The role of early adversity and cognitive vulnerability in postnatal stress and depression

The purpose of the present study was to examine vulnerability factors in expecting parents that might lead to mental illness in the perinatal period. Specifically, we studied how parental early adversity, attentional bias to infant faces, repetitive negative thinking, and demographic factors, were associated with pre- and postnatal depressive symptoms and parenting stress. Participants were expecting parents taking part in the Northern Babies Longitudinal Study, where assessments were made both pre- and postnatally. Assessments included both questionnaires and cognitive tasks. About half of the participants received the Newborn Behavior Observation (NBO)-intervention after birth, between pre- and postnatal assessments. Results show that repetitive negative thinking was a significant predictor of both depressive symptoms and parenting stress, while education, social support, and parity came out as protective factors, especially in mothers. Parental early adversity had an indirect effect on postnatal depressive symptoms and parenting stress, mediated by prenatal and postnatal depressive symptoms, respectively. The NBO intervention did not affect the results, signifying the importance of early childhood adverse events and negative thinking on parents' postnatal adjustment and mood, even when an intervention is provided. In conclusion, repetitive negative thinking is a significant vulnerability factor independent of the presence of depressive symptoms, and health professionals must be aware of parents’ thinking style both during pregnancy and after birth.

Implicit Cognitive Vulnerability through Nudges, Boosts and Bounces

Implicit Cognitive Vulnerability is a developing theoretical understanding, wherein feeling safe within an instructional environment is of significant impact upon short-term and long-term memory’s cognitive acquisition of information so as to embed new information within a learner’s conceptual framework of understanding. Towards successfully individualizing a learner’s implicit cognitive vulnerability, the primary focus has been upon the larger community environment in which the learner is housed, yet the viability of the learner’s ability and cognitive viability must also be addressed through nudges, boosts and bounces of motivational support. Recognizing this individualized need of learners, this discussion revolves around the ability of a learner to embed implicit cognitive vulnerability within their own cognitive viability through structured and unstructured synchronous and asynchronous nudges and boosts that support self-regulatory and self-efficacy understandings.

A Validated WISC-V Short-Form to Estimate Intellectual Functioning in Very Preterm Children at Early School Age

Very preterm children (gestational age < 32 weeks) frequently show neurodevelopmental difficulties (Inattention/dysexecutiveness) throughout their life-stages. A scarcity of resources, along with this population’s cognitive vulnerability, makes the neuropsychological evaluation of these children both complicated and time-consuming. This study aimed to develop a specific and valid Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) short-form to estimate intellectual functioning in this population. Eighty-four very preterm children (39 female; mean age = 6.50; SD: 0.06) were assessed with the WISC-V. Short-forms were developed following two independent strategies: a) multiple linear regressions for each index; b) correlational analyses between scores on all administered subtests and Full-Scale IQ. Validity of short-forms was analyzed. A short-form (Vocabulary, Matrix Reasoning, Picture Span, and Symbol Search) that satisfied 2/3 validation criteria was proposed. This validated short-form could facilitate the identification of cognitive difficulties in very preterm children, so that they could benefit from early care and support services, avoiding long assessment procedures.

Referral Processes and Dispositions in a Multidisciplinary Team for Older Adults With Cognitive Vulnerability

Multidisciplinary team care for community-dwelling older adults with multiple chronic conditions has proven value. Older adults receiving team care experience better outcomes than by solo practitioners alone, and teams are being established as outgrowths of primary care and other clinical settings. Yet little is known about the inner workings of multidisciplinary teams, both in terms of how referral patterns among team members are established and the extent to which older adults and their families accept referrals from team leaders to other clinical disciplines within teams. In this presentation, we provide details about referral patterns and rates of acceptance by study participants in an ongoing clinical trial testing a multidisciplinary team designed to provide care management to older adults (age >65) with cognitive vulnerability due to dementia, depression, and/or delirium (3D Team). Nurse practitioners lead the 3D Team, conduct in-home clinical assessments and make referrals to other team members based on study protocols specifying participants’ eligibility for each 3D Team member. Results are based on the first 209 older adults randomized to the 3D Team. Pharmacist: all 209 members accepted having their medications reviewed and reconciled. Registered Dietician: of 134 referrals, 52 (38.8%) accepted. Occupational Therapist, of 117 referrals, 65 (55.6%) accepted. Physical Therapist: of 109 referrals, 92 (84.4%) accepted. Community Health Educator: of 106 referrals, 101 (95%) accepted. LCSW for depression-related problem solving therapy: of 76 referrals, 55 (72.4%) accepted. Criteria for referrals and interpretations of variations in referral acceptance rates by older adults and their families will be discussed.

Narrow Specificity of Pessimistic Attribution Style and other Attribution Styles in Clinically Diagnosed Anxiety Disorders: A Systematic Review

Objective: Research has established that cognitive vulnerability has a role in mood disorder. Researchers have taken a keen interest in exploring the role of pessimistic attribution style (PAS) found in depression, expecting that it can also explain comorbid disorders to depression. The objectives of this systematic review are to explore the narrow specificity of PAS, and to search for other attribution style, if any, in anxiety disorders. Method: PubMed, Research4Life and APA PsycArticles® databases were searched for relevant articles recorded up to May 18, 2021. All published empirical articles, systematic review or meta-analysis, which included at least any of the anxiety disorders diagnosed using Diagnostic and Statistical Manual (DSM, APA) or International Classification of Disease (ICD, WHO) in the context of attribution bias, were included. Title, abstract and methodology of the publications were screened for potential selection. Risk of bias in the reviewed articles was assessed using the GRADE system. Result: Total 628 records were screened, out of which 19 were found eligible for inclusion. Result suggests narrow specificity of PAS has limited evidence and studies lack a rigorous methodology to establish it. Conclusion: There is indication that various attribution biases can be present in different anxiety disorders including those reported in depression.

Cross-Cultural and Gender Invariance of Five Common Symptom and Cognitive Vulnerability Measures in the United States and Singapore

Reliable and valid measurements of anxiety, chronic worry, depressive, and obsessive-compulsive symptoms is essential when seeking to draw cross-cultural and gender comparisons. Accordingly, the current study determined the psychometric properties of five widely used symptom measures in the United States (U.S.) and Singapore (SG) and across gender: Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Obsessive Beliefs Questionnaire (OBQ), Obsessive-Compulsive Inventory-Revised (OCI-R), and the Penn State Worry Questionnaire-Abbreviated (PSWQ-A). Participants comprised college students (U.S.: n = 292; SG: n = 144). Strict measurement invariance (equal factor loadings, item thresholds, residual variances) was observed for all measures across cultures and genders, except for the BAI, which met partial Level 1 strict cross-gender invariance. Overall, findings suggest a strong degree of cross-cultural and cross-gender construct compatibility, but also point to some notable exceptions, thereby providing ample material for theory-building and future research on transdiagnostic symptom and cognitive vulnerability measures across diverse groups.

O010 The role of dysfunctional beliefs and attitudes about sleep in the association between daily sleep and affect in adolescents and emerging adults

Introduction Sleep and affect are closely related. Late adolescence and emerging adulthood are associated with unique sleep patterns and risk for mood disturbances. This daily study examined whether dysfunctional beliefs and attitudes about sleep (DBAS), a modifiable cognitive vulnerability factor, moderated daily sleep-affect associations. Methods 421 community adolescents (n=205, 54.1% females, M±SDage=16.9±0.87) and emerging adults (n=216, 73.1% females, M±SDage=21.31±1.73) self-reported sleep and affect (adapted 12-item PANAS) and wore an actigraphy device for 7–28 days, providing >5000 daily observations. Linear mixed models tested whether DBAS moderated daily associations between self-reported and actigraphic sleep duration (total sleep time), sleep efficiency, and next-day affect on between and within-person levels. Both valence (positive/negative) and arousal (high/low) dimensions of affect were examined. Covariates included age, gender, ethnicity, day of week, and previous-day affect. Results DBAS significantly moderated associations between average sleep and next-day positive, but not negative, affect. Individuals with higher DBAS had significantly lower high arousal positive affect as average sleep duration (actigraphic: p=.002; self-reported: p=.014) and efficiency (actigraphic: p=.014) decreased. Similar moderation was found for average self-reported sleep duration and low arousal positive affect (p=.032). No significant results emerged on the within-person level. Previous-day affect significantly predicted next-day affect across models and outcomes (all p<.001). Discussion Adolescents and emerging adults with more negative views about sleep may experience dampened positive affect in shorter, or poorer, sleep periods. DBAS may constitute a modifiable factor increasing affective vulnerability on a global but not day-to-day level, and a therapeutic target for sleep-related affect disturbances in youths.