Behavioural symptoms, cognitive deficits, and findings from electrophysiological, neuroimaging and genetic studies all suggest atypical performance monitoring in ADHD. Performance monitoring involves error detection and post-error behavioural adjustment and is crucial to behavioural self-regulation and reinforcement learning, both of which are dysfunctional in ADHD. Therefore, post-error slowing was examined in children with ADHD and controls using a modified flanker task both with, and without, error detection provided. There was a significant main effect of group on post-error slowing across conditions and when error-detection was provided, significant post-error slowing deficits were found in children with ADHD. These findings suggest that the performance monitoring deficit in ADHD is specific to post-error behavioural adjustment and supports the inclusion of this deficit in the neurocognitive profile of ADHD. Findings are discussed in terms of current neurocognitive reinforcement learning models of ADHD.

Post-stroke fatigue (PSF) is a common yet under-diagnosed and undertreated phenomenon. The unresolved debate over what is PSF has hampered the ability of clinicians to study and develop treatments for this condition. Patients with stroke (n=70) seeking neurorehabilitation at Toronto Rehabilitation Institute completed self-report ratings of fatigue, depressive and anxiety symptoms, and sleepiness. Data were collected from objective measures of stroke topography, sleep disorders, physical fatigability and comorbid medical conditions. A Principal-Components Analysis was performed. Factor 1, the “Distress” factor, was comprised of the all of the self-reported scales i.e. depression, anxiety, fatigue and sleepiness. Factor 2, the “Physical State” factor, was comprised of a diagnosis of Obstructive Sleep Apnea, stroke territory and total medical burden. Factor 3, the “Performance” factor, was comprised by the 6 Minute Walk Test. An orthogonal rotation was the most parsimonious fit to the data, suggesting that the three factors are uncorrelated to each other.

The purpose of this study was to investigate the presentation and outcome of anorexia nervosa (AN) within the pediatric population. A retrospective chart review of individuals who were admitted for the first time to hospital between 2000-2005 for treatment of AN was completed. Individuals were classified as Early Pediatric AN (admitted <14 years old) or Later Pediatric AN (≥14 years old). It was hypothesized that the Early Pediatric AN group would have a less severe presentation, as measured by percent ideal body weight (%IBW) and medical stability at admission, and better outcome as measured by rate of weight gain post-discharge, number of hospitalizations and the Morgan-Russell General Outcome Scale rating. The study contained a total of 207 cases, larger than many previous studies in pediatric AN. The study found that younger age at presentation was associated with admission at a higher %IBW but not medical stability. Age at presentation did not predict rate of weight gain or rehospitalization; however, the Early Pediatric AN group had a better outcome on the Morgan-Russell scale.

Purpose: The objective of this study was to investigate both depression and psychological distress as determinants of breast and cervical cancer screening. Methods: Ontario female respondents to the Canadian Community Health Survey version 1.2 (2002) were assessed for both Major Depressive Disorder (World Mental Health-Composite International Diagnostic Interview for depression) and psychological distress (Kessler 6-item Distress Scale (K6)>/= 8). Respondents eligible for screening (N=4042 for cervical cancer; N=1403 for breast cancer) were linked to Ontario administrative health service data to prospectively ascertain screening outcomes. Results: Women with K6 >/= 8 had reduced breast cancer screening compliance in adjusted analyses (AOR 0.63, 95% CI 0.40-0.97). The association between K6 >/= 8 and cervical cancer screening approached significance in women over age 40 (AOR=0.65, 95%CI 0.41-1.04). Conclusion: Decreased likelihood of screening in women with clinically significant psychological distress suggests that attention to adequacy of preventive services is a potential target for intervention.

Problem gambling is the subclinical form of pathological gambling and both are characterized by difficulties in the limiting of money and time spent on gambling. Genetic and personality factors have been implicated in gambling disorders (PG). As PG is classified as an impulse-control disorder, the serotonin (5-HT) system has been suggested to be involved. We sought to better understand the complex relationship between personality traits, PG, and 5-HT genes. We investigated ten 5-HT candidate genes for association with PG and personality traits. We also examined personality traits for association with PG. We found that MAOA and HTR3A haplotypes were associated with Agreeableness and Conscientiousness personality domains, PG was associated with high Neuroticism and low Conscientiousness scores, and the MAOA gene may play a role in PG. Our findings contribute to the better understanding of how 5-HT genes may be involved in the neurobiological mechanisms underlying PG and personality.

Post-stroke fatigue (PSF) is a common yet under-diagnosed and undertreated phenomenon. The unresolved debate over what is PSF has hampered the ability of clinicians to study and develop treatments for this condition. Patients with stroke (n=70) seeking neurorehabilitation at Toronto Rehabilitation Institute completed self-report ratings of fatigue, depressive and anxiety symptoms, and sleepiness. Data were collected from objective measures of stroke topography, sleep disorders, physical fatigability and comorbid medical conditions. A Principal-Components Analysis was performed. Factor 1, the “Distress” factor, was comprised of the all of the self-reported scales i.e. depression, anxiety, fatigue and sleepiness. Factor 2, the “Physical State” factor, was comprised of a diagnosis of Obstructive Sleep Apnea, stroke territory and total medical burden. Factor 3, the “Performance” factor, was comprised by the 6 Minute Walk Test. An orthogonal rotation was the most parsimonious fit to the data, suggesting that the three factors are uncorrelated to each other.

The purpose of this study was to investigate the presentation and outcome of anorexia nervosa (AN) within the pediatric population. A retrospective chart review of individuals who were admitted for the first time to hospital between 2000-2005 for treatment of AN was completed. Individuals were classified as Early Pediatric AN (admitted <14 years old) or Later Pediatric AN (≥14 years old). It was hypothesized that the Early Pediatric AN group would have a less severe presentation, as measured by percent ideal body weight (%IBW) and medical stability at admission, and better outcome as measured by rate of weight gain post-discharge, number of hospitalizations and the Morgan-Russell General Outcome Scale rating. The study contained a total of 207 cases, larger than many previous studies in pediatric AN. The study found that younger age at presentation was associated with admission at a higher %IBW but not medical stability. Age at presentation did not predict rate of weight gain or rehospitalization; however, the Early Pediatric AN group had a better outcome on the Morgan-Russell scale.

Purpose: The objective of this study was to investigate both depression and psychological distress as determinants of breast and cervical cancer screening. Methods: Ontario female respondents to the Canadian Community Health Survey version 1.2 (2002) were assessed for both Major Depressive Disorder (World Mental Health-Composite International Diagnostic Interview for depression) and psychological distress (Kessler 6-item Distress Scale (K6)>/= 8). Respondents eligible for screening (N=4042 for cervical cancer; N=1403 for breast cancer) were linked to Ontario administrative health service data to prospectively ascertain screening outcomes. Results: Women with K6 >/= 8 had reduced breast cancer screening compliance in adjusted analyses (AOR 0.63, 95% CI 0.40-0.97). The association between K6 >/= 8 and cervical cancer screening approached significance in women over age 40 (AOR=0.65, 95%CI 0.41-1.04). Conclusion: Decreased likelihood of screening in women with clinically significant psychological distress suggests that attention to adequacy of preventive services is a potential target for intervention.

Problem gambling is the subclinical form of pathological gambling and both are characterized by difficulties in the limiting of money and time spent on gambling. Genetic and personality factors have been implicated in gambling disorders (PG). As PG is classified as an impulse-control disorder, the serotonin (5-HT) system has been suggested to be involved. We sought to better understand the complex relationship between personality traits, PG, and 5-HT genes. We investigated ten 5-HT candidate genes for association with PG and personality traits. We also examined personality traits for association with PG. We found that MAOA and HTR3A haplotypes were associated with Agreeableness and Conscientiousness personality domains, PG was associated with high Neuroticism and low Conscientiousness scores, and the MAOA gene may play a role in PG. Our findings contribute to the better understanding of how 5-HT genes may be involved in the neurobiological mechanisms underlying PG and personality.

Behavioural symptoms, cognitive deficits, and findings from electrophysiological, neuroimaging and genetic studies all suggest atypical performance monitoring in ADHD. Performance monitoring involves error detection and post-error behavioural adjustment and is crucial to behavioural self-regulation and reinforcement learning, both of which are dysfunctional in ADHD. Therefore, post-error slowing was examined in children with ADHD and controls using a modified flanker task both with, and without, error detection provided. There was a significant main effect of group on post-error slowing across conditions and when error-detection was provided, significant post-error slowing deficits were found in children with ADHD. These findings suggest that the performance monitoring deficit in ADHD is specific to post-error behavioural adjustment and supports the inclusion of this deficit in the neurocognitive profile of ADHD. Findings are discussed in terms of current neurocognitive reinforcement learning models of ADHD.