O uso de crack é um importante problema de saúde pública no Brasil. Recentes estudos mostraram que a prevalência de uso do crack no Brasil é de 0,7%. Dados atuais sugerem que o trauma de infância é associado a piores desfechos entre os usuários de cocaína e maiores escores de impulsividade. Este estudo avaliou o trauma infantil através do Childhood Trauma Questionnaire (CTQ) e as funções executivas, utilizando o Wisconsin Card Sorting Test (WCST), em 84 usuários de crack. Os resultados demonstrados a partir de regressão linear apontam que o trauma de infância, o uso contínuo de crack sem períodos de abstinência, a comorbidade com outras substâncias ilícitas e IQ explicaram 44% da variância no funcionamento executivo dos pacientes. Os escores de impulsividade Barrat (BIS 11) foram associados com o trauma de infância, sugerindo que o trauma infantil pode ser um fator de risco para prejuízos mais severos entre usuários crack. / The use of crack cocaine is a major public health concern in Brazil. Recent studies showed that the lifetime prevalence of crack cocaine use among Brazilians is about 0.7%. Recent data suggest that childhood trauma is associated with worse outcomes among cocaine users and higher impulsivity scores. This study evaluated childhood trauma using the Childhood Trauma Questionnaire (CTQ) and executive functioning, using the Wisconsin Card Sorting Test (WCST), among 84 crack cocaine users. The results of a linear regression showed that childhood trauma, continuous use of crack without periods of abstinence, multidrug use and IQ predicted 44% of the variance in the executive functioning of patients. Barrat Impulsivity Scores (BIS 11) were associated with childhood trauma, which suggests that trauma may be a risk factor for more severe impairment among crack cocaine users.

The process of controlling executive and motor behaviours is central to one’s ability to self-regulate and accomplish day-to-day goals across the lifespan. Executive and motor control share a set of underlying neural substrates that support a common set of processes, including planning, sequencing and monitoring of behaviour. They share a bidirectional relationship, such that gains or deficits in one area can have profound effects on the other. This doctoral dissertation examines the interplay between executive and motor control at three distinct stages of life and in the context of neurological conditions whose clinical manifestations shed additional light on the nature of the constructs. Central to each investigation is the methodological theme of intraindividual variability, as a means of leveraging valuable data within-persons. Chapter 2 examines executive and motor control in typically developing children and children with attention-deficit/hyperactivity disorder (ADHD). Findings suggest that dysregulation of motor processes accounts for hyperactive symptoms in ADHD and detracts from higher-order executive control. Chapter 3 examines the impact of mild traumatic brain injury (mTBI) in young adult varsity athletes, who routinely practice executive motor control by virtue of their level of play. Findings suggest that the impacts of mTBI are discernible through a dampened electrophysiological response during computerized tests of higher order executive functioning, and may not outweigh the otherwise myriad health benefits of athletic engagement. Chapter 4 examines the impact of dementia on executive motor control during gait dual-tasking in older adults. Findings suggest that the consistency of performance across multiple indicators of gait is sensitive to dementia, and that engagement in cognitive and social lifestyle behaviours is protective against likelihood of both dementia and mild cognitive impairment (MCI) classification. On mass, these findings highlight the importance of assessing executive motor control to understand the pathophysiology of neurological conditions. The potential benefits that may generalize from one area to the other offer unique opportunities for preventative and rehabilitative efforts. / Graduate

The effectiveness of memory specificity training (MeST) was compared with standard cognitive processing therapy (CPT) in treatment of individuals with posttraumatic stress disorder. Eighteen adults aged 18-36 were randomly assigned to the MeST intervention (n = 9) or to the active control group (n = 9) of CPT. Both treatments were administered in group format across 6 weeks. MeST consisted of 6 weekly sessions, while CPT consisted of 12 biweekly sessions. The trial was undertaken in the Psychology Clinic of the University of North Texas, with randomization to conditions accomplished via computer random number generator. The primary outcome measure was change in PTSD symptoms post-treatment from baseline. Sixteen individuals (13 women and 3 men; MeST n = 8 and CPT n = 8) completed treatment and their data was analyzed. MeST significantly decreased PTSD symptomology at post-treatment and these results were maintained at 3 months post-treatment. MeST was found to be as effective as the established CPT intervention at reducing PTSD symptomology. Both MeST and CPT significantly increased participants' ability to specify memories upon retrieval at post-treatment, with results maintained at follow-up. There were no significant effects of MeST or CPT in ability to increase overall controlled cognitive processing at post-treatment or follow-up. No individual in either group reported any adverse effects during treatment or at 3 months follow-up. MeST appears to hold promise as an efficacious treatment option for PTSD. MeST was as effective as CPT in reducing symptoms of PTSD, but required only half the number of treatment sessions to accomplish these gains. Replication of these findings in larger samples is encouraged.

Factors that confer predisposition and vulnerability for alcoholism and other substance abuse disorders may be described usefully within the gene-environment interplay framework. Thus, it is postulated that heritability provides a major contribution not only to alcohol but also to other substances of abuse. Studies of evoked potential amplitude reduction have provided a highly suitable and testable method for the assessment of both environmentally-determined and heritable characteristics pertaining to substance use and dependence. The different personal attributes that may co-exist with parental influence or exist in a shared, monozygotic relationship contribute to the final expression of addiction. In this connection, it appears that personality disorders are highly prevalent co-morbid conditions among addicted individuals, and, this co-morbidity is likely to be accounted for by multiple complex eti-ological relationships, not least in adolescent individuals. Co-morbidity associated with deficient executive functioning may be observed too in alcohol-related aggressiveness and crimes of violence. The successful intervention into alcohol dependence and craving brought about by baclofen in both human and animal studies elucidates glutamatergic mechanisms in alcoholism whereas the role of the dopamine transporter, in conjunction with both the noradrenergic and serotonergic transporters, are implicated in cocaine dependence and craving. The role of the cannabinoids in ontogeny through an influence upon the expression of key genes for the development of neurotransmitter systems must be considered. Finally, the particular form of behaviour/ characteristic outcome due to childhood circumstance may lie with biological, gene-based determinants, for example individual characteristics of monoamine oxidase (MAO) activity levels, thereby rendering simple predictive measures both redundant and misguiding.

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The present study investigated the interrelationships between various constructs drawn from the attachment, temperament, and neuropsychology frameworks in the context of self-regulation development and maintenance. In particular, the study sought to determine whether attachment security in early childhood was a predictor of self-regulation and social competence in adolescence, and to elucidate the roles of inhibitory control (IC), maternal sensitivity, and self-control in this relationship. Structural equation modeling was used to create an integrated theoretical developmental model of self-regulation. Attachment Security at 24 months was found to be a significant predictor of Social Skills at age 15 years. In addition, IC at 54 months, Maternal Sensitivity during third grade, and Self-Control during 4 th grade, were found to be subsequent partial mediators of this relationship. Overall, results of the study suggest that foundational self-regulatory capacities such as inhibitory control evolve from patterns of sensitive caregiver-child interactions in early attachment relationships. Furthermore, these capacities appear to be maintained in part through sensitive caregiving throughout childhood and into mid-adolescence. Additional implications of these results for integrating concepts of divergent theoretical domains are also discussed.

The study of high-contact sport athletes and the implications of repetitive head injury (RHI) associated with these sports has been at the forefront of traumatic brain injury (TBI) research for the last decade. The present study represents a quasi-experimental study exploring whether an experimental group (N=39) consisting of amateur and professional competitive mixed martial arts (MMA) athletes differ in three operations of executive functioning ability (shifting, updating and inhibition) when compared to a control group (N=44) of non-contact sports athletes. Participants completed a self-report measure of executive functioning ability as well as six computerized executive function (EF) tasks. The results from the study demonstrated no statistically significant differences between the experimental group and the control group on the performance of each executive functioning operation. A moderate negative correlation was found between the number of years competing and performance on shifting and updating in the experimental group. A moderate negative correlation between the number of reported competitive fights and all three EF operations within the experimental group was also reported. The results also showed a statistically significant difference in the beliefs of executive functioning abilities between the experimental group and the control group.  The experimental group reported a higher level of belief in poorer executive functioning ability than that of the control group. These findings provide evidence that while competing in MMA does have implications on executive functioning abilities, they are not in line with previous research done on other high-contact sports athletes. / Att studera hur utövare av fullkontaktsporter påverkas av upprepade huvudskador (RHI), associerat med utövandet av sporten, har varit ett fokusområde för forskningsfältet inom traumatiska huvudskador (TBI). Denna uppsats utgör en kvasi-experimentell studie som undersöker huruvida en experimentell grupp (N=39) bestående av amatörer och professionella ’mixed martial arts’ (MMA)- atleter skiljer sig i sin förmåga inom tre typer av exekutiva funktioner (skiftning, uppdatering och inhibition) jämfört med en kontrollgrupp (N=44) som inte utövar fullkontaktsport. Deltagarna fick först fylla i ett formulär där de skattade sin egen förmåga inom exekutiva funktioner, varpå de slutförde sex digitala test som gav ett mått på deras exekutiva funktioner. Studien påvisade ingen signifikant skillnad mellan de två grupperna för någon av de testade exekutiva förmågorna. Däremot fann studien en moderat negativ korrelation mellan antal år av tävlan och prestation på skifte och uppdatering, liksom en moderat negativ korrelation mellan antal tävlingstillfällen och de tre måtten på exekutiva funktioner, för den experimentella gruppen. Resultaten visade även en signifikant skillnad i självskattningen av exekutiv förmåga, mellan den experimentella gruppen och kontrollgruppen där experimentgruppen rapporterade sämre upplevda exekutiva förmågor, jämfört med kontrollgruppen. Dessa fynd indikerar att tävlan inom MMA har implikationer för exekutiva förmågor, även om de inte är i linje med tidigare forskning gjord på utövare av andra fullkontaktsporter.

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Research conducted with youth with type 1 diabetes (T1D) has shown that glycemic extremes and poorer T1D management are associated with poorer performance on measures of executive functioning (EF) compared to non-T1D counterparts. Deficits in EF may negatively impact the development of healthy T1D management skills. Our primary aim was to conduct a meta-analytic review of previous studies investigating the associations between glycemic control and EF in children with T1D across the developmental span. Comprehensive literature searches were conducted using PubMed, MedLine, PsycInfo, Google Scholar, and EBSCO for articles that met eligibility criteria. Eligibility criteria included correlational, randomized, and non-randomized studies published after 1985 involving participants ages 0-26 with a diagnosis of T1D. Studies evaluated EF using the Behavior Rating Inventory of Executive Functioning (BRIEF) or fMRI and evaluated glycemic control using Hemoglobin A1c. Across twelve studies examining the effect of glycemic control on EF in patients with T1D, 2,204 children, adolescents, and emerging adults were included in the study. Effect sizes (Hedges' g) were calculated between the T1D group and either control participants or a normative sample. Participant age was included as a moderator to determine whether the hypothesized association varied in magnitude across development. Participant A1c was used as a moderator to determine whether the hypothesized variation varied with diabetic management. A trend towards poorer performance on measures of executive functioning was observed in the T1D group compared to the normative sample (g = -0.22). In comparing age cohorts to the normative sample, a significantly poorer performance on measures of EF was observed in the 9-11, 15-17, and 18-26 age cohorts (g = -0.201, -0.258, and -0.452, respectively) compared to other age cohorts. Overall, research indicates that poor diabetic management may result in poorer performance on measures of EF compared to non-diabetic participants. These findings imply that this trend of poorer EF in children and adolescents with type 1 diabetes may lead to suboptimal diabetic management. Research suggests that suboptimal diabetic management often persists across the lifespan. Examining this association across critical periods where diabetes management may exert the most influence on the developing brain may provide guidance about when youth may benefit most from T1D management interventions.

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