Background/Aim: During the past two decades, major advances in maternal-fetal medicine, neonatology, and the development of regionalized perinatal care have resulted in dramatic increases in survival rates, by more than 60%, of extremely immature (EI) infants born at less than 26 completed weeks of gestation, creating a new infant population. Studies of school-age outcomes in children with an extremely low birth weight of < 1000 g, born in the1980s, indicated that these children had a substantially high prevalence of low-severity neuropsychological deficits, behavioral problems, and difficulties at school. Information on school-age outcomes of extremely preterm children born in the 1990s is sparse, and mainly restricted to the neurobehavioral and developmental outcome. The aim of this research was to investigate the comprehensive neurological, developmental, functional, and mental health status and health care needs of children born at 23-25 weeks of gestation in the 1990s, allowing a total view of the child in the context of the family, his peers, school, and the health care system. The ultimate aim was to obtain a clearer understanding of the functional capacities of these vulnerable children and the possibilities of ameliorative interventions, as a basis for planning and provision of services for this growing population. Methods: We studied 11-year-old children born from 1990 through 1992 before 26 completed weeks of gestation in all of Sweden. All had been evaluated at a corrected age of 36 months. Of 89 eligible children, 86 (97%) were studied at a mean age of 11 years. An equal number of children born at term served as controls. The following methods were used: 1) well validated, mailed questionnaires filled out by the parents, class teachers and the children themselves; 2) structured interviews were conducted with a parent or a primary caregiver; 3) review of pediatric case records and records from other specialist health care services; and 4) anthropometric measurements (length, weight, head circumference and body mass index) from birth to 11 years of age. The following domains were explored: current health status, growth attainment, mental health assessment, emotional well-being, adaptive functioning and social competencies, school performance, executive functions, and learning and language skills. Relations of socioeconomic background and of environmental and perinatal risk factors to the long-term outcome were evaluated. Results: EI children compared with the controls had significantly higher rates of specific diagnoses or disabilities including neurosensory impairment (15% vs 2%, respectively), asthma (20% vs 6%), poor motor skills (26% vs 3%), poor visual perception (21% vs 4%), poor learning skills (27% vs 3%),poor adaptive functioning (42% vs 9%), and poor academic performance (49% vs 7%). As a consequence of these disabilities, significantly more EI children than controls had chronic conditions, which included functional limitations (64% vs 11%), compensatory dependency needs (59% vs 25%), and services above those routinely required by children in general (67% vs 22%). Regarding growth attainment, EI children had significantly lower values for all three growth parameters (length, weight and head circumference) than the controls at 11 years. They showed a sharp decline in weight and height z scores up to 3 months’ corrected age, followed by good catch-up growth in both weight and height up to 11 years. EI children did not exhibit catch-up growth in head circumference after the first 6 months of life. Preterm birth and parental height were significant predictors of 11-year height, and group status (prematurity) correlated strongly with head circumference. Our results also suggest that the EI children had a significantly greater risk for poorer mental health and poorer emotional well-being than the control participants, including internalizing (anxiety/depression, withdrawn behavior and somatic complaints), and attention, social, and thought problems. No differences in externalizing problems were found between the EI cohort and controls. Multivariable analyses disclosed a number of significant predictors of behavioral adjustment: group status (EI vs control), family function, social risk, male gender, and presence of a chronic medical condition. Concerning school performance, more than half (59%) of our EI cohort were experiencing school difficulties and 15%, compared with 5% of the control children were attending special schools or having full-time special education. Despite fewer adaptive skills in the EI cohort these children were not different from the controls in respect to being happy and being positively adjusted in their day-to-day life. Compared with controls, EI children had a significantly increased risk for executive dysfunctions in most of the areas assessed (Attention control and Attention switching, Hypoactivity, Planning/organizing, and Working memory). EI children were also at increased risk for deficient skills in language tasks (comprehension, communication, and expression) and in the four standard measures of learning skills (reading/writing, math, general learning, and coping in learning). However, only a relatively small number of EI children exhibited severe impairments in executive or non-executive skills. Multivariate analyses revealed that prematurity, executive dysfunction and male gender were associated with poor learning skills. Conclusions and implications: Children born extremely immature have significantly greater health problems and special health care needs that require ongoing services through the school years. However, it is notable that very few children have severe impairments that curtail major activities of daily living. The overall results of this study are reassuring. Despite having an increased risk for mental health problems, executive dysfunctions and school difficulties, 85% of the EI children were in the mainstream schools and a majority were not having major adjustment difficulties. In terms of growth, most of our EI children showed good catch-up in late childhood and were within 2SD of their mean midparental height at 11 years of age. Although biological immaturity is associated with an increased risk for a substantial number of behavioral/emotional problems, improvement of the modifiable environmental factors will benefit the outcome in EI children. We also believe that knowledge of the course of development of psychopathological conditions from early childhood to adolescence and beyond is crucial for identifying the need for intervention and prevention strategies. Thus when there is evidence to suggest neuropsychological and behavioral or emotional problems, early identification and preventive measures might help families to manage these from an early stage. Our findings further suggest that current preterm follow-up programs might benefit from the addition of psychological and family services to traditional neurodevelopmental assessments, especially in the neonatal period and first years of life.

[Truncated abstract] Central to the study of general intelligence is Spearman?s g, one definition of which is general fluid reasoning ability. At a cognitive level of explanation, it has recently been hypothesized that individual differences in g is based in the executive functions of the frontal lobes. This theory can be contrasted with the theory that the fount of g is speed of information processing. The aim of this thesis was to test the idea that the two contrasting theories of g could be reconciled by invoking an alternative theory which suggests that there may be two g?s one related to individual differences in intelligence and attributable to differences in speed of information processing and one related to the development of intelligence and based in executive functions of the frontal lobes. This was done with a series of neuropsychological studies that tested groups of adults and children with and without putative central nervous system damage on tests of fluid intelligence, executive function, goal-neglect, and speed of information processing. In study 1, three adults with focal frontal lobe lesions and ten adults with frontotemporal dementia (FTD) were administered three common intelligence tests. In comparison to premorbid and crystallized measures on intelligence, the majority of frontal patients exhibited impaired fluid g. In study 2, 10 patients with FTD, 8 patients with Alzheimer?s disease (AD), 10 adult controls, and 15 adults with low fluid g, were tested on a fast and slow version of a goal-neglect task (thought to measure executive functioning) and a measure of speed of processing. A classical double dissociation was found. Frontal patients with impaired fluid g displayed goal-neglect but intact speed of information processing whereas the adults with low fluid g exhibited slowed speed of information 2 processing but not goal-neglect. It was concluded that the link between fluid g and goal-neglect in adults (demonstrated by previous research) was based on a speed of information processing confound in the goal-neglect task. In study 3, a series of hierarchical regressions were conducted to analyse the performances of 116 children aged 6- to 11-years on all tests. The statistical attempt to dissociate executive function and speed of information processing only provided tentative support for the hypothesis that executive functions are the basis of developmental changes in g

No description available.

No description available.

To be accepted into social groups, individuals must internalise and reproduce appropriate group conventions, such as rituals. The high fidelity copying of such rigid and socially stipulated behavioural sequences places heavy demands on executive function abilities. Given previous research showing that challenging executive functioning also improves it, it was hypothesised that prolonged engagement in ritualistic behaviours would improve executive functioning in children, in turn improving their ability to delay gratification. A three month circle-time-games intervention with primary school children in two contrasting cultural environments (Slovakia and Vanuatu) was conducted. In both environments we found the intervention improved children's executive function and in turn their ability to delay gratification. Moreover, these effects were amplified when the intervention task was imbued with ritual, rather than instrumental, cues. The findings presented in this thesis have potentially far-reaching implications for child-rearing and educational practices, suggesting ritual participation may be necessary for the cultivation of future mindedness.

Parmi les personnes atteintes de maladies chroniques qui participent à des programmes de réhabilitation, deux tiers ne modifient pas leurs comportements à l’issue des interventions. Dans le domaine de l’activité physique et de la sédentarité, identifier les facteurs impliqués dans la régulation de ces comportements est donc crucial. En psychologie de la santé, les modèles contemporains indiquent que nos comportements sont le fruit de processus motivationnels à la fois explicites et implicites. Les processus explicites sont définis comme conscients et intentionnels ; à l’inverse, les processus implicites sont caractérisés par leur non-intentionnalité et leur caractère plutôt inconscient. A mi-chemin entre les domaines de la réhabilitation et la psychologie de la santé, les objectifs de cette thèse étaient (i) d’examiner le rôle de processus explicites et implicites dans la prédiction des comportements de l’activité physique et de la sédentarité, et (ii) d’étudier la malléabilité de ces variables motivationnelles en contexte de réhabilitation. Les résultats indiquent que les attitudes implicites sont associées avec les niveaux d’activité physique des participants, pendant les programmes et en post-réhabilitation. Les processus explicites (e.g., intentions) étudiés dans cette thèse n’étaient eux pas associés aux comportements. Sur le plan de la malléabilité des processus motivationnels, nos résultats mettent en évidence une amélioration significative mais minime de certaines variables au cours d’un programme de réhabilitation. Ces processus se sont toutefois montrés insensibles à une manipulation expérimentale délivrée en plus des programmes de réhabilitation. / Only two thirds of people living with chronic diseases and admitted for rehabilitation programs are sufficiently active in postrehabilitation. In the physical activity and sedentary behavior context, identifying the determinants of these behaviors is thus crucial. In the health psychology field, contemporary models indicate that people’s behaviors are regulated by two distinct motivational processes, defined as explicit and implicit. Explicit processes are intentional and conscious ; by contrast, implicit processes are defined as unintentional and less accessible to consciousness. The objectives of this thesis were (i) to examine the role of explicit and implicit processes in the prediction of physical activity and sedentary behaviors, and (ii) to study the malleability of these processes in rehabilitation context. Our results indicated that implicit attitudes, are significantly associated with participants’ physical activity levels, during and after rehabilitation programs. On the contrary, the explicit processes studied in this thesis were not significantly associated with physical activity or sedentary behaviors. Concerning the malleability of these processes, results highlighted significant but small favorable change of certains motivational variables during rehabilitation. Nonetheless, these motivational processes were not modified by an experimental intervention conducted during a rehabilitation program.

Este trabalho teve como objetivo investigar as funções executivas (FE) e alterações do humor em pacientes com doença de Parkinson (DP). O primeiro estudo procurou apresentar uma revisão sistemática da literatura sobre o tema. No artigo seguinte, em um estudo empírico, comparou-se o desempenho das FE e alterações do humor em um grupo de pacientes com DP (N= 40) e um grupo controle (N= 30). O grupo clínico apresentou desempenho significativamente inferior em diversas medidas de avaliação cognitiva, especialmente no instrumento Behavioural Assessment of the Dysexecutive Syndrome (BADS), mas não para as variáveis ansiedade e depressão (p< 0,05). Os resultados demonstram que as alterações das FE e depressão são transtornos frequentes, mesmo em fases iniciais da DP. / This work aimed to investigate the executive functions (EF) and mood changes in patients with Parkinson's disease (PD). The first study sought to present a systematic review of the literature on the subject. In the second, in an empirical study, we compared the performance in EF and mood in a group of PD patients (N = 40) and a control group (N = 30). The clinical group had a significantly poorer performance on several measures of cognitive assessment, especially the BADS, but not for the variables anxiety and depression (p <0.05). The results show that changes in EF are frequent disorders, even in early stages of PD.

The consequence of many psychiatric and neurodegenerative disorders, such as Parkinson's disease and schizophrenia, is an impairment in ‘executive functioning'; an umbrella term for several cognitive processes, including the focussing and shifting of attention and the inhibition of responding. The ability to form an ‘attentional set' involves learning to discriminate qualities of a multidimensional cue, and to subsequently learn which quality is relevant, and therefore predictive of reward. According to recent research, the subthalamic nucleus (STN) and possibly the adjacent zona incerta (ZI) may mediate the formation of attentional set. Dysregulation of the STN as a result of Parkinson's disease contributes to characteristic motor symptoms, and whilst deep-brain stimulation of this region may treat gross motor impairments, it may also impair cognition. The work in this thesis aimed to expand our understanding of the mechanisms of attentional set-formation, and the role of the STN in this process. This thesis evaluates new methods for examining set-formation in the attentional set-shifting task; rather than inferring this behaviour solely from the cost of shifting set, modifications to the task design in Chapters 3 & 4 explored several hypotheses designed to exploit a deficit in this behaviour. Chapter 6 revealed that inhibition of this region with designer receptors leads to a disruption in attentional selectivity, which compromises the ability to form an attentional set. This manifested as an inability to parse relevant information from irrelevant, and instead, animals learned the stimuli holistically. The findings in this thesis also suggested that reversal and attentional shifting processes do not operate independently, but rather in a hierarchy, and that consequently, the STN is a region that may be crucial in selecting appropriate responses during associative learning that leads to the formation of an attentional set.

Syftet med denna uppsats var att undersöka om det finns något samband mellan upplevd ensamhet och exekutiva funktioner hos äldre. Urvalet bestod av 98 ålderspensionärer mellan 65 och 75 år. Upplevd ensamhet mättes med Three-Item Loneliness Scale (TILS). Exekutiva funktioner mättes med nio olika test som avsåg mäta de tre processerna inhibering, shifting och uppdatering. Inhibering mättes med testerna Flanker, Simon och Stroop. Shifting mättes med Local Global, Color Shape och Number Letter. Uppdatering mättes med Letter Memory, Matrix Monitoring och Numerical 2-back. Andel korrekta svar samt responstid användes som utfallsvariabler. Data analyserades med hjälp av korrelationsanalyser där signifikanta samband analyserades vidare i hierarkiska regressionsanalyser. Resultatet visade på ett signifikant samband mellan upplevd ensamhet och responstid för Number Letter, där högre skattad ensamhet var associerad med längre responstid. Ensamhet förklarade 4% av variansen i responstid. Denna uppsats ger därmed stöd åt att det verkar finnas ett samband mellan upplevd ensamhet och nedsatt prestation bland vissa exekutiva funktioner, i detta fall shifting mätt genom responstid för Number Letter. Framtida studier bör undersöka detta vidare. Detta blir särskilt relevant med tanke på att världens befolkning blir allt äldre, tillsammans med det faktum att många äldre upplever ensamhet. Om upplevd ensamhet är associerad med försämrade exekutiva funktioner kan interventioner som syftar till att minska ensamheten vara till stor nytta både för den enskilda individen och samhället i stort. / The aim of this paper was to investigate whether there are any associations between perceived loneliness and executive functions in older people. Participants consisted of 98 senior citizens between the ages of 65 and 75. Perceived loneliness was measured with the Three-Item Loneliness Scale (TILS). Executive functions were measured with nine different tests aimed at measuring the three processes of inhibition, shifting and updating. Inhibition was measured with Flanker, Simon and Stroop task. Shifting was measured with Local Global, Color Shape and Number Letter task. Updating was measured with Letter Memory, Matrix Monitoring and Numerical 2-back task. Proportion of correct answers as well as response time were used as dependent variables. Data was analysed by correlation analyses where significant correlations were further analysed in hierarchical regressions. Results showed a significant association between perceived loneliness and response time in the Number Letter task; higher reported loneliness was associated with longer response time. Loneliness explained 4% of the variance in response time. This paper thus supports that there appears to be an association between perceived loneliness and reduced performance in certain executive functions, in this case shifting as measured through response time in the Number Letter task. Future studies should investigate this further. This becomes particularly relevant considering that the world's population is getting older, along with the fact that many elderly experience loneliness. If perceived loneliness is associated with deteriorating executive functions, interventions aimed at reducing loneliness may be of great benefit both to individuals and society as a whole.

Nous avons étudié le développement du raisonnement par analogie. La conception traditionnelle de ce développement est qu’il dépend de l’accroissement des connaissances des enfants (Gentner, 1983, 1988 ; Goswami & Brown, 1989, 1990). Nous l’avons abordé sous l’angle du développement des fonctions exécutives, en particulier - de la composante d’inhibition. La capacité d’inhibition permet la suppression des informations saillantes mais non pertinentes pour faire l’analogie. Elle est requise lors de la recherche de la solution analogique. Neuf études ont été réalisées dans le cadre de cette thèse. Nous avons utilisé une tâche classique d’analogie du type A : B :: C : ?. Le rôle de la capacité d’inhibition a été testé par la présence de distracteurs perceptifs ou sémantiques qui entrent en compétition avec la solution analogique. Ils doivent être inhibés lors de sa recherche. Les résultats montrent que les informations saillantes mais non pertinentes pour trouver la solution analogique interfèrent avec sa découverte ou sa construction. Par conséquent, les performances des enfants à la tâche d’analogie dépendraient du degré de développement de leurs fonctions exécutives. Ces résultats sont compatibles avec les résultats de Richland, Morrison & Holyoak (2006) qui expliquent les performances des enfants à une tâche d’analogie par les limitations dans leur fonctionnement exécutif. / We explored the development of the analogical reasoning. The traditional conception of this development is that it is dependent of knowledge accretion in children (Gentner, 1983, 1988; Goswami & Brown, 1989, 1990). We used a different approach which explains it as dependent of the development of the executive functions, particularly of the component of inhibition. The capacity of inhibition allows the suppression of the salient but irrelevant information for analogy-making in children. It is required while searching for the analogical solution. Nine studies involving a classical analogy-making task A : B :: C : ? were performed in this dissertation. The role of the capacity of inhibition was tested using perceptual or semantic distractors conflicting with the analogical solution. The distractors must be inhibited while searching for the analogical solution. Results show that all salient but irrelevant information for analogy-making interferes with the discovery or the construction of the analogical solution. Therefore, children’s performances of the analogy-making task depend on the degree of development of their executive functions. These results are consistent with the results of Richland, Morrison & Holyoak (2006) explaining children’s performances on an analogy-making task by the limitations of their executive functioning.