emotional information. Socioemotional Selective Theory (SST) suggests that as we age we become more adept at using cognitive ER strategies to reduce negative emotion because we have less time left in life. As a result of these motivational changes, a branch of SST, the positivity effect, proposes older versus younger adults attend to and remember more pleasant than unpleasant stimuli. Research that systematically examines different types of cognitive ER in controlled (reappraisal) and automatic (directed attention) contexts, using neurophysiological measures, has the potential to clarify the nature of the positivity effect. The present research capitalizes on the excellent temporal resolution of the late positive potential (LPP) which is sensitive to attention to emotion and the use of cognitive ER strategies: increasing emotional responses produces larger LPP amplitudes and decreasing smaller LPP amplitudes. Chapter one served to first evaluate whether cognitive ER impacts memory performance and if the LPP during a cognitive ER task was associated with memory performance in younger adults (N = 49). Subsequent research presented uses the LPP to understand whether younger (n = 49) and older adults (n =28) differ in: a) how they attend to emotional information during a passive viewing task (bottom-up); b) how they use two types of cognitive ER strategies, reappraisal (top-down) and directed attention (intermediary top-down); c) how cognitive ER strategies impact memory performance. Results highlight several important contributions to the cognitive ER and aging literature. First, in the initial study results showed that instructions to increase emotional responses to unpleasant stimuli results in larger LPP amplitudes as compared to viewing or decreasing emotional responses. Memory performance in the increase and view conditions was better than the decrease condition. Additionally, larger LPP amplitudes in the increase and decrease conditions were associated with better memory performance. Second, older adults showed sustained attention to emotional stimuli; however younger and older adults did not show preferential attention to unpleasant and pleasant stimuli (respectively). Third, younger and older adults did not differ in their ability to use reappraisal as measured via the LPP, but did show differences in LPP amplitudes on the directed attention task to unpleasant stimuli. Younger, but not older adults showed larger LPP amplitudes to unpleasant stimuli presented with an arousing versus non-arousing focus. Fourth, age differences in memory performance did not emerge; however stimuli presented with an arousing focus were remembered more than those with a non-arousing focus. Fifth, only larger LPP amplitudes to unpleasant stimuli in the decrease condition (relative to a neutral maintain) were associated with better memory performance for younger and older adults. Taken together results suggest that older versus younger adults may sustain processing of emotional stimuli and that age differences in cognitive ER may lie within bottom-up cognitive ER tasks as opposed to reappraisal. Results hold promise that the LPP may be a useful tool for examining other types of cognitive ER strategies in younger and older adults.
Roles of dopamine D1 and D2, opioid and glutamate NMDA receptor signaling in the acquisition and expression of fat- and glucose-conditioned flavor preferences in rats and c-Fos analysis of the dopamine mesotelencephalic and nigrostriatal pathways following intake of sugars and fats in rats.
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Systemic administration of the non-competitive NMDA antagonist, MK-801, demonstrated that acquisition, but not expression, were found to affect the orosensory-mediated (flavor/flavor: f/f) fructose-conditioned flavor preference (CFP). The present studies demonstrated a similar outcome when f/f and f/n processes were combined. Fat-CFP and glucose-CFP studies indicated that systemic injections of the NMDA antagonist, MK-801, were able to significantly reduce acquisition, but not expression, of Corn-Oil (CO)-CFP and glucose-CFP. Both studies appear to have mitigated effects on acquisition as compared to the separate orosensory and postingestive CFP studies. Previous studies found that systemic administration of dopamine (DA) D1 (SCH23390) and D2 (raclopride) antagonists blocked both the acquisition and expression of the orosensory-mediated fructose-CFP and sham sucrose-CFP. DA D1, but not D2, blocked the f/n acquisition, and to a lesser degree, expression, of IG sucrose-CFP. The current study of both fat-CFP and glucose-CFP found that DA D1 and D2 antagonists did attenuate the acquisition and expression of conditioned flavor preference of CO-CFP and oral glucose-CFP, but to a lesser degree. Similar to how a combined f/f and f/n solution is affected by an NMDA antagonist, DA D1 and D2 antagonists do affect the combined f/f and f/n solutions of CO and glucose, but not to the degree observed for fructose-CFP or IG glucose-CFP. It is suspected that certain areas of the mesotelencephalic and nigrostriatal DA pathways affect CFP, such as the nucleus accumbens (NAc), the amygdala (AMY), the medial prefrontal cortex (mPFC), or the dorsal striatum (caudate and putamen: CPu). The present study examined the origin of DA (ventral tegmental area: VTA) and the five projection zones (NAc shell, NAc core, AMY, mPFc and CPu) simultaneously for fos-like immunoreactivity (FLI) following oral ingestion of CO (f/f and f/n), glucose (f/f and f/n), fructose (f/f) and three controls (water, saccharin and xanthan gum). CO, which was isocaloric to fructose and glucose, elicited significantly higher FLI in the NAc core, the AMY, the mPFC, the VTA and the CPu than the controls. Glucose elicited significantly higher FLI in the AMY, the CPu and the NAc core than the controls. Fructose elicited significantly higher FLI in the AMY and the CPu than the controls.
Couple Communication, Attachment Status and Relationship Satisfaction.
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Researchers have been working to understand how relationships begin, what makes them last, what the ingredients are for a satisfying relationship, and what predicts their dissolution. Adult attachment has been found to be associated with the formation, satisfaction, maintenance of, and communication within romantic relationships. The present study explores the associations among adult attachment, communication, and marital and premarital satisfaction. Most studies rely on an individual's self-report of his or her intimate relationship, while few base their conclusions on observations of relationship interaction. This study looks at specific, audiotaped, interactions between couples as well as self-reports of attachment style, communication style, and relationship satisfaction. There were a number of significant findings that indicate a relationship between couple communication, relationship satisfaction, and attachment status. In addition, there were replications of previous findings on couple communication, couple attachment, and relationship satisfaction. The majority of hypotheses were supported: relationship satisfaction was significantly linked to attachment status, positive aspects of communication were linked to women's attachment status, men's use of Support Validation was significantly related to their partners' attachment status, couple communication and relationship satisfaction were significantly related, and relationship satisfaction (specifically problem intensity) was significantly associated with couple communication. The present study evidences a connection between couples' intrapsychic attachment representations (as measured by self-reports) and their interpersonal relationship communication behavior (as observed using the IDCS). It makes a major contribution to the couple attachment literature by linking the intrapsychic sphere of attachment to the interpersonal sphere of communication behavior.