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Biomedical subjects

J E Bates

Publications and source records attributed to J E Bates.

At least 19 recordsLinked to original sources

Global and domain-specific cognitive impairment and outcome after subarachnoid hemorrhage.

BACKGROUND: Cognitive dysfunction is the most common form of neurologic impairment after subarachnoid hemorrhage (SAH). OBJECTIVE: To evaluate the impact of global and domain-specific cognitive impairment on functional recovery and quality of life (QOL) after SAH. METHODS: One hundred thirteen patients (mean age 49 years; 68% women) were evaluated 3 months after SAH. Three simple tests of global mental status and neuropsychological tests to assess seven specific cognitive domains were administered. Four aspects of outcome (global handicap, disability, emotional status, and QOL) were compared between cognitively impaired and unimpaired patients with analysis-of-covariance models controlling for age, race/ethnicity, and education. Multiple linear regression was used to evaluate the relative contribution of global and domain-specific cognitive status for predicting concurrent modified Rankin Scale (mRS) and Sickness Impact Profile (SIP) scores. RESULTS: Impairment of global mental status on the Telephone Interview of Cognitive Status (TICS) was associated with poor performance in all seven cognitive domains (all p < 0.0005) and was the only cognitive measure associated with poor recovery in all four aspects of outcome (all p < or = 0.005). Cognitive impairment in four specific domains was also associated with functional disability or reduced QOL. After accounting for global cognitive impairment with the TICS, however, neuropsychological testing did not contribute additional predictive value for concurrent mRS or SIP total scores. CONCLUSIONS: Cognitive impairment impacts broadly on functional status, emotional health, and QOL after SAH. The TICS may be a useful alternative to more detailed neuropsychological testing for detecting clinically relevant global cognitive impairment after SAH.

Adult↗

Continuous EEG monitoring and midazolam infusion for refractory nonconvulsive status epilepticus.

BACKGROUND: Although cIV-MDZ has emerged as a popular alternative to barbiturate therapy for refractory status epilepticus (RSE), experience with its use for this indication is limited. OBJECTIVE: - To evaluate the efficacy of continuous intravenous midazolam (cIV-MDZ) for attaining sustained seizure control in patients with RSE. METHODS: The authors reviewed 33 episodes of RSE treated with cIV-MDZ in their neurologic intensive care unit over 6 years. All patients were monitored with continuous EEG (cEEG). MDZ infusion rates were titrated to eliminate clinical and EEG seizure activity; cIV-MDZ was discontinued once patients were seizure-free for 24 hours. Acute treatment failures (seizures 1 to 6 hours after starting cIV-MDZ), breakthrough seizures (after 6 hours of therapy), post-treatment seizures (within 48 hours of discontinuing therapy), and ultimate treatment failure (frequent seizures that led to treatment with pentobarbital or propofol) were identified. RESULTS: All patients were in nonconvulsive SE at the time cIV-MDZ was started; the mean duration of SE before treatment was 3.9 days (range 0 to 17 days). In addition to benzodiazepines, 94% of patients had received at least two antiepileptic drugs (AED) before starting cIV-MDZ. The mean loading dose was 0.19 mg/kg, the mean maximal infusion rate was 0.22 mg/kg/h, and the mean duration of cIV-MDZ therapy was 4.2 days (range 1 to 14 days). Acute treatment failure occurred in 18% (6/33) of episodes, breakthrough seizures in 56% (18/32), post-treatment seizures in 68% (19/28), and ultimate treatment failure in 18% (6/33). Breakthrough seizures were clinically subtle or purely electrographic in 89% (16/18) of cases and were associated with an increased risk of developing post-treatment seizures (p = 0.01). CONCLUSIONS: Although most patients with RSE initially responded to cIV-MDZ, over half developed subsequent breakthrough seizures, which were predictive of post-treatment seizures and were often detectable only with cEEG. Titrating cIV-MDZ to burst suppression, more aggressive treatment with concurrent AED, or a longer period of initial treatment may reduce the high proportion of patients with RSE who relapse after cIV-MDZ is discontinued.

Adult↗

Peer rejection in childhood, involvement with antisocial peers in early adolescence, and the development of externalizing behavior problems.

A longitudinal, prospective design was used to examine the roles of peer rejection in middle childhood and antisocial peer involvement in early adolescence in the development of adolescent externalizing behavior problems. Both early starter and late starter pathways were considered. Classroom sociometric interviews from ages 6 through 9 years, adolescent reports of peers' behavior at age 13 years, and parent, teacher, and adolescent self-reports of externalizing behavior problems from age 5 through 14 years were available for 400 adolescents. Results indicate that experiencing peer rejection in elementary school and greater involvement with antisocial peers in early adolescence are correlated but that these peer relationship experiences may represent two different pathways to adolescent externalizing behavior problems. Peer rejection experiences, but not involvement with antisocial peers. predict later externalizing behavior problems when controlling for stability in externalizing behavior. Externalizing problems were most common when rejection was experienced repeatedly. Early externalizing problems did not appear to moderate the relation between peer rejection and later problem behavior. Discussion highlights multiple pathways connecting externalizing behavior problems from early childhood through adolescence with peer relationship experiences in middle childhood and early adolescence.

Adolescent↗

The timing of child physical maltreatment: a cross-domain growth analysis of impact on adolescent externalizing and internalizing problems.

In a sample of 578 children assessed in kindergarten through the eighth grade, we used growth modeling to determine the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors for three physical maltreatment groups of children-early-harmed (prior to age 5 years), later-harmed (age 5 years and over), and nonharmed--controlling for SES and gender. Results demonstrated that the earlier children experienced harsh physical treatment by significant adults, the more likely they were to experience adjustment problems in early adolescence. Over multiple domains, early physical maltreatment was related to more negative sequelae than the same type of maltreatment occurring at later periods. In addition, the fitted growth models revealed that the early-harmed group exhibited someswhat higher initial levels of teacher-reported externalizing problems in kindergarten and significantly different rates of change in these problem behaviors than other children, as reported by mothers over the 9 years of this study. The early-harmed children were also seen by teachers, in kindergarten, as exhibiting higher levels of internalizing behaviors. The later-harmed children were seen by their teachers as increasing their externalizing problem behaviors more rapidly over the 9 years than did the early- or nonharmed children. These findings indicate that the timing of maltreatment is a salient factor in examining the developmental effects of physical harm.

Adolescent↗

A cross-domain growth analysis: externalizing and internalizing behaviors during 8 years of childhood.

In a sample of 405 children assessed in kindergarten through the seventh grade, we determined the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors using cross-domain latent growth modeling techniques. We also investigated the effects of race, socioeconomic level, gender, and sociometric peer-rejection status in kindergarten on these trajectories. The results indicated that, on average, the development of these behaviors was different depending upon the source of the data. We found evidence of the codevelopment of externalizing and internalizing behaviors within and across reporters. In addition, we found that African-American children had lower levels of externalizing behavior in kindergarten as reported by mothers than did European-American children but they had greater increases in these behaviors when reported by teachers. Children from homes with lower SES levels had higher initial levels of externalizing behaviors and teacher-reported internalizing behaviors. Males showed greater increases in teacher-reported externalizing behavior over time than did the females. Rejected children had trajectories of mother-reported externalizing and internalizing behavior that began at higher levels and either remained stable or increased more rapidly than did the trajectories for non-rejected children which decreased over time.

Black or African American↗

Early developmental precursors of externalizing behavior in middle childhood and adolescence.

This study examined the infancy- and toddler-age precursors of children's later externalizing problem behavior. Risk constructs included suboptimal patterns of observed caregiver-child interaction and the caregiver's perception of child difficultness and resistance to control. In addition, a novel dimension of caregiver-child relationship quality, the caregiver's perception of her toddler's unresponsiveness to her, was examined as a possible precursor of children's externalizing behavior. Externalizing problem outcomes were assessed throughout the school-age period and again at age 17, using multiple informants. As toddlers, children at risk for later externalizing behavior were perceived as difficult and resistant to control, and relationships with their caregivers were relatively low in warmth and affective enjoyment. Finally, the caregiver's perception of her toddler as emotionally unresponsive to her was a consistent predictor of later externalizing behavior, suggesting that negative maternal cognitions associated with child conduct problems may begin in toddlerhood. These predictive patterns were similar for boys and girls, and with minor exceptions, generalized across different subdimensions of externalizing problem behavior. Our findings underscore the importance of the infancy and toddler periods to children's long-term behavioral adjustment, and indicate the desirability of further research into the nature of caregivers' early perceptions of child unresponsiveness.

Adolescent↗

Discipline responses: influences of parents' socioeconomic status, ethnicity, beliefs about parenting, stress, and cognitive-emotional processes.

Direct and indirect precursors to parents' harsh discipline responses to hypothetical vignettes about child misbehavior were studied with data from 978 parents (59% mothers; 82% European American and 16% African American) of 585 kindergarten-aged children. SEM analyses showed that parents' beliefs about spanking and child aggression and family stress mediated a negative relation between socioeconomic status and discipline. In turn, perception of the child and cognitive-emotional processes (hostile attributions, emotional upset, worry about child's future, available alternative disciplinary strategies, and available preventive strategies) mediated the effect of stress on discipline. Similar relations between ethnicity and discipline were found (African Americans reported harsher discipline), especially among low-income parents. Societally based experiences may lead some parents to rely on accessible and coherent goals in their discipline, whereas others are more reactive.

Black or African American↗

Measurement of impulsivity: construct coherence, longitudinal stability, and relationship with externalizing problems in middle childhood and adolescence.

This study focused on the assessment of impulsivity in nonreferred school-aged children. Children had been participants since infancy in the Bloomington Longitudinal Study. Individual differences in impulsivity were assessed in the laboratory when children were 6 (44 boys, 36 girls) and 8 (50 boys, 39 girls) years of age. Impulsivity constructs derived from these assessments were related to parent and teacher ratings of externalizing problems across the school-age period (ages 7-10) and to parent and self-ratings of these outcomes across adolescence (ages 14-17). Consistent with prior research, individual measures of impulsivity factor-analyzed into subdimensions reflecting children's executive control capabilities, delay of gratification, and ability or willingness to sustain attention and compliance during work tasks. Children's performance on the main interactive task index, inhibitory control, showed a signficant level of stability between ages 6 and 8. During the school-age years, children who performed impulsively on the laboratory measures were perceived by mothers and by teachers as more impulsive, inattentive, and overactive than others, affirming the external validity of the impulsivity constructs. Finally, impulsive behavior in the laboratory at ages 6 and 8 predicted maternal and self-ratings of externalizing problem behavior across adolescence, supporting the long-term predictive value of the laboratory-derived impulsivity measures.

Adolescent↗

Early behavior problems as a predictor of later peer group victimization: moderators and mediators in the pathways of social risk.

This study is a prospective investigation of the predictive association between early behavior problems (internalizing, externalizing, hyperactivity-impulsiveness, immaturity-dependency) and later victimization in the peer group. Teacher ratings of the behavioral adjustment of 389 kindergarten and 1st-grade children (approximate age range of 5 to 6 years-old) were obtained, using standardized behavior problem checklists. These ratings predicted peer nomination scores for victimization, obtained 3 years later, even after the prediction associated with concurrent behavior problems was statistically controlled. Further analyses suggested that the relation between early behavior problems and later victimization is mediated by peer rejection and moderated by children's dyadic friendships. Behavior problems appear to play an important role in determining victimization within the peer group, although the relevant pathways are complex and influenced by other aspects of children's social adjustment.

Aggression↗

Quality of early family relationships and individual differences in the timing of pubertal maturation in girls: a longitudinal test of an evolutionary model.

In an 8-year prospective study of 173 girls and their families, the authors tested predictions from J. Belsky, L. Steinberg, and P. Draper's (1991) evolutionary model of individual differences in pubertal timing. This model suggests that more negative-coercive (or less positive-harmonious) family relationships in early childhood provoke earlier reproductive development in adolescence. Consistent with the model, fathers' presence in the home, more time spent by fathers in child care, greater supportiveness in the parental dyad, more father-daughter affection, and more mother-daughter affection, as assessed prior to kindergarten, each predicted later pubertal timing by daughters in 7th grade. The positive dimension of family relationships, rather than the negative dimension, accounted for these relations. In total, the quality of fathers' investment in the family emerged as the most important feature of the proximal family environment relative to daughters' pubertal timing.

Adolescent↗

Peer group victimization as a predictor of children's behavior problems at home and in school.

This study reports a short-term prospective investigation of the role of peer group victimization in the development of children's behavior problems, at home and in school. Sociometric interviews were utilized to assess aggression, victimization by peers, and peer rejection, for 330 children who were in either the third or fourth grade (approximate mean ages of 8-9 years old). Behavior problems were assessed using standardized behavior checklists completed by mothers and teachers. A follow-up assessment of behavior problems was completed 2 years later, when the children were in either the fifth or sixth grade (approximate mean ages of 10-11 years old). Victimization was both concurrently and prospectively associated with externalizing, attention dysregulation, and immature/dependent behavior. Victimization also predicted increases in these difficulties over time, and incremented the prediction in later behavior problems associated with peer rejection and aggression. The results of this investigation demonstrate that victimization in the peer group is an important predictor of later behavioral maladjustment.

Aggression↗

Multiple risk factors in the development of externalizing behavior problems: group and individual differences.

The aim of this study was to test whether individual risk factors as well as the number of risk factors (cumulative risk) predicted children's externalizing behaviors over middle childhood. A sample of 466 European American and 100 African American boys and girls from a broad range of socioeconomic levels was followed from age 5 to 10 years. Twenty risk variables from four domains (child, sociocultural, parenting, and peer-related) were measured using in-home interviews at the beginning of the study, and annual assessments of externalizing behaviors were conducted. Consistent with past research, individual differences in externalizing behavior problems were stable over time and were related to individual risk factors as well as the number of risk factors present. Particular risks accounted for 36% to 45% of the variance, and the number of risks present (cumulative risk status) accounted for 19% to 32% of the variance, in externalizing outcomes. Cumulative risk was related to subsequent externalizing even after initial levels of externalizing had been statistically controlled. All four domains of risk variables made significant unique contributions to this statistical prediction, and there were multiple clusters of risks that led to similar outcomes. There was also evidence that this prediction was moderated by ethnic group status, most of the prediction of externalizing being found for European American children. However, this moderation effect varied depending on the predictor and outcome variables included in the model.

Black or African American↗

Interaction of temperamental resistance to control and restrictive parenting in the development of externalizing behavior.

Child temperament and parental control were studied as interacting predictors of behavior outcomes in 2 longitudinal samples. In Sample 1, data were ratings of resistant temperament and observed restrictive control in infancy-toddlerhood and ratings of externalizing behavior at ages 7 to 10 years; in Sample 2, data were retrospective ratings of temperament in infancy-toddlerhood, observed restrictive control at age 5 years, and ratings of externalizing behavior at ages 7 to 11 years. Resistance more strongly related to externalizing in low-restriction groups than in high-restriction groups. This was true in both samples and for both teacher- and mother-rated outcomes. Several Temperament x Environment interaction effects have been reported previously, but this is one of very few replicated effects.

Child↗

Daughter and mother report of individual symptoms on the Children's Depression Inventory.

PURPOSE: To examine differences between early adolescent girls' and their mothers' perceptions of girls' depressive symptoms. METHODS: 313 daughter-mother dyads completed the Children's Depression Inventory. RESULTS: Low to modest agreement was found for most symptoms, although higher agreement was found for symptoms relating to school performance. The hypothesis that girls would report more ideational symptoms and mothers more behavioral symptoms of depression was tested; girls generally reported more ideational and behavioral symptoms when differences occurred. However, several specific ideational symptoms (feeling like crying; feeling sad; guilt; worrying) tended to be more frequently endorsed by girls and had particularly poor daughter-mother agreement. Examining third variables associated with daughter-mother agreement, girls scoring high on social desirability tended to have smaller daughter-minus-mother difference scores for ideational, but not for behavioral items; therefore, social desirability may be associated with girls underreporting ideational symptoms. CONCLUSIONS: Mothers appear to be reliable raters of symptoms related to school functioning, but may be less aware of certain covert depressive symptoms in their early adolescent daughters.

Adolescent↗

Reactive and proactive aggression in school children and psychiatrically impaired chronically assaultive youth.

The authors proposed that reactively aggressive and proactively aggressive types of antisocial youth would differ in developmental histories, concurrent adjustment, and social information-processing patterns. In Study 1, 585 boys and girls classified into groups called reactive aggressive, proactive aggressive, pervasively aggressive (combined type), and nonaggressive revealed distinct profiles. Only the reactive aggressive groups demonstrated histories of physical abuse and early onset of problems, adjustment problems in peer relations, and inadequate encoding and problem-solving processing patterns. Only the proactive aggressive groups demonstrated a processing pattern of anticipating positive outcomes for aggressing. In Study 2, 50 psychiatrically impaired chronically violent boys classified as reactively violent or proactively violent demonstrated differences in age of onset of problem behavior, adjustment problems, and processing problems.

Adolescent↗

Achilles tendon insertion: an in vitro anatomic study.

Seventeen adult fresh-frozen below-knee amputation cadaver specimens were studied. Calcific Achilles tendinitis was present in three specimens. After exposing the Achilles tendon insertion on the calcaneus, the insertion was outlined with waterproof paint. The specimens were photographed on a special plexiglass apparatus to highlight important findings. For the purpose of showing the length of insertion on lateral radiographs, lead beads were placed on the most superior and most inferior aspects of the insertion. All specimens showed that the tendon terminated at the medial and lateral bone borders of the calcaneus without significant extension around the medial or lateral wall. All specimens revealed a greater distance of insertion on the medial calcaneus than on the lateral side. In the specimens that had calcific Achilles tendinitis, the posterior bone surface of the spurs was devoid of tendinous insertion, instead, the insertion occurred between the spur and the posterior wall of the calcaneus. All spurs were located laterally at the most inferior border of the tendon insertion.

Achilles Tendon↗

Subtypes of social withdrawal in early childhood: sociometric status and social-cognitive differences across four years.

From a sample of 567 kindergartners observed during free play, 150 children were classified as socially withdrawn and followed over 4 years. A cluster analysis involving teacher ratings was used to identify subtypes of withdrawn children. Four clusters were identified, 3 fitting profiles found in the literature and labeled unsociable (n = 96), passive-anxious (n = 23), and active-isolate (n = 19), and 1 typically not discussed, labeled sad/depressed (n = 12). Sociometric ratings indicated that unsociable children had elevated rates of sociometric neglect, active-isolates had higher than expected levels of rejection, and sad/depressed children had elevated rates of both neglect and rejection. Subtypes also differed in social information-processing patterns, with active-isolate children displaying the least component skills. The findings that some experience more difficulty than others might account for the ambiguity in extant studies regarding whether or not social withdrawal is a risk factor in psychosocial development, because withdrawal has most often been treated as a unitary construct in the past.

Anxiety↗

The early socialization of aggressive victims of bullying.

This study reports the first prospective investigation of the early family experiences of boys who later emerged as both aggressive and bullied (i.e., aggressive victims) during their middle childhood years. It was hypothesized that a history of violent victimization by adults leads to emotion dysregulation that results in a dual pattern of aggressive behavior and victimization by peers. Interviews with mothers of 198 5-year-old boys assessed preschool home environments. Four to 5 years later, aggressive behavior and peer victimization were assessed in the school classroom. The early experiences of 16 aggressive victims were contrasted with those of 21 passive (nonaggressive) victims, 33 nonvictimized aggressors, and 128 normative boys. Analyses indicated that the aggressive victim group had experienced more punitive, hostile, and abusive family treatment than the other groups. In contrast, the nonvictimized aggressive group had a history of greater exposure to adult aggression and conflict, but not victimization by adults, than did the normative group, whereas the passive victim group did not differ from the normative group on any home environment variable.

Adult↗