Le vieillissement normal comporte une diminution légère des fonctions cognitives supérieures qui n’entrave pas le fonctionnement quotidien de la personne. Cependant, ce déclin peut rendre la personne âgée plus vulnérable si celle-ci subit une atteinte cérébrale acquise, tel un traumatisme craniocérébral (TCC). Devant le vieillissement démographique de la population, l’intérêt pour l’étude du vieillissement cérébral normal et pathologique a significativement augmenté au cours des dernières années. Malgré ce fait, on constate une absence de programmes validés de réadaptation cognitive pour les personnes âgées qui subissent un TCC, alors que la cause la plus fréquente de TCC chez la personne âgée sont les chutes de sa propre hauteur, dont la fréquence augmente avec l’âge. Ces faits permettent de présager une augmentation significative de cas de personnes âgées qui subissent un TCC, ce qui représentera un fardeau additionnel pour le déjà surchargé système de santé. Le présent projet de recherche clinique visait à compenser une telle carence en évaluant l’efficacité d’un programme d’entrainement cognitif, le Programme d’enrichissement cognitif (PEC), spécifiquement développé par l’auteur de cette thèse pour les personnes qui ont subi un TCC à l’âge de 55 ans et plus. Le PEC est composé de trois modules intégrant des méthodes de réadaptation qui visent des processus cognitifs fréquemment atteints tant chez la personne âgée que chez les personnes ayant subi un TCC : conscience de soi, mémoire épisodique et fonctions exécutives. Deux études de l’efficacité du PEC, effectuées par le biais d’un devis contrôlé semi-randomisé à simple aveugle, sont présentées dans la présente thèse. La première étude visait à démontrer l’efficacité du PEC pour améliorer la mémoire épisodique. Le deuxième module du PEC, composé d’exercices d’entrainement mnémonique tirés du Programme MEMO, vise tout particulièrement cette dimension mnésique. Le Programme MEMO a été originalement conçu et démontré comme étant efficace pour les personnes âgées présentant un déclin cognitif léger (ou mild cognitive impairment). Il s’agit de la première étude impliquant le Programme MEMO auprès de personnes ayant subi un TCC. Une ANCOVA a mis en évidence des améliorations significatives sur une mesure psychométrique de mémoire épisodique et d’une mesure auto-rapportée de généralisation dans la vie quotidienne des participants du groupe expérimental. De plus, une amélioration cliniquement significative a été constatée au niveau de leur perception de bien-être psychologique. La deuxième étude évaluait l’efficacité du PEC pour le fonctionnement exécutif des participants, tel que mesuré par des instruments psychométriques évaluant des composantes exécutives, ainsi que des mesures de généralisation à la vie quotidienne. Les résultats ont montré une amélioration significative dans le groupe expérimental pour des sous-tâches d’une épreuve de fonctionnement exécutif, ainsi qu’une réduction significative des différences entre les participants au PEC et leurs proches sur une échelle de fonctionnement exécutif dans la vie quotidienne. De plus, le nombre d’activités quotidiennes abandonnées était significativement réduit 6 mois plus tard dans le groupe expérimental. L’intégration de programmes de réadaptation cognitive comme le PEC dans les services de réadaptation nous paraît tout à fait nécessaire et hautement recommandée, tout comme la formation de neuropsychologues en méthodes et stratégies de réadaptation cognitive et neuropsychologiques afin d’améliorer significativement l’offre de services à la population vieillissante et générale. / Aging is a natural process that includes decline in higher cognitive functions. This decline doesn’t impede daily functioning but may render a person more vulnerable if they acquire a traumatic bran injury (TBI). The world’s demographic aging has motivated a rise of the interest for the study of normal and neuropathological cognitive decline. Despite this fact, there is a gap in terms of validated neurocognitive training programs specifically conceived for ageing persons who sustain a TBI, even though the main causes of TBI are falls from one’s own height, which become more frequent with age. These facts point to an expected rise of TBI among older people, creating a burden on the already overloaded public health system. This clinical research project aimed to compensate this gap by evaluating the efficacy of a cognitive training program specifically developed by the author of this thesis for people who suffered a TBI at the age of 55 years old or more. This program is named Cognitive Enrichment Program (CEP). The CEP is composed of three modules integrating rehabilitation methods of cognitive functions frequently disturbed during aging and in TBI: self-awareness, episodic memory, and executive functions. Two studies evaluating the efficacy of the CEP, using a controlled semi-randomized single-blind design, are reported in this thesis. The first study aimed to demonstrate the CEP’s efficacy in improving episodic memory. The CEP’s second module is composed of the training mnemonic exercises of the MEMO Program, which focuses mainly on this memory dimension. The MEMO program was originally conceived and demonstrated to be effective for people suffering from mild cognitive impairment. This is the first study to use the MEMO Program with individuals having sustained a TBI. ANCOVA showed significant improvements in a psychometric episodic memory measure, and on a daily-life generalisation self-reported measure in experimental group participants. In addition, they showed clinically significant improvement in self-perceived psychological well-being. The second study assessed CEP efficacy on participants’ executive functioning using psychometric measures of executive functions, and on daily-life generalization measures. Results showed significant improvement in the experimental group on subtasks of a psychometric executive function measure, as well as a significant reduction in CEP participant-significant other differences on a self-reported scale assessing executive functioning in daily life. Also, the number of forsaken daily activities was significantly reduced 6 months later in the experimental group. Integration of cognitive rehabilitation programs such as the CEP into holistic rehabilitation programs is necessary and highly recommended, as is training neuropsychologists on cognitive and neuropsychological rehabilitation methods and strategies, to improve services offered to the aging and general population.

Rationale Although there is evidence that impaired executive functioning plays a role in addictive behavior, the longitudinal relationship between the two remains relatively unknown. Objectives In a prospective-longitudinal community study, we tested the hypothesis that lower executive functioning is associated with more addictive behavior at one point in time and over time. Methods Three hundred and thirty-eight individuals (19–27 years, 59% female) from a random community sample were recruited into three groups: addictive disorders related to substances (n = 100) or to behaviors (n = 118), or healthy controls (n = 120). At baseline, participants completed nine executive function tasks from which a latent variable of general executive functioning (GEF) was derived. Addictive behavior (i.e., quantity and frequency of use, and number of DSM-5 criteria met) were assessed using standardized clinical interviews at baseline and three annual follow-ups. The trajectories of addictive behaviors were examined using latent growth curve modeling. Results At baseline, we found weak to no evidence of an associations between GEF and addictive behavior. We found evidence for an association between a lower GEF at baseline and a higher increase in the quantity of use and a smaller decrease in frequency of use over time, but no evidence for an association with an increase in the number of DSM-5 criteria met. Conclusions Lower EFs appear to lead to a continuing loss of control over use, whereas addictive disorders may develop secondarily after a long period of risky use. Previous etiological models assuming lower EF as a direct vulnerability factor for addictive disorders need to be refined.

[pt] O Comprometimento cognitivo vascular subcortical (CCVs) caracteriza-se, do ponto de vista cognitivo, por déficits em funções executivas em seus estágios iniciais, levando a dificuldades funcionais precoces na população acometida. Contudo, dados da literatura indicaram que a condição é frequentemente subdiagnosticada, o que pode ser atribuído, dentre outras razões, à falta de instrumentos de rastreio acurados para a condição, cujas características clínicas diferem dos quadros neurodegenerativos. Esta escassez foi evidenciada pela revisão sistemática realizada como parte do presente trabalho. O Teste Breve de Memória e Funções Executivas (BMET) foi desenvolvido por Brookes e cols. (2012) especificamente para a detecção destes quadros clínicos. O objetivo desta dissertação foi discorrer sobre o CCVs e adaptar o BMET para o uso na população acima dos 60 anos do Brasil. Para tanto, seguiram-se etapas de tradução, avaliação de juízes de linguística e de neuropsicologia, avaliação por representante do público-alvo, retrotradução e, por fim, aplicação à amostra. Foi conduzido um estudo piloto para verificar a aplicabilidade e fornecer dados psicométricos preliminares do teste. Conclui-se que o BMET é de simples e rápida aplicação, podendo ser administrado por diferentes profissionais da saúde e possivelmente adequado à atenção primária em saúde. Considerando o contexto atual de um rápido envelhecimento populacional e do consequente aumento na prevalência de agravos associados às faixas etárias avançadas, tais como os transtornos neurocognitivos, é de grande relevância a detecção precoce do CCVs visando ao planejamento de intervenções e medidas de profilaxia secundária, contribuindo assim, para a qualidade de vida da população idosa. / [en] Subcortical Vascular Cognitive Impairment (sVCI) is characterized, upon a cognitive perspective, by the presence of dysexecutive function in its initial stages, leading to early functional difficulties for sufferers of this condition. However, data has indicated that it is often underdiagnosed, which could be attributed to the lack of accurate screening tools for the disorder. This shortcoming has been evidenced by a systematic review conducted as part of the current project. The Brief Memory and Executive Test (BMET) has been specifically developed by Brookes et al. (2012) for the detection of sVCI. This thesis aimed to discuss about sVCI and to adapt BMET for use in subjects over 60 years old from Brazil. For this purpose, consecutive stages, comprising translation, evaluation by experts in linguistics and neuropsychology, assessment by representant of the target population, retro-translation and, finally, application to an older sample, have been performed. A pilot study has been carried out to analyze the applicability and to draw preliminary information about psychometric properties of the scale. In conclusion, BMET has revealed to be easy and rapid to administer, feasible to be applied by different categories of health practitioners and possibly adequate for primary health settings. Considering the current context of a fast population aging and a rise in the prevalence of conditions associated with late-life, such as neurocognitive disorders, it is relevant to detect sVCI in its early stages, so that therapeutic and secondary preventive strategies could be planned, which could impact on the quality of lives of older population.

L’étude de la sexualité dans le contexte des maladies neurologiques est un domaine émergent qui nous permet de mieux comprendre les corrélats cérébraux et neurocomportementaux de divers aspects de la sexualité. Les changements au sujet de la sexualité sont fréquents à la suite de troubles neurologiques tels que les blessures de la moelle épinière, la sclérose en plaques, l’accident vasculaire cérébral, l'épilepsie et les traumatismes craniocérébraux (TCC). Compte tenu de la complexité de la sexualité après un TCC, celle-ci doit être analysée à partir d'une perspective biopsychosociale qui comprend trois facteurs interdépendants : a) les facteurs neuropsychologiques et psychologiques, b) les variables médicales et physiques, et c) les facteurs relationnels. L’objectif de cette thèse était d’étudier certains éléments de la sexualité auprès de personnes ayant subi un TCC afin de fournir des preuves empiriques pour contribuer à la validation d’une perspective biopsychosociale de la sexualité après un TCC. Trois études quantitatives originales ont été effectuées auprès de personnes ayant subi un TCC léger, modéré ou grave et ayant reçu des services de réadaptation post-TCC, et d’un groupe de témoins en bonne santé, tous vivant dans la communauté. Les groupes étaient comparables en ce qui concerne l’âge, le sexe, le nombre d’années de scolarité, le statut d’emploi et relationnel, et le revenu annuel. Les variables ciblant la sexualité, incluses dans cette thèse, étaient la qualité de vie sexuelle, le comportement sexuel à risque, et la sociosexualité (p. ex., les différences individuelles en ce qui concerne la volonté d’une personne à avoir des relations sexuelles sans engagement). Les variables neuropsychologiques et psychologiques incluaient les fonctions exécutives, la dépression et l’anxiété. Les aspects médicaux et physiques englobaient les symptômes postcommotionnels. Les facteurs relationnels comprenaient les attitudes envers l'infidélité. Les résultats démontrent que par rapport aux témoins en santé, les individus avec un TCC ont montré une diminution de la qualité de vie sexuelle, alors que les groupes étaient comparables sur le plan du comportement sexuel à risque, de la sociosexualité et des attitudes envers l'infidélité. Par ailleurs, les résultats ont montré une différence entre les hommes et les femmes sur le plan de la sociosexualité (p. ex., plus restrictive chez la femme). Chez les personnes ayant subi un TCC, une faible qualité de vie sexuelle était significativement associée à un nombre élevé de symptômes postcommotionnels, un comportement sexuel plus à risque corrélait avec une plus grande fréquence de symptômes dysexécutifs, et une plus faible acceptation de l'infidélité était liée à une sociosexualité moins restrictive. Les résultats de ces trois études soutiennent une perspective biopsychosociale de la sexualité après le TCC. Elles apportent des connaissances nouvelles en ce qui a trait aux domaines de la sexualité qui peuvent être touchés après un TCC, ainsi qu’à certaines variables neuropsychologiques et psychologiques, médicales et physiques, et relationnelles qui sont associées à ces changements. Les implications théoriques, ainsi que pour la pratique clinique et la réadaptation sont discutées. Les limitations des études sont présentées et des recommandations pour la recherche sont proposées. Le modèle biopsychosocial peut être utilisé comme une référence pour guider la recherche future dans ce domaine. D’autres études sur la sexualité et le développement d'interventions multidisciplinaires dans ce domaine pour les personnes TCC sont nécessaires. / The study of sexuality in the context of neurological disorders is an emerging area leading us to better understand the brain and neurobehavioral correlates of various aspects of sexuality. Changes in sexuality are common following neurological disorders, such as spinal cord injury, multiple sclerosis, stroke, epilepsy, and traumatic brain injury (TBI). Given the complexity of sexuality after TBI, it needs to be analyzed from a biopsychosocial perspective that includes three interrelated factors: a) neuropsychological and psychological factors, b) medical and physical variables, and c) relationship factors. The objective of this thesis was to study certain aspects of sexuality in individuals with TBI to provide empirical evidence to contribute to the validation of a biopsychosocial perspective of sexuality after TBI. Three original quantitative studies were conducted in individuals with mild, moderate, and severe TBI who received post-TBI rehabilitation services and in a group of healthy controls living in the community. The groups were comparable in age, sex, years of education, work and relationship status, and annual income. The variables targeting sexuality included in this thesis were sexual quality of life, risky sexual behavior, and sociosexuality (e.g., individual differences regarding the willingness to engage in uncommitted sexual relationships). Neuropsychological and psychological variables included executive function, depression and anxiety. Medical and physical aspects encompassed postconcussion symptoms. Relationship factors involved attitudes toward infidelity. The results demonstrate that compared to healthy controls, individuals with TBI showed lower sexual quality of life, while the groups were comparable in risky sexual behavior, sociosexuality, and attitudes toward infidelity. Furthermore, the results showed differences between men and women regarding sociosexuality (e.g., more restrictive in women). In individuals with TBI, lower sexual quality of life was significantly associated with the presence of post concussion symptoms; an increase in risky sexual behavior correlated with greater frequency of dysexecutive symptoms, and lower acceptance of infidelity was linked to a less restricted sociosexuality. The results of these three studies support a biopsychosocial perspective of sexuality following TBI. They provide new knowledge in the areas of sexuality that may be affected after a TBI, as well as some neuropsychological and psychological, medical and physical, and relational variables associated with these changes. The theoretical implications, as well as those related to clinical practice and rehabilitation are discussed. The limitations of the studies are presented and recommendations for research are proposed. The biopsychosocial model can be used as a reference to guide future research in this area. Other studies about sexuality and the development of multidisciplinary interventions in this area for individuals with TBI are warranted.

Durant les dernières décennies, les différences intersexes en matière de conduite avec les capacités affaiblies par l’alcool (CCAA) ont suscité l’attention, alors que le comportement est en augmentation chez les femmes tandis qu’il diminue chez les hommes. Les données suggèrent que, chez les femmes, la CCAA s’associe à des caractéristiques psychologiques différentes de celles qui se retrouvent chez les contrevenants masculins (c.-à-d. davantage de problèmes liés à l’alcool et aux drogues et de psychopathologies, mais moins de recherche de sensations et de comportements délinquants). Malgré ce profil différentiel, les femmes contrevenantes de la CCAA demeurent une population hautement méconnue, particulièrement en ce qui a trait au profil des récidivistes. Alors que chez les hommes, des données émergentes indiquent que des limitations cognitives sont présentes chez les récidivistes et qu’elles constituent potentiellement un mécanisme sous-jacent au comportement, le profil cognitif des femmes récidivistes demeure inexploré. Des données exploratoires obtenues chez les contrevenantes et la documentation de champs de recherche connexes suggèrent que les femmes se distinguent notamment en ce qui concerne leur fonctionnement exécutif qui pourrait être préservé, alors que leur fonctionnement visuospatial serait déficitaire en comparaison de leurs vis-à-vis masculins. L’objectif de la présente thèse est d’approfondir les connaissances sur les caractéristiques des femmes récidivistes, ce qui permettra de mieux comprendre l’hétérogénéité de cette population et de générer des hypothèses au regard des mécanismes cognitifs sous-jacents à la répétition du comportement de CCAA. Plus spécifiquement, la thèse a pour objectif premier d’étudier les différences entre les sexes en matière de fonctionnement visuospatial et de mémoire visuelle, d’attention et de fonctionnement exécutif (c.-à-d. flexibilité cognitive, abstraction, inhibition). L’objectif secondaire consiste à comparer ces contrevenants au regard de leurs caractéristiques psychologiques (problèmes liés à l’alcool et aux drogues, impulsivité, recherche de sensations, traits antisociaux, anxiété et dépression). L’hypothèse examinée soutient que les femmes et les hommes récidivistes de la CCAA performent moins bien que les femmes et les hommes non-contrevenants en termes de fonctionnement visuospatial, attentionnel et exécutif. En outre, il est attendu que les femmes récidivistes présentent des performances inférieures à celles des hommes récidivistes en ce qui a trait aux fonctions visuospatiales. Par ailleurs, l’hypothèse prévoit que les hommes récidivistes aient des performances inférieures à celles des femmes récidivistes sur le plan exécutif et attentionnel. En matière de caractéristiques psychologiques, il est attendu que les femmes et les hommes récidivistes présentent significativement plus de problèmes liés à l’alcool et aux drogues, d’impulsivité, de recherche de sensations et d’indices de psychopathologies (tendance antisociale, dépression, anxiété) que les non-contrevenants. En outre, il est attendu que les femmes récidivistes présentent plus de problèmes liés à l’alcool et aux drogues et d’indices de dépression et d’anxiété que les hommes récidivistes. Enfin, il est attendu que les hommes récidivistes présentent significativement plus d’impulsivité, de recherche de sensations et de traits antisociaux que les femmes récidivistes. Ces hypothèses se confirment partiellement, alors que les hommes récidivistes (n = 39) présentent des performances inférieures à celles des hommes non-contrevenants (n = 20) et des femmes récidivistes (n = 20) sur le plan attentionnel et exécutifs. Toutefois, les femmes récidivistes ne se distinguent pas des femmes non-contrevenantes (n = 20) en matière de fonctionnement neuropsychologique. En ce qui a trait aux caractéristiques psychologiques, les résultats soutiennent partiellement les hypothèses. La discussion met en lumière que les femmes et des hommes récidivistes présentent des caractéristiques similaires, hormis en ce qui a trait au fonctionnement attentionnel et exécutif qui semble jouer un rôle dans la récidive au masculin, alors que cela n’apparaît pas être le cas chez les femmes chez qui le comportement pourrait être davantage situationnel. La nécessité que des études futures soient réalisées au moyen de devis expérimentaux, de même que les difficultés inhérentes au recrutement des femmes récidivistes sont discutées. / During the past decade, female driving while impaired by alcohol (DWIA) have gathered more attention as DWIA is increasing in females while decreasing in males. Data suggest that DWIA risk in females is associated with distinct psychological characteristics from those of male offenders (i.e. more alcohol and drug-related problems, and psychopathology, while less sensation seeking and delinquency). Despite this differential profile, female DWIA offenders remain a highly unknown population, especially regarding recidivism. In addition, growing data, mostly based on male offenders, support the idea that cognitive limitations are present in recidivists and represent a potential underlying mechanism to their behavior. Exploratory data collected in female offenders and data from other germane research fields suggest that female recidivists are cognitively distinct, especially in terms of executive functioning that could be relatively spared while their visuospatial functioning would be more impaired in comparison of male offenders. The objective of this dissertation is to enhance knowledge on female recidivist’s characteristics. This will allow a better comprehension of the heterogeneity of DWIA recidivist’s population and generate hypotheses concerning potential mechanisms that underlie their repetitive DWIA behavior. The thesis is especially targeting neuropsychological and psychological characteristics of female recidivists. More specifically, the study’s first aim is to examine DWIA recidivists sex differences regarding visuospatial functioning, attentional and executive functions (i.e. cognitive flexibility, abstraction, inhibition). The secondary objective is to compare offenders on psychological characteristics (alcohol and drug use, impulsivity, sensation seeking, anxiety, depression and antisocial tendencies). It is hypothesized that female and male DWIA recidivists would present a lower performance than their respective non-offender counterparts in terms of visuospatial, attentional and executive functions. In addition, it is expected that female recidivists would present a lower visuospatial performance than male recidivists. It is also hypothesized that male recidivists would exhibit lower attentional and executive performances than female recidivists. Regarding psychological characteristics, it is expected that recidivists would present more alcohol and drug-related problems, impulsivity, sensations seeking and psychopathology (antisocial tendencies, depression, anxiety) than non-offenders and that female recidivists would present more alcohol and drug-related problems, depression and anxiety than male recidivists. Finally, hypotheses suggest that male recidivists would present more impulsivity, sensations seeking and antisocial tendencies than female recidivists. These hypotheses are partially supported as male recidivists (n = 39) present lower attentional and executive performances than male non-offenders (n = 20) and female recidivists (n = 20). However, female recidivists do not significantly differ from female non-offenders (n = 20) in terms of neuropsychological functioning. In regard to psychological characteristics, results partially support hypotheses. The discussion highlights female and male similar characteristics except for attentional and executive mechanisms that seem to play a role in male recidivism, while it is apparently not the case in female recidivists whose behavior could be more situational. The need for further studies with experimental design as well as difficulty in female recruitment are discussed.

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No description available.

Theory of Mind (ToM) is the ability to infer others’ mental states and thus to predict their behavior (Perner, 1991). Therefore, ToM is essential for the adequate adjustment of behavior in social situations. ToM can be divided into: 1) cognitive ToM encompassing inferences about intentions and beliefs and 2) affective ToM encompassing inferences about emotions (Shamay-Tsoory, Harari, Aharon-Peretz, & Levkovitz, 2010). Well-functioning skills of both ToM aspects are much-needed in the developmental period of adolescence because in this age phase peer relationships become more important and romantic relationships arise (Steinberg & Morris, 2001). Importantly, affective psychopathological disorders often have their onset in adolescence. ToM development in adolescence might be based on underlying cognitive mechanisms such as the ability to inhibit one’s own thoughts in order to understand another person’s thoughts (Carlson & Moses, 2001). Another possible mechanism relates to functional brain development across adolescence (Blakemore, 2008). Therefore, neurocognitive mechanisms may underlie ongoing ToM development in adolescence. First studies indicate an ongoing behavioral and functional brain development of ToM (e.g. Blakemore, 2008). However, ToM development in adolescence and how this might relate to underlying (neuro)cognitive functions remains largely underexamined. The major aims of the current thesis were first to answer the overall question whether there is an ongoing development of ToM in adolescence. This question relates to both behavioral and functional brain development. As a second major aim, the present work sought to elucidate possible (neuro)cognitive mechanisms of ongoing ToM development across adolescence. Specifically, these cognitive mechanisms might be basic cognitive functions as well as executive functions. Additionally, the present work aimed at exploring potential (neuro)cognitive mechanisms through an integration of both behavioral and functional brain studies. The current experimental work spans three cross-sectional studies investigating adolescents (aged around 12-15 years) and young adults (aged around 18-22 years) to examine for the first time both the behavioral (studies I and II) and functional brain development of ToM (study III) in adolescence and its underlying (neuro)cognitive mechanisms. In all three studies, more complex, advanced ToM tasks were employed to avoid ceiling effects. Study I was aimed at investigating if cognitive and affective ToM continues to develop in adolescence and at exploring if basic cognitive variables such as verbal ability, speed of processing, and working memory capacity underlie such development. Hence, two groups of adolescents and young adults completed tasks of ToM and basic cognitive abilities. Large age effects were revealed on both measures of ToM: adolescents performed lower than adults. These age differences remained significant after controlling for basic cognitive variables. However, verbal ability covaried with performance in affective ToM. Overall, results support the hypothesis of an ongoing development of ToM from adolescence to adulthood on both cognitive and affective aspects. Results may further indicate verbal ability being a basic cognitive mechanism of affective ToM. Study II was designed to further explore if affective ToM, as measured with a dynamic realistic task, continues to develop across adolescence. Importantly, this study sought to explore executive functions as higher cognitive mechanisms of developing affective ToM across adolescence. A large group spanning adolescents and young adults evaluated affective mental states depicted by actors in video clips. Additionally, participants were examined with three subcomponents of executive functions, inhibition, updating, and shifting following the classification of Miyake et al. (2000). Affective ToM performance was positively related to age and all three executive functions. Specifically, inhibition explained the largest amount of variance in age related differences of affective ToM performance. Overall, these results indicate the importance of inhibition as key underlying mechanism of developing an advanced affective ToM in adolescence. Study III set out to explore the functional brain development of affective ToM in adolescence by using functional magnetic resonance imaging (fMRI). The affective ToM measure was the behavioral developmentally sensitive task from study II. An additional control condition consisted of the same emotional stimuli with the instruction to focus on physical information. This study faced methodical challenges of developmental fMRI studies by matching performance of groups. The ventromedial prefrontal cortex (vMPFC) was significantly less deactivated in adolescents in comparison to adults, which might suggest that adolescents seem to rely more on self-referential processes for affective ToM. Furthermore, adolescents compared to adults showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in the control condition, indicating that adolescents might be distracted by the emotional content and therefore needed to focus more on the physical content of the stimulus. These findings suggest affective ToM continues to develop on the functional brain level and reveals different underlying neurocognitive strategies for adolescents in contrast to adults. In summary, the current thesis investigated whether ToM continues to develop in adolescence until young adulthood and explored underlying (neuro)cognitive mechanisms. Findings suggest that there is indeed an ongoing development of both the cognitive and affective aspect of ToM, which importantly contributes to the conceptual debate. Moreover, the second benefit to the debate is to demonstrate how this change may occur. As a basic cognitive mechanism verbal ability and as an executive functioning mechanism inhibition was revealed. Furthermore, neurocognitive mechanisms in form of different underlying neurocognitive strategies of adolescents compared to adults were shown. Taken together, ToM development in adolescence seems to mirror a different adaptive cognitive style in adolescence (Crone & Dahl, 2012). This seems to be important for solving the wealth of socio-emotional developmental tasks that are relevant for this age span.

[pt] Diversos estudos apontam o efeito do nível de escolaridade parental no desenvolvimento das funções cognitivas, em especial a linguagem e as funções executivas. Evidenciam a importância da interação entre o cuidador e a criança, a qualidade da estimulação e a promoção de experiências de desenvolvimento, propiciadas a criança, como fundamentais para o desenvolvimento das funções executivas. Há poucos estudos desse efeito no desenvolvimento de crianças brasileiras. O objetivo da dissertação foi investigar o efeito do nível de escolaridade dos pais, separadamente, no desempenho em tarefas de memória de longo prazo, memória de trabalho, controle inibitório e flexibilidade cognitiva de crianças e adolescentes com baixo nível socioeconômico na cidade do Rio de Janeiro. Participaram do estudo 352 crianças entre 7 a 15 anos de escolas privadas com perfil de baixo nível socioeconômico na cidade do Rio de Janeiro. Os instrumentos utilizados foram a Figura Complexa de Rey, a Aprendizagem auditivo verbal de Rey, o paradigma de Stroop e as tarefas de Fluência Verbal fonêmica e semântica. Os resultados mostraram efeitos para a escolaridade de ambos os pais. Resultados sistemáticos aconteceram na fluência verbal, na faixa de 9-10 anos. Não foram encontrados efeitos significativos em controle inibitório e memória de trabalho. O efeito da escolaridade parental apareceu de forma sistemática em funções executivas, mas não em outras funções, em uma amostra homogênea, o que levanta a ideia de que outros fatores como a renda e a cultura, se somam ao efeito ambiental no desenvolvimento cognitivo. / [en] Several studies demonstrated the effect of parents educational level in the development of cognitive functions, especially language and executive functions. Highlight the importance of interaction between the caregiver and the child, the quality of stimulation and promotion of development experiences afforded the child, as fundamental for the development of executive functions. There are few studies of this effect in the development of Brazilian children. The objective of the study is to analyze the effect of the education level of parents, separately, in the cognitive performance of long-term memory, working memory, inhibitory control and cognitive flexibility in children and adolescents living at Rio de Janeiro with low socioeconomic status. The study included 352 children between 7-15 years of private schools with low socioeconomic profile students of city of Rio de Janeiro. The instruments used were the Rey–Osterrieth Complex Figure Test, the Rey Auditory Verbal Learning Test, the Stroop test (Victoria Version) and Verbal Fluency phonemic and semantic. The results showed effects on education of both parents. Systematic results happened in verbal fluency, in the 9-10 year group. There were no significant effects on inhibitory control and working memory. The effect of parental education appeared systematically in executive functions, but not in other functions, raises the idea that other factors such as income and culture add to the environmental effect on cognitive development.

L'exclusion sociale est considérée comme l'une des situations les plus douloureuses pour les êtres humains. Les travaux dans ce domaine montrent que même de brefs épisodes d’ostracisme (paradigme du Cyberball) ont des effets importants aux niveaux neurophysiologique, émotionnel et comportemental, l’impact de cet ostracisme au niveau cognitif néanmoins n'a pas reçu beaucoup d'attention. Des résultats récents mettent en évidence une influence négative de l'ostracisme sur les marqueurs électrophysiologiques du contrôle cognitif, il n'y a cependant à ce jour aucune preuve directe d’une réduction de contrôle cognitif sous l’effet d’une exclusion sociale. Dans nos travaux nous avons étudié l'impact de l'ostracisme (Cyberball) sur le contrôle cognitif avec la tâche standard de Simon couplée à des analyses distributionnelles des temps de réaction auprès de populations caractérisées ou non par des expériences chroniques d’ostracisme (i.e., des étudiants ordinaires dans l’Étude 1, des personnes illettrées dans l'Étude 2 et des chômeurs de longue durée dans l'Étude 3). Dans les trois études, de brefs épisodes d'exclusion sociale suffisent à dégrader le niveau de satisfaction exprimé par les participants à l’égard des besoins fondamentaux (appartenance sociale, existence significative, estime de soi, contrôle des événements). Ces effets, cependant, s’avèrent réduits dans les populations chroniquement frappées d'ostracisme, suggérant leur moindre sensibilité à l'exclusion sociale en jeu dans le Cyberball. Plus important encore, cet ostracisme provoque chez les participants non stigmatisés une diminution du contrôle cognitif (Étude 1), mise en évidence dans nos travaux par un effet Simon stable (plutôt que réduit) sur les temps de réaction les plus longs pourtant les plus sensibles à l’expression d’un processus d'inhibition. Cependant, nos résultats ne montrent aucune différence de sensibilité entre les participants chroniquement ostracisés et leurs groupes contrôle (les Études 2 et 3), suggérant une certaine faiblesse du paradigme Cyberball auprès des personnes en situation d'exclusion sociale dans leur vie quotidienne. Nos résultats remettent donc en question la prédominance de ce paradigme pour la compréhension des effets cognitifs de l’exclusion sociale, au moins chez les individus caractérisés par un ostracisme chronique. / Impact on cognitive control, emotions and fundamental needsRésumé : Social exclusion is considered as one of the most painful situations for human beings. Past research showed that even brief episodes of ostracism (the Cyberball paradigm) have strong effects at the neurophysiological, emotional, and behavioral levels, its impact at the cognitive level however did not receive much attention. Recent findings revealed a negative influence of ostracism on electrophysiological markers of cognitive control, yet there is no direct evidence that being socially excluded reduces cognitive control. Here, we investigated the impact of ostracism (using the Cyberball) on cognitive control using a standard Simon task and distributional reaction time analyses with non-chronically-ostracized and chronically-ostracized populations (regular students in Study 1, illiterate people in Study 2, and long-term unemployed people in Study 3). In the three studies, brief episodes of social exclusion had negative effects on participants’ self-reports of fundamental needs' satisfaction (belonging, meaningful existence, self-esteem, and control). These effects, however, were substantially reduced in chronically-ostracized populations, suggesting that ostracism based on the Cyberball is a bit less meaningful for those populations. More importantly, this ostracism caused a transitory reduction in cognitive control in the non-chronically-ostracized participants (Study 1), as indicated by a stable (rather than decreased) Simon effect on longer reaction times where inhibition yet is more likely. However, we found no evidence of a differential sensitivity between the chronically-ostracized participants and their control groups (Study 2 and Study 3), suggesting that the Cyberball paradigm is not powerful enough with people experiencing social exclusion in their ordinary life. Our findings therefore call into question the predominance of the Cyberball paradigm for our understanding of the cognitive effects of ostracism, at least in chronically ostracized-individuals.