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  • 1. Aaro Jonsson, Catherine C.
    et al.
    Emanuelson, Ingrid M.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Variability in quality of life 13 years after traumatic brain injury in childhood2014In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 37, no 4, p. 317-322Article in journal (Refereed)
    Abstract [en]

    With the aim of describing variability in the long-term outcome of quality of life after neurosurgically treated pediatric traumatic brain injury, mostly self-reports of 21 individuals with mild or moderate/severe injury were gathered using Mayo-Portland Adaptability Inventory in telephone interviews 13 years aftyer injury. A majority of the participants reported brain injury-related problems. The median outcome on Mayo-Portland Adaptability Inventory was mild to moderate limitations. The variation within the moderate/severe group varied between relatively good outcome and moderate/severe limitations. Concentration, irritability, fatigue, and transportation were reported as the most problematic areas, whereas self-care was reported as well functioning. Societal participation appeared to be the best functional domain in this Swedish study. Examples of individual reports of the life-situation at various outcome levels were provided. Variability in outcome is large within severity groups, and research may gain by addressing both outcomes of the individuals and groups. Objective questions of outcome should be accompanied by questions of actual functioning in everyday life. To ensure long-term support for quality of life for those with remaining dysfunction after pediatric traumatic brain injury, healthcare systems should implement systematic routines for referral to rehabilitation and support.

  • 2. Aaro Jonsson, Catherine
    et al.
    Catroppa, Cathy
    Godfrey, Celia
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Anderson, Vicki
    Cognitive Recovery and Development after Traumatic Brain Injury in Childhood: A Person-Oriented, Longitudinal Study2013In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 30, no 2, p. 76-83Article in journal (Refereed)
    Abstract [en]

    Influence of childhood traumatic brain injury (TBI) on cognitive recovery and subsequent development is poorly understood. In this longitudinal study we used cluster analysis to explore acute stage individual profiles of injury age and cognition in 118 children with traumatic brain injury. Repeated measures of cognitive function were conducted at 30 months, indicating recovery, and 10 years post-injury, indicating development. Nine clusters were identified. Recovery was evident in three clusters, two of them with low functioning profiles. Developmental gains occurred for three clusters and an acute profile of higher freedom from distractibility (FFD) and lower processing speed (PS) was related to positive differences. One cluster, average low functioning and especially low verbal comprehension, demonstrated a slower development than peers. This suggests that developmental change after TBI in childhood takes place on a continuum, with both chance of long-term catching up, and risk of poor development. An acute profile of higher FFD and lower PS seemed to reflect injury consequences and were followed by developmental gains. These results challenge previous findings, and warrant further investigation.

  • 3.
    Aaro Jonsson, Catherine
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Leis Ljungmark, Mia
    Institution for clinical sciences, Dept. of pediatrics, Sahlgrenska Academy at Göteborg University.
    Emanuelson, Ingrid
    Institution for clinical sciences, Dept. of pediatrics, Sahlgrenska Academy at Göteborg University.
    Long-term cognitive outcome after neurosurgically treated childhood traumatic brain injury2009In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 23, no 13-14, p. 1008-1016Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the cognitive long term outcome of two cohorts of patients neurosurgically treated for childhood traumatic brain injury (CTBI), either in 1987-1991 according to an older concept, or 1997-2001 with a stronger emphasis on volume targeted interventions. Research design and methods: Participants in the two cohorts were subject to an extensive neuropsychological assessment, 13.2 and 6.1 years post injury, respectively. In a between group design, assessment results of the two cohorts, n 18 and n 23, were compared to each other and to controls. Data were analyzed with multivariate analyses of variance. Results: Long-term cognitive deficits for both groups of similar magnitude and character were observed in both groups. Abilities were especially low regarding executive and memory function and verbal IQ. The cognitive results are discussed in terms of  vulnerability of verbal functions and decreased executive control over memory-functions. Conclusions: There is a definite need for long term follow up of cognitive deficits after neurosurgically treated CTBI, also with the newer neurosurgical concept. Verbal learning and the executive control over memory functions should be addressed with interventions aimed at restoration, coping and compensation.

  • 4. Anttila, Sten
    et al.
    Clausson, Eva
    Eckerlund, Ingemar
    Helgesson, Gert
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Håkansson, Per-Arne
    Kadesjö, Björn
    Lindblom, Jonas
    Lundahl, Lisbeth
    Smedje, Hans
    Wiklund, Stefan
    Pettersson, Agneta
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Syversson, Anneth
    Werkö, Sophie
    Program för att förebygga psykisk ohälsa hos barn: En systematisk litteraturöversikt2010Report (Other academic)
    Abstract [sv]

    Det är angeläget att finna metoder för att förebygga psykisk ohälsa hos barn. Det finns tecken på att psykisk ohälsa hos barn kan ha ökat under de senaste decennierna och strukturerade insatser för att komma till rätta med problemen blir allt vanligare såväl inom kommunal verksamhet som inom hälso- och sjukvård. Interventionen utgörs av så kallade program som är standardiserade och finns beskrivna i manual eller motsvarande. Här sammanfattas det vetenskapliga underlaget för två typer av program: dels de som främst syftar till att förebygga utagerande beteenden hos barn och ungdomar, dels de som i första hand syftar till att förebygga inåtvända problem som ångest, depression och självskadebeteende. Program som har en allmänt hälsobefrämjande effekt, t ex för att förebygga drogmissbruk och våldshandlingar ingår följaktligen inte. Programmen är avsedda att ha effekt, inte bara direkt efter att programmet har avslutats utan även i framtiden. Rapporten har tagits fram på förfrågan av Kungliga Vetenskapsakademien och UPP-centrum (Utvecklingscentrum för barns psykiska hälsa) vid Socialstyrelsen. Båda har efterfrågat en systematisk litteraturöversikt för att klarlägga nyttan med att använda program för att förebygga psykisk ohälsa hos barn. Slutsatser:

    - Av 33 bedömda standardiserade och strukturerade insatser (program) som syftar till att förebygga psykisk ohälsa hos barn har sju ett begränsat vetenskapligt stöd i den internationella litteraturen. Det är föräldrastödsprogrammen Incredible Years och Triple P, familjestödsprogrammet Family Check-Up samt skolprogrammen Good Behavior Game, Coping Power, Coping with Stress och FRIENDS. Effekterna är med få undantag små. Studierna är utförda i andra länder. Eftersom effekterna sannolikt varierar med sociala och kulturella sammanhang är det oklart i vilken utsträckning som programmen kan överföras till Sverige med bibehållen effekt. Programmen kan också behöva anpassas så att de överensstämmer med svenska värderingar och syn på barns rätt.

    - I Sverige används ett hundratal olika program för att förebygga psykisk ohälsa hos barn, i huvudsak av utagerande typ. Inget av dem har utvärderats i Sverige i randomiserade studier med minst sex månaders uppföljning. Programmen De otroliga åren (översatt från Incredible Years), Triple P och Family Check-Up har enligt internationella studier begränsat vetenskapligt stöd för förebyggande effekt. Programmen KOMET, COPE, SET, StegVis, Beardslees familjeintervention, Connect och DISA har undersökts i minst en kontrollerad studie vardera men har inte tillräckligt vetenskapligt stöd för förebyggande effekt. Övriga program som används i Sverige är inte vetenskapligt utprövade som preventionsprogram.

    - Program som bygger på att ungdomar med utagerande problem träffas i grupp kan öka risken för normbrytande beteenden. Andra negativa effekter för såväl program för utagerande som för inåtvända problem är tänkbara men ofullständigt belysta.

    - Det behövs randomiserade studier som undersöker om de program som används har förebyggande effekt i svenska populationer och inte medför risker. Det behövs också hälsoekonomiska studier som undersöker om programmen är kostnadseffektiva.

  • 5. Böhm, Birgitta
    et al.
    Lundequist, Aiko
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Visual-motor and executive functions in children born preterm: The Bender Visual Motor Gestalt Test revisited2010In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 51, no 5, p. 376-384Article in journal (Refereed)
    Abstract [en]

    Visual-motor development and executive functions were investigated with the Bender Test at age 51/2 years in 175 children born preterm and 125 full-term controls, within the longitudinal Stockholm Neonatal Project. Assessment also included WPPSI-R and NEPSY neuropsychological battery for ages 4-7 (Korkman, 1990). Bender protocols were scored according to Brannigan & Decker (2003), Koppitz (1963) and a complementary neuropsychological scoring system (ABC), aimed at executive functions and developed for this study. Bender results by all three scoring systems were strongly related to overall cognitive level (Performance IQ), in both groups. The preterm group displayed inferior visual-motor skills compared to controls also when controlling for IQ. The largest group differences were found on the ABC scoring, which shared unique variance with NEPSY tests of executive function. Multiple regression analyses showed that hyperactive behavior and inattention increased the risk for visual-motor deficits in children born preterm, whereas no added risk was seen among hyperactive term children. Gender differences favoring girls were strongest within the preterm group, presumably reflecting the specific vulnerability of preterm boys. The results indicate that preterm children develop a different neurobehavioral organization from children born at term, and that the Bender test with a neuropsychological scoring is a useful tool in developmental screening around school start.

  • 6.
    Emanuelson, Ingrid
    et al.
    Institute of Clinical Sciences, Dept. of Pediatrics at Sahlgrenska Academy University of Gothenburg.
    Aaro Jonsson, Catherine
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Rydenhag, Bertil
    Institute of Neuroscience at Sahlgrenska Academy University of Gothenburg.
    Silander, Hans
    Institute of Neuroscience at Sahlgrenska Academy University of Gothenburg.
    Åkerman, Anna-Karin
    Institute of Clinical Sciences, Dept. of Pediatrics at Sahlgrenska Academy University of Gothenburg.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Traumatic brain injury in children treated at the neurosurgical unit at Sahlgrenska University Hospital in 1987-1991 and 1997-2001: An analysis of the process of careManuscript (preprint) (Other academic)
    Abstract [en]

    Background: In 1992, a new volume targeted treatment, the  “Lund Protocol”, was introduced in the field of neurosurgical care at Sahlgrenska University Hospital. The mortality rate for adults dropped markedly while the number of patients in a vegetative state remained at the same level. As  yet, changes in mortality and outcome for children have not been investigated in detail. Aim: To describe the causes and severity of injury, process of care from emergency care to rehabilitation, and the rate of received rehabilitation and to follow-up two cohorts treated for  child traumatic brain injury (CTBI) before and after the initiation of the  “Lund Protocol”. For group 2, treated after the initiation of  the  “Lund Protocol” an additional aim was to relate brain injury severity parameters in the acute care stage to functional outcome. Methods: A retrospective population-based study of patient records of former paediatric patients treated  neurosurgically for CTBI between 1987-1991 and 1997-2001. Epidemiological results are presented as descriptive statistics. To evaluate the relationship between brain injury parameters and outcome an exploratory cluster analysis was performed on the data from group 2. Results: For both groups traffic accidents were the most common cause of injury. The Glasgow Coma Scale indicated a more severe injury level in group1. The mortality rate in group1 was 8 %  compared with 2 % in group 2 (n.s.). The Glasgow outcome score was on the same level (median 5), and the rate of received rehabilitation was equally low in both groups, 27 % versus 33 %. The cluster analysis revealed that length of care and time in a respirator had a stronger relationship with outcome than the Reaction Level Scale (RLS). Conclusion: There is still no stable process of care after CTBI as 67 % in the later treated group did not receive rehabilitation and 50 % of those did not receive any medical check- ups in the long- term perspective. 

  • 7.
    Eninger, Lilianne
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology.
    Ferrer-Wreder, Laura
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology.
    Eichas, Kyle
    Allodi Westling, Mara
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Olsson, Tina
    Sedem, Mina
    Ginnner Hau, Hanna
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    Herkner, Birgitta
    Domitrovic, Celene
    Culture and Young Children’s Social EmotionalCompetence: Findings and Implications for the Cultural Adaptation of Interventions2017Conference paper (Other academic)
  • 8.
    Ginner Hau, Hanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Recidivism in convicted young offenders participating in community-based rehabilitative programmes: 18-month follow-up of 189 Swedish male offendersIn: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397Article in journal (Refereed)
    Abstract [en]

    Recidivism over 18 months was investigated in a representative group of Swedish male offenders, 15-17 years old, who had been referred to community based rehabilitative programmes (n=189). Also, registry data on earlier contacts with social services and previous convictions was collected.  Eighteen months after programme start, 60% of the young offenders were registered as suspected of new crimes, 48% for crime of violence.  Previous contacts with social services had been documented for 44%, and 30% were registered as previously convicted. However, the group was highly heterogeneous, and all registry data corresponded well with self-reported history of antisocial behaviour collected at programme start, by which three subgroups (n=60, 64 and 64, respectively)  with significantly different problem profiles had been identified. Results are discussed in relation to developmental theories of antisocial development, and the need to adher o the risk principle when designing interventions for young offenders. 

  • 9.
    Ginner Hau, Hanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Self-reported strengths and difficulties in Swedish young offenders in community-based rehabilitative programmesIn: Child & Youth Care Forum, ISSN 1053-1890Article in journal (Refereed)
    Abstract [en]

    Mental health was investigated in a representative group of Swedish male offenders, 15-17 years of age,  referred to community based rehabilitative programmes (n=188). Self -report scores of the Strength and Difficulties Questionnaire (SDQ) were compared to those of a norm group, for the entire sample and for three subgroups with different levels of antisocial behaviour. The young offenders reported elevated levels of total difficulties, conduct problems and hyperactivity/inattention, significantly more scores in the clinical range and more negative impact on everyday life. The heterogeneity was substantial, and the subgroup with the most extensive history of antisocial behaviour was largely responsible for the overall results. Screening for mental health should be part of routine assessment, particularly in youths with extensive histories of antisocial behaviour.

  • 10.
    Ginnner Hau, Hanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Different problems – same treatment: Swedish juvenile offenders in community-based rehabilitative programmes2011In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 20, no 1, p. 87-96Article in journal (Refereed)
    Abstract [en]

    Young delinquents may be regarded as children in need of rehabilitation or as offenders deserving of consequences proportional to the committed crime. The focus has increasingly been on the latter, while research shows that individual risk assessment is essential for effective rehabilitation. This study explored self-reported history of antisocial behaviour among Swedish male offenders 15-17 years of age (n=189) who were sentenced to participate in rehabilitative programmes conducted by local social services. Antisocial behaviour was extensive and, according to a principal component analysis, consisted of three dimensions: (i) adolescent delinquency; (ii) violence and theft, (iii) drug-related crimes. Using cluster analysis, the participants were divided into four subgroups representing different levels and characteristics of delinquency, which explained 73 per cent of the variance in antisocial behaviour. The conclusion is that assignment to rehabilitative programmes appeared unrelated to subgroups, i.e. to risk level. Organisational obstacles to an evidence based practice are discussed.

  • 11.
    Ginnner Hau, Hanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Young male offenders in community-based rehabilitative programmes: Self-reported history of antisocial behaviour predicts recidivism2011In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 20, no 4, p. 413-420Article in journal (Refereed)
    Abstract [en]

    Recidivism over 18 months was investigated in a representative group of young Swedish male offenders, 15-17 years old, referred to community-based rehabilitative programmes (n = 189). Registry data on their earlier contacts with social services and previous convictions were also collected. Eighteen months after programme start, 60 per cent of the young offenders were registered as suspected of new crimes, 48 per cent were registered for crimes of violence. Previous contacts with the social services had been documented for 44 per cent, and 30 per cent were registered as previously convicted. However, the group was highly heterogeneous, and all registry data corresponded well with self-reported history of antisocial behaviour collected at the start of the programme, which identified three subgroups (n = 60, 65 and 64, respectively) with significantly different problem profiles. Results are discussed in relation to developmental theories of antisocial development and the need to adhere to the risk principle when designing interventions for young offenders.

  • 12. Hwang, Philip
    et al.
    Lundberg, IngvarSmedler, Ann-CharlotteStockholm University, Faculty of Social Sciences, Department of Psychology.
    Grunderna i vår tids psykologi2012Collection (editor) (Other academic)
    Abstract [sv]

    Bokinformation:

    Grunderna i vår tids psykologi ger en gedigen grund till den moderna psykologin. Några av Sveriges främsta forskare har här samlat den mest aktuella psykologiska vetenskapen utifrån ledande svensk och internationell forskning. Tack vare författarnas omfattande undervisningserfarenhet blir framställningen begriplig, levande och nyanserad. Resultatet är en heltäckande skildring av de byggstenar som behövs för att gå vidare inom psykologins olika tillämpningsfält.

    Grunderna i vår tids psykologi är:

    Människokunskap blir vetenskap

    Biologisk psykologi

    Motivation och emotion

    Kognitionspsykologi

    Utvecklingspsykologi

    Personlighetspsykologi

    Socialpsykologi

    Boken riktar sig främst till psykologistuderande, men kan läsas på alla utbildningar där grundkunskaper i ämnet ingår. Den ger också en utmärkt introduktion till den som är nyfiken på vår tids psykologi.

  • 13. Jonsson, Catherine Aaro
    et al.
    Catroppa, Cathy
    Godfrey, Celia
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Anderson, Vicki
    Individual profiles of predictors and their relations to 10 years outcome after childhood traumatic brain injury2013In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 27, no 7-8, p. 831-838Article in journal (Refereed)
    Abstract [en]

    Background: Outcome after childhood traumatic brain injury (CTBI) is heterogeneous, with several predictors influencing long-term outcome. Method: This exploratory study used person-oriented cluster analysis to investigate individual profiles of medical, psychological and social predictors and their relation to longitudinal development in a sample of 127 participants with mild, moderate and severe CTBI. Outcome of cognitive, adaptive and academic function was measured at 30 months and 10 years post-injury. Results: A nine-cluster solution, explaining 67% of the variance in the sample, resulted in two clusters with individuals with mostly mild injuries, five with mostly moderate injured individuals and two clusters with severely injured individuals. Best outcome at 10 years post-injury had a cluster with individuals with moderate injuries, young age at injury, average socioeconomic status (SES) and high pre-injury adaptive function. Worst outcome had a small cluster with severely injured individuals, young age at injury, average SES and average pre-injury adaptive function. Conclusions: The findings suggest that pre-injury adaptive function is an influential predictor of outcome following moderate CTBI. Age at injury in the severe group appears to have increased influence over time, with younger age at injury associated with reduced outcome at 10 years after severe CTBI.

  • 14.
    Lundequist, Aiko
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Bohm, Birgitta
    Lagercrantz, Hugo
    Forssberg, Hans
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 3, p. 292-299Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5.

    Methods: We tested 134 adolescents born preterm with a very low birthweight of <1500g and 94 term-born controls with a comprehensive cognitive battery at 18years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23-27, 28-31 and 32-36weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age.

    Results:Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks.

    Conclusion: Adolescents born at 28weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits.

  • 15.
    Lundequist, Aiko
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Böhm, Birgitta
    Forssberg, Hans
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    The Stockholm Neonatal Project: Stability and prediction of cognitive outcome from preschool age through adolescence in children born pretermManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To investigate the stability of development in general intelligence (IQ) and executive functions (EF), and to identify predictors of cognitive development from preschool age through adolescence, in a cohort of preterm and term-born children.

    Participants and Methods:  As part of the longitudinal Stockholm Neonatal Project, 134 adolescents born preterm with very low birth weight (< 1500g) and 94 matched controls born at term, participated in follow-up studies at ages 5 ½ and 18 years. On both occasions, the participants were assessed with an age appropriate Wechsler IQ test and tests of executive functions (EF). Stability in cognitive outcome was tested with Pearson correlations. Stepwise regression analyses were used to investigate how cognitive outcome at age 18 was predicted by EF at age 5 ½, parental education, gender, medical risk, and birth weight ratio.

    Results: IQ was quite stable form preschool age through adolescence (r =.78 in whole group, r = .84 in preterm and r= .61 in controls), as were EF (r =  .65 in whole group, r = .64 in preterm and r = .53 in controls).  In controls, EF at age 5 ½ and parental education predicted IQ (R² = .205) and EF at 18 years (R² = .249). In the preterm group, EF at age 5 ½, parental education, medical risks and birth weight ratio predicted IQ 18 years (R² = .508), and EF at age 5 ½ and medical risks predicted EF at18 years (R² = .432).

    Conclusions: Stability in cognitive outcomes from preschool through adolescence was high, particularly in the preterm group. EF at 5 ½ strongly predicted cognitive and executive functions at 18 years, in both groups. Over the same period, parental education had a continued positive effect on cognitive development. Among preterm children, perinatal medical risks predicted a less favorable continued cognitive development, especially in EF, and a low birth-weight ratio had a negative impact on general intelligence.

  • 16.
    Lundequist, Aiko
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet.
    Böhm, Birgitta
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Individual neuropsychological profiles at age 5 1/2 years in children born preterm in relation to medical risk factors2013In: Child Neuropsychology, ISSN 0929-7049, E-ISSN 1744-4136, Vol. 19, no 3, p. 313-331Article in journal (Refereed)
    Abstract [en]

    Follow-up studies of preterm children have reported a range of cognitive deficits, particularly in executive functions, visuospatial abilities, and learning. However, few researchers have adopted a person-oriented approach, exploring individual neuropsychological profiles. The aim of this study was to identify typical neuropsychological profiles among preterm children and control children, respectively. A second aim was to investigate if neuropsychological profiles at age 51/2 might be associated with perinatal medical risk factors. As part of the longitudinal Stockholm Neonatal Project, NEPSY for 4- to 7-year-old children (Korkman, 1990), WPPSI-R, and Movement ABC were administered at age 51/2 years to 145 preterm (mean gestational age 28 weeks) and 117 control children born at term. For the present study, the NEPSY results of each child were transformed into summary z scores for each of 5 neuropsychological domains: attention, memory, sensory-motor, verbal, and visuospatial functions. Subsequently, Ward's cluster analysis was performed for the preterm and control groups separately, identifying 5 neuropsychological profiles in both groups explaining around 56% and 57% of the variance, respectively. Overall, preterm children had lower neuropsychological results but also more diverging profiles compared to controls. The variability in outcome could not be sufficiently explained by birth weight, gestational age, or medical risks. The results suggest that prematurity interacts dynamically with genetic, medical, and environmental factors in neuropsychological development.

  • 17.
    Lundequist, Aiko
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Böhm, Birgitta
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Screening for executive dysfunction before school start: Concurrent and predictive validity of the Bender testManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to investigate if the Bender test, administered to late preschoolers and evaluated with a neuropsychological scoring system ,  can identify and predict executive dysfunctions at preschool age and in late adolescence, respectively.

    Participants and Methods: As part of the longitudinal Stockholm Neonatal Project, 134 adolescents born preterm with very low birth weight (< 1500g) and 94 matched controls born at term, participated in follow-up studies at ages 5 ½ and 18 years. On both occasions, the participants were assessed with an age appropriate intelligence test and tests of executive functions (EF) .  Bender Visual Motor Gestalt Test was given at age 5 ½, and scored with ABC neuropsychological system. Stepwise regression analysis was used to investigate how cognitive outcome at age 18 was predicted by the Bender ABC score and EF at age 5 ½, gender,  medical risk, birth weight ratio, and parental education. The validity of the Bender ABC neuropsychological score in screening for executive dysfunction was evaluated by Receiver Operating Characteristics-analysis (ROC).

    Results: Bender ABC neuropsychological scores predicted general intelligence and EF at 18 years almost as well as a more comprehensive battery, in both groups. ROC analysis showed that the Bender ABC had good diagnostic and predictive validity for identifying executive dysfunctions, with AUC-values of .84 in both cases.

    Conclusion: Bender with ABC neuropsychological scoring is a promising screening instrument for identifying executive dysfunctions before school start.

  • 18.
    Lundequist, Aiko
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Stålnacke, Johanna
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Böhm, Birgitta
    Lagercrantz, Hugo
    Forssberg, Hans
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Executive function development in adolescents born very and extremely pretermIn: Article in journal (Refereed)
    Abstract [en]

    Executive function deficits are often reported as being a specific weakness in preterm born children. Yet, stability in function and development over time is largely unknown. In a prospective longitudinal study, 115 participants born very or extremely preterm, ≤ 31 weeks of gestation, participated in neuropsychological assessments at ages 5½ years and 18 years. Executive functions were separated into working memory and cognitive flexibility. Gestational age at birth, intrauterine growth, sex, perinatal medical complications, and parental education were tested as predictors, and developmental stability was investigated using Structural Equation Modeling. Working memory and cognitive flexibility were highly stable from preschool age to late adolescence. Higher parental education, higher gestational age, and female sex were related to better outcome at 5½ years which in turn fully mediated outcome at age 18 years. Perinatal medical complications and restricted intrauterine growth negatively influenced cognitive flexibility in late adolescence. The study poses an argument for identification of executive deficits before school entry among children born preterm, as such deficits are unlikely to diminish as a consequence of maturation.

  • 19.
    Lundh, Lars-Gunnar
    et al.
    Lunds universitet.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Personlighetspsykologi2012In: Grunderna i Vår tids psykologi / [ed] Philip Hwang, Ingvar Lundberg & Ann-Charlotte Smedler (, Stockholm: Natur och kultur, 2012, 1, p. 221-272Chapter in book (Other academic)
    Abstract [sv]

    Bokinformation: Grunderna i vår tids psykologi ger en gedigen grund till den moderna psykologin. Några av Sveriges främsta forskare har här samlat den mest aktuella psykologiska vetenskapen utifrån ledande svensk och internationell forskning. Tack vare författarnas omfattande undervisningserfarenhet blir framställningen begriplig, levande och nyanserad. Resultatet är en heltäckande skildring av de byggstenar som behövs för att gå vidare inom psykologins olika tillämpningsfält.

    Grunderna i vår tids psykologi är:

    Människokunskap blir vetenskap

    Biologisk psykologi

    Motivation och emotion

    Kognitionspsykologi

    Utvecklingspsykologi

    Personlighetspsykologi

    Socialpsykologi

    Boken riktar sig främst till psykologistuderande, men kan läsas på alla utbildningar där grundkunskaper i ämnet ingår. Den ger också en utmärkt introduktion till den som är nyfiken på vår tids psykologi.

  • 20. Nagy, Zoltan
    et al.
    Ashburner, John
    Andersson, Jesper
    Jbabdi, Saad
    Draganski, Bogdan
    Skare, Stefan
    Böhm, Birgitta
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Forssberg, Hans
    Lagercrantz, Hugo
    Structural Correlates of Preterm Birth in the Adolescent Brain2009In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 124, no 5, p. e964-e972Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The Stockholm Neonatal Project involves a prospective,cross-sectional, population-based, cohort monitored for 12 to17 years after birth; it was started with the aim of investigatingthe long-term structural correlates of preterm birth and comparingfindings with reports on similar cohorts.

    METHODS: High-resolution anatomic and diffusion tensor imagingdata measuring diffusion in 30 directions were collected byusing a 1.5-T MRI scanner. A total of 143 adolescents (12.18–17.7years of age) participated in the study, including 74 formerlypreterm infants with birth weights of 1500 g (range: 645–1486g) and 69 term control subjects. The 2 groups were well matchedwith respect to demographic and socioeconomic data. The anatomicMRI data were used for calculation of total brain volumes andvoxelwise comparison of gray matter (GM) volumes. The diffusiontensor imaging data were used for voxelwise comparison of whitematter (WM) microstructural integrity.

    RESULTS: The formerly preterm individuals possessed 8.8% smallerGM volume and 9.4% smaller WM volume. The GM and WM volumesof individuals depended on gestational age and birth weight.The reduction in GM could be attributed bilaterally to the temporallobes, central, prefrontal, orbitofrontal, and parietal cortices,caudate nuclei, hippocampi, and thalami. Lower fractional anisotropywas observed in the posterior corpus callosum, fornix, and externalcapsules.

    CONCLUSIONS: Although preterm birth was found to be a risk factorregarding long-term structural brain development, the outcomewas milder than in previous reports. This may be attributableto differences in social structure and neonatal care practices.

  • 21. Norberg, Hanna
    et al.
    Stålnacke, Jannica
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Heijtz, Rochellys Diaz
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Nyman, Margareta
    Forssberg, Hans
    Norman, Mikael
    Antenatal corticosteroids for preterm birth: dose-dependent reduction in birthweight, length and head circumference2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 3, p. 364-369Article in journal (Refereed)
    Abstract [en]

    Aim: This study was undertaken to evaluate the effects of repeated courses of antenatal corticosteroids (ACS) on foetal growth. Methods: We studied 94 infants exposed to 2-9 courses of ACS. Mean gestational age (GA) at first exposure was 29 and at birth 34 weeks. Exposure data were retrieved from case record files. Information on potential confounders was collected from the Swedish Medical Birth Registry. Standard deviation scores (SDS) for birthweight (BW), birthlength (BL) and head circumference (HC) were calculated and considered as outcomes. Results: GA at start of ACS did not affect outcome. BW-SDS, BL-SDS and HC-SDS were -0.21, -0.19 and +0.25 in infants exposed to two courses, compared to -1.01, -1.04 and -0.23 in infants exposed to >= 4 courses of ACS (p = 0.04-0.07). In multiple regression analyses, >= 4 courses were associated with lower BW-SDS, BL-SDS and HC-SDS (p = 0.007-0.04) compared to SDS after 2-3 courses. The effects from >= 4 courses on BW and BL were comparable to reduction in birth size seen in twins and on HC to that observed after maternal smoking. Conclusions: Multiple courses of ACS are associated with a dose-dependent decline in foetal growth, which may affect later development and health.

  • 22. Oakland, Thomas
    et al.
    Leach, Mark M.
    Bartram, Dave
    Lindsay, Geoff
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Zhang, Houcan
    An International Perspective on Ethics Codes for Psychology: A Focus on Test Development and Use2012In: The Oxford Handbook of International Psychological Ethics / [ed] Andrea Ferrero, Yeşim Korkut, Mark M. Leach, Geoff Lindsay, Michael J. Stevens, New York: Oxford University Press, 2012, p. 1-19Chapter in book (Refereed)
    Abstract [en]

    The purpose of this chapter is to describe and discuss the international status of ethics codes and other documents that address test development and use in light of fundamental characteristics of such codes. The selection of issues associated with test development and use to assist in a discussion of ethics codes was due, in part, to the early onset and international nature of their development and use. Models of ethics codes and documents are examined, including similarities and differences in their emphasis on principles and standards, as well as professionals impacted by a code. Test issues are discussed in light of codes and documents that apply to individual countries, a regional code for countries that have considerable diversity, a regional code for countries that have considerable cultural consistency, and internationally. Information in this article may assist national psychological associations engaged in developing or revising their ethics codes.

  • 23.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Forskningsetik2012In: Att göra effektutvärderingar / [ed] Knut Sundell, Stockholm: Gothia Förlag AB, 2012, p. 57-90Chapter in book (Other academic)
    Abstract [sv]

    Bokinformation: Varje år berörs hundratusentals personer av psykosociala och pedagogiska interventioner. Det handlar exempelvis om behandling av missbruk, insatser för utsatta barn och läsundervisning i grundskolan. Endast undantagsvis har dessa interventioner utvärderats, vilket innebär att vi inte vet vilken effekt de har eller om de rentav kan skada. I antologin Att göra effektutvärderingar beskrivs hur man genomför effektutvärderingar, som ger kunskap om hur interventioner fungerar. Boken ger detaljerad och praktisk vägledning som är till nytta för alla som är intresserade av att lära sig mer om effektutvärderingar – både forskarstuderande och forskare som redan ansvarat för effektutvärderingar. Ämnen som tas upp är bland annat forskningsetik, studiedesign, mätinstrument, urval och rekrytering av undersökningspersoner, datainsamling, ekonomiska analyser, dataanalys och tolkning samt rapportskrivning. Bokens författare har lång erfarenhet inom området och representerar olika discipliner såsom psykologi, folkhälsovetenskap, socialt arbete, pedagogik, statistik, epidemiologi, sociologi, evolutionsbiologi, medicinsk vetenskap och datavetenskap. Redaktör för boken är Knut Sundell, docent i psykologi och socialråd på Socialstyrelsen, som har lång erfarenhet av att utvärdera interventioner inom förskola, skola och socialtjänst.

  • 24.
    Smedler, Ann-Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Wiklund, Stefan
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Anttila, Sten
    Pettersson, Agneta
    Programs for prevention of externalizing problems in children: limited evidence for effect beyond 6 Months post intervention2015In: Child and Youth Care Forum, ISSN 1053-1890, E-ISSN 1573-3319, Vol. 44, no 2, p. 251-276Article in journal (Refereed)
    Abstract [en]

    Background: Preventing externalizing problems in children is a major societal concern, and a great number of intervention programs have been developed to this aim. To evaluate their preventive effects, well-controlled trials including follow-up assessments are necessary.

    Methods: This is a systematic review of the effect of prevention programs targeting externalizing problems in children. The review covered peer reviewed publications in English, German, French, Spanish and Scandinavian languages. Experimental studies of standardized programs explicitly aiming at preventing externalizing mental ill-health in children (2–19 years), with outcome assessments at ≥6 months post intervention for both intervention and control groups, were included. We also included long-term trials with consecutive observations over several years, even in the absence of follow-up ≥6 months post intervention. Studies of clinical populations or children with impairments, which substantially increase the risk for mental disorders, were excluded.

    Results: Thirty-eight controlled trials assessing 25 different programs met inclusion criteria. Only five programs were supported by scientific evidence, representing selective parent training (Incredible Years and Triple-P), indicated family support (Family Check-Up), and school-based programs (Good Behavior Game, universally delivered, and Coping Power, as an indicated intervention). With few exceptions, effects after 6–12 months were small. Long-term trials showed small and inconsistent effects.

    Conclusions: Despite a vast literature, the evidence for preventive effects is meager, largely due to insufficient follow-up post intervention. Long-term follow up assessment and effectiveness studies should be given priority in future evaluations of interventions to prevent externalizing problems in children.

  • 25.
    Smedler, Ann-Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Tideman, Eva
    At teste børn og unge: om tesmetoder i den psykologiske undersøgelse2011 (ed. 1)Book (Other academic)
    Abstract [da]

    "At teste boern og unge" er en grundbog i psykologisk testning og undersoegelse af boern og unge. Bogen er en opdatert og utvidet udgave af den svenske klassiker, "Att testa barn", og er forsynet med et dansk forord af professor Annegen Trillingsgaard. Forfatterne forklarer, i hvilke sammenhaenge det kan vare aktuelt at teste boern og unge, og giver en grundig presentation af relevant psykometri samt principperne bag valg av testmetoder. En raekke centrale test praesenteres med grundige kommentarer: udviklings- og intelligenstest, specifikke funktionstest og personlighedstest. Ud fra deres mangeårige erfaring beskriver forfatterne, hvad man skal vare oppmaerksom på i den pratiske testsituation, og hvordan forskellige testresultater kan tolkes. I bogen beskrives også, hvordan man giver feedback på undersoegelseresultater - i skriftlige psykologudtalelser og i samtaler. Et saerligt kapitel er viet testning af boern med anden sproglig och kulturel baggrund. Test er hjaelpemiddel, det kraever solide psykolgiske kundskaper or kritisk taenkning for at kunne bruges på den rigtige måde. Forfatterne goer sig derfor til fortalere for et helhedssyn og understreger, at testresultater boer vejes sammen med al anden information om barnet eller den unge.

  • 26.
    Smedler, Ann-Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Tideman, Eva
    Att testa barn och ungdomar: om testmetoder i psykologiska utredningar2009Book (Other academic)
    Abstract [sv]

    Att testa barn och ungdomar handlar om testmetoders användning i barn- och ungdomspsykologiska utredningar. Boken kombinerar teoretiska och praktiska resonemang om psykologisk testning med en presentation och kritisk granskning av ett antal test.

    Inledningsvis ges en översikt över i vilka sammanhang det kan vara aktuellt med testning av barn och ungdomar, och vilka fördelar och risker som kan finnas med test. Kapitel 2 pekar på de psykometriska utmaningar som det innebär att utveckla fungerande test för barn och ungdomar. Det tredje kapitlet redogör för hur man i utredningssammanhang väljer test, och den teoretiska referensramens betydelse. I kapitel 4 presenteras 19 test, med avseende på respektive tests användning och teoretiska bakgrund, uppbyggnad och innehåll, psykometriska kvaliteter, utprövning för svenska förhållanden och en sammanfattande rekommendation. I kapitel 5 behandlas den praktiska testsituationen: Vad är en standardiserad testsituation? Vad innebär det att etablera kontakt inför en testning? Vilka kompletterande observationer bör man göra, och för vilket syfte? I det sjätte kapitlet ges en rad handfasta tips till den som står i begrepp att göra övningstestningar inom ramen för en utbildning eller för att tillägna sig en ny metod. Grundläggande psykometriska begrepp aktualiseras i kapitel 7, med siktet inställt på praktisk testanvändning. Kapitel 8 behandlar en fråga som de flesta psykologer har brottats med: Hur kan man använda svenska test då man utreder barn som kommer från ett annat land, med en helt annan kultur? I kapitel 9 ges råd kring utlåtandeskrivning och muntlig återgivning av utredningsresultat. I det avslutande kapitlet återfinns några fallbeskrivningar, som exemplifierar hur test kan användas för att skapa förståelse för ett barns eller en tonårings styrkor, svårigheter och behov.

  • 27.
    Smedler, Ann-Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Kliniska avdelningen.
    Winiarski, Jacek
    Karolinska insitutet.
    Neuropsychological outcome in very young hematopoietic SCT recipients in relation to pretransplant conditioning.2008In: Bone Marrow Transplantation, ISSN 0268-3369, Vol. 42, no 8, p. 515-22Article in journal (Refereed)
    Abstract [en]

    Stem cell transplantation involves conditioning with TBI and/or intensive chemotherapy, which may cause long-term neuropsychological deficits, particularly in children treated at a very young age. The aim of this study was to investigate whether very young children who receive chemotherapy-based conditioning only (BUCY) may have a more favorable neuropsychological outcome than children conditioned with TBI-CY. Twenty-two children who underwent allogeneic SCT at 0.4-3.6 years of age were subject to an extensive neuropsychological assessment at an average of 6.5 years post-therapy. The test results of 10 children exposed to BU were compared to the results of 12 children who had received TBI. Ten of them had received single-dose TBI, whereas two had received fractionated TBI. The BU group performed at age level on verbal measures, but tended to score below age level in the executive and visuo-spatial domains (P<0.01). By comparison, children treated with TBI had more pervasive neuropsychological impairments, including motor deficits (P<0.01) and varying degrees of perceptual (P<0.05), executive and cognitive (P<0.05) problems. In conclusion, children transplanted at a very young age had a more favorable neuropsychological development if conditioned with BUCY than if conditioned with single-dose TBI-CY.

  • 28.
    Stålnacke, Jannica
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Psychosocial Experiences and Adjustment Among Adult Swedes With Superior General Mental Ability2011In: Journal for the Education of the Gifted, ISSN 0162-3532, E-ISSN 2162-9501, Vol. 34, no 6, p. 900-918Article in journal (Refereed)
    Abstract [en]

    In Sweden, special needs of high-ability individuals have received little attention. For this purpose, adult Swedes with superior general mental ability (GMA; N = 302), defined by an IQ score > 130 on tests of abstract reasoning, answered a questionnaire regarding their views of themselves and their giftedness. The participants also rated their self-theory of intelligence and completed the Sense of Coherence Scale (SOC-13). At large, the participants experienced being different but felt little need to downplay their giftedness to gain social acceptance. Most participants encompassed an entity self-theory of intelligence, while also recognizing that it takes effort to develop one’s ability. The group scored lower (p < .001) than Swedes in general on the SOC, which may be a reflection of social difficulties associated with being gifted in an egalitarian society. However, it may also indicate that the SOC carries a different meaning for those with superior GMA.

  • 29.
    Stålnacke, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Diaz Heijtz, Rochellys
    Norberg, Hanna
    Norman, Mikael
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Forssberg, Hans
    Cognitive outcome in adolescents and young adults after repeat courses of antenatal corticosteroids2013In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 163, no 2, p. 441-446Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether repeat courses of antenatal corticosteroids have long-term effects on cognitive and psychological functioning. Study design In a prospective cohort study, 58 adolescents and young adults (36 males) who had been exposed to 2-9 weekly courses of betamethasone in utero were assessed with neuropsychological tests and behavior self-reports. Unexposed subjects (n = 44, 25 males) matched for age, sex, and gestational age at birth served as a comparison group. In addition, individuals exposed in utero to a single course (n = 25, 14 males) were included for dose-response analysis. Group differences were investigated using multilevel linear modeling. Results Mean scores obtained in 2 measures of attention and speed were significantly lower in subjects exposed to 2 or more antenatal corticosteroids courses (Symbol Search, P = .009; Digit Span Forward, P = .02), but these were not dose-dependent. Exposure to repeat courses of antenatal corticosteroids was not associated with general deficits in higher cognitive functions, self-reported attention, adaptability, or overall psychological function. Conclusions Although this study indicates that repeat exposure to antenatal corticosteroids may have an impact on aspects of executive functioning, it does not provide support for the prevailing concern that such fetal exposure will have a major adverse impact on cognitive functions and psychological health later in life.

  • 30.
    Stålnacke, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lundequist, Aiko
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Böhm, Birgitta
    Forssberg, Hans
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Individual cognitive patterns and developmental trajectories after preterm birth2015In: Child Neuropsychology, ISSN 0929-7049, E-ISSN 1744-4136, Vol. 21, no 5, p. 648-667Article in journal (Refereed)
    Abstract [en]

    Cognitive outcome after preterm birth is heterogeneous, and group level analyses may disguise individual variability in development. Using a person-oriented approach, this study investigated individual cognitive patterns and developmental trajectories from preschool age to late adolescence. As part of a prospective longitudinal study, 118 adolescents born preterm, with a birth weight <1,500 g, participated in neuropsychological assessments at age 5½ years and at 18 years. At each age, four cognitive indices, two tapping general ability and two tapping executive functions, were formed to reflect each individual’s cognitive profile. Cluster analyses were performed at each age separately, and individual movements between clusters across time were investigated. At both 5½ and 18 years, six distinct, and similar, cognitive patterns were identified. Executive functions were a weakness for some but not all subgroups, and verbal ability was a strength primarily among those whose overall performance fell within the normal range. Overall, cognitive ability at 5½ years was highly predictive of ability at age 18. Those who performed at low levels at 5½ did not catch-up, but rather deteriorated in relative performance. Over half of the individuals who performed above norm at 5½ years improved their relative performance by age 18. Among those performing around norm at 5½ years, half improved their relative performance over time, whereas the other half faced increased problems, indicating a need for further developmental monitoring. Perinatal factors were not conclusively related to outcome, stressing the need for cognitive follow-up assessment of the preterm born child before school entry.

  • 31.
    Stålnacke, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Psykologutredning i skolan: underlag till Socialstyrelsen2013Report (Other academic)
  • 32. Vollmer, Brigitte
    et al.
    Lundequist, Aiko
    Mårtensson, Gustaf
    Nagy, Zoltan
    Lagercrantz, Hugo
    Smedler, Ann-Charlotte
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Forssberg, Hans
    Correlation between white matter microstructure and executive functions suggests early developmental influence on long fibre tracts in preterm born adolescents2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 6, article id e0178893Article in journal (Refereed)
    Abstract [en]

    Main objectives: Executive functions are frequently a weakness in children born preterm. We examined associations of executive functions and general cognitive abilities with brain structure in preterm born adolescents who were born with appropriate weight for gestational age and who have no radiological signs of preterm brain injury on neuroimaging.

    Methods: The Stockholm Neonatal Project (SNP) is a longitudinal, population-based study of children born preterm (<36 weeks of gestation) with very low birth weight (<1501g) between 1988–1993. At age 18 years (mean 18 years, SD 2 weeks) 134 preterm born and 94 full term participants underwent psychological assessment (general intelligence, executive function measures). Of these, 71 preterm and 63 full term participants underwent Magnetic Resonance Imaging (MRI) at mean 15.2 years (range 12–18 years), including 3D T1-weighted images for volumetric analyses and Diffusion Tensor Imaging (DTI) for assessment of white matter microstructure. Group comparisons of regional grey and white matter volumes and fractional anisotropy (FA, as a measure of white matter microstructure) and, within each group, correlation analyses of cognitive measures with MRI metrics were carried out.

    Results: Significant differences in grey and white matter regional volumes and widespread differences in FA were seen between the two groups. No significant correlations were found between cognitive measures and brain volumes in any group after correction for multiple comparisons. However, there were significant correlations between FA in projection fibres and long association fibres, linking frontal, temporal, parietal, and occipital lobes, and measures of executive function and general cognitive abilities in the preterm born adolescents, but not in the term born adolescents.

    Overall significance of the study: In persons born preterm, in the absence of perinatal brain injury on visual inspection of MRI, widespread alterations in regional brain tissue volumes and microstructure are present in adolescence/young adulthood. Importantly, these alterations in WM tracts are correlated with measures of executive function and general cognitive abilities. Our findings suggest that disturbance of neural pathways, rather than changes in regional brain volumes, are involved in the impaired cognitive functions.

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