A-20 Frailty Is Associated with Decreased Social–Emotional Functioning in People with HIV: A National Institutes of Health Toolbox Emotion Battery Study

Objective People with HIV (PWH) are more likely to experience problematic emotions and are at increased risk for frailty. In the general population, frailty is broadly associated with worse social–emotional functioning. However, the extent of this dysfunction has largely been isolated to depression and these relationships have yet to be examined among PWH. Thus, this study examined associations between frailty and summary factor scores developed from the National Institutes of Health Toolbox Emotion Battery (NIH-TB-EB) among PWH. Method Participants were 320 PWH (mean age = 52.3, SD = 12.7). Three previously validated composite scores from the NIH-TB-EB were used to assess social–emotional functioning: negative affect, social satisfaction, and psychological well-being. Using the Fried Phenotype, the sample was dichotomized into non-frail (n = 155) and prefrail/frail (n = 165) groups. Multiple regression was used to examine the association between frailty and social–emotional functioning. Covariates included age, estimated duration of HIV infection, antiretroviral therapy (ART) status, and antidepressant medication count. Results Being prefrail/frail was associated with increased negative affect (B = 0.26, p < 0.001), decreased social satisfaction (B = -0.18, p = 0.002), and decreased psychological well-being (B = -0.25, p < 0.001). Increased age was associated with decreased negative affect (B = -0.17, p = 0.002), and was unrelated to social satisfaction and psychological well-being. Estimated duration of infection, ART status, and antidepressant use were not associated with social–emotional functioning. Conclusions Pre-frail/frail PWH have worse social–emotional functioning, above and beyond age, duration of HIV disease, ART status, and antidepressant use. This suggests both frailty and poor social–emotional functioning may be important targets to screen and treat in order to improve prognosis and quality of life for PWH.

Social-emotional functioning in pediatric hydrocephalus: comparison of the Hydrocephalus Outcome Questionnaire to the Behavior Assessment System for Children

OBJECTIVE Hydrocephalus can impact all areas of health, including physical, cognitive, and social-emotional functioning. The social-emotional health of children who have had surgery for hydrocephalus is not well characterized. In this study, the authors sought to examine social-emotional functioning using the Behavior Assessment System for Children, Third Edition (BASC-3) and the Hydrocephalus Outcome Questionnaire (HOQ) in 66 children aged 5 to 17 years. METHODS Caregivers of pediatric patients with hydrocephalus completed the BASC-3 and the HOQ. BASC-3 internalizing, externalizing, and executive functioning caregiver-reported scores were compared with the BASC-3 normative sample using one-sample t-tests to evaluate overall social-emotional functioning. BASC-3 scores were correlated with the social-emotional domain of the HOQ using Pearson’s r to determine if the HOQ accurately captured the social-emotional functioning of children with hydrocephalus in a neurosurgery setting. BASC-3 and HOQ scores of children with different etiologies of hydrocephalus were compared using the Kruskal-Wallis one-way analysis of variance to determine if differences existed between the following etiologies: intraventricular hemorrhage secondary to prematurity, myelomeningocele, communicating congenital hydrocephalus, aqueductal stenosis, or other. RESULTS Children with hydrocephalus of all etiologies had more difficulties with social-emotional functioning compared with normative populations. Children with different hydrocephalus etiologies differed in executive functioning and overall HOQ scores but not in internalizing symptoms, externalizing symptoms, or social-emotional HOQ scores. The social-emotional domain of the HOQ correlated more strongly with the BASC-3 than did the physical and cognitive domains. CONCLUSIONS These results have provided evidence that children who have had surgery for hydrocephalus may be at increased risk of social-emotional and behavioral difficulties, but etiology may not be particularly helpful in predicting what kinds or degree of difficulty. The results of this study also support the convergent and divergent validity of the social-emotional domain of the HOQ.

Yoga and Mindfulness Interventions for Preschool-Aged Children in Educational Settings: A Systematic Review

Early childhood and the pre-school stage of development constitute a dynamic period for acquisition of social-emotional competencies. Yoga and mindfulness practices (YMP) have become increasingly used in schools for social emotional learning, but less is known about their utility in early childhood settings. A systematic review using PRISMA guidelines was undertaken to explore the effect of YMP on social emotional function among preschool-aged children (3–5 years). The review resulted in identification of 1115 records, of which 80 full text articles were screened, with final inclusion of 16 studies. Included studies evaluated the effect of YMP on social-emotional functioning, and identified the potential for YMP to improve regulatory skills such as behavioral self-regulation and executive function. Among studies reviewed, 13 reported improvements in these domains, but quality appraisal indicated significant variability in risk of bias across studies, and heterogeneity of outcome measurements hindered comparison. Programs appeared to produce better results when implemented for at least 6 weeks and among children who had lower baseline social-emotional functioning. YMP constitute a promising strategy for social emotional development in early childhood settings, but additional rigorously designed studies are needed to expand understanding of how and why these programs are effective.

A Picture Book Is Worth a Thousand Words: Building a Character Literacy Library

According to the U.S. Department of Education, character education refers to teaching “the habits of thought and deed that help people live and work together as families, friends, neighbors, communities, and nations.”Character education has long been viewed as an essential part of the mission of schools, and some have even suggested that it may be the primary purpose of education in the future. In addition, meta-analytic studies have linked character education to decreased risk behaviors, increased prosocial behaviors, favorable school outcomes, and healthy social-emotional functioning.

Disrupted caregiving behavior as a mediator of the relation between disrupted prenatal maternal representations and toddler social–emotional functioning

The development of maternal representations of the child during pregnancy guides a mother’s thoughts, feelings, and behavior toward her child. The association between prenatal representations, particularly those that are disrupted, and toddler social-emotional functioning is not well understood. The present study examined associations between disrupted prenatal representations and toddler social-emotional functioning and to test disrupted maternal behavior as a mediator of this association. Data were drawn from 109 women from a larger prospective longitudinal study (N=120) of women and their young children. Prenatal disrupted maternal representations were assessed using the Working Model of the Child Interview disrupted coding scheme, while disrupted maternal behavior was coded 12-months postpartum from mother-infant interactions. Mother-reported toddler social-emotional functioning was assessed at ages 12 and 24 months. Disrupted prenatal representations significantly predicted poorer toddler social-emotional functioning at 24 months, controlling for functioning at 12 months. Further, disrupted maternal behavior mediated the relation between disrupted prenatal representations and toddler social-emotional problems. Screening for disrupted representations during pregnancy is needed to facilitate referrals to early intervention and decrease the likelihood of toddler social-emotional problems.

Late Receipt of a Second Cochlear Implant: Better Late than Never?

The present study explored the incremental benefits of late receipt of a second cochlear implant (CI) by examining various aspects of educational, cognitive and social-emotional functioning among college-age CI users. Secondary analyses were conducted on data from seven studies that had compared deaf students who were active CI users, deaf students who had never used CIs and hearing students; information concerning unilateral or bilateral CI use had been collected but was not analysed previously. The seven studies provided for comparisons on four dozen dimensions including executive function, world knowledge, visual-spatial ability, academic achievement and quality of life. Ages of first/only cochlear implantation did not differ significantly in any of the comparisons, nor did the groups differ significantly on most of the outcome measures across cognitive and social-emotional domains. The findings consistently indicated that while cognitive and social-emotional differences might be apparent between samples of unilateral and bilateral CI users during earlier childhood, they were not evident in this group of CI users who had reached college-age. Limitations of this study related to the nature of the participant samples indicate the need for further research on long-term benefits of bilateral implantation.