| Popis: |
Down syndrome (DS) is the most common genetic cause of intellectual disability (ID), affecting 1 out of every 691 infants. Although maladaptive behavior has been studied in individuals with DS, there are few adolescent studies, and none that examine factors predictive of maladaptive behaviors in this specific age group. Children with DS are more likely to display behavior problems when compared to typically developing children. Preliminary findings in adolescents suggest a decline in externalizing maladaptive behaviors and an increase in internalizing symptoms during this time period. Understanding more about the development of internalizing symptoms at this stage of development is particularly important as adults with DS are more prone to depression when compared to others with ID and are also at a significantly higher risk for dementia compared with the general population. Further, it has been hypothesized that a continuum exists in the general population between late-life depression, mild cognitive impairment, and dementia, and preliminary work in DS provides evidence for a similar phenomenon. Thus, an examination of factors associated with maladaptive behavior in DS across the lifespan may also have important implications for the larger aging population. Executive functioning (EF) abilities have been shown to be related to the presence of mood symptoms in both typically developing and clinical adolescent populations, and are critical to ability level even in the absence of mood symptoms. The present study explored the relationship between EF and maladaptive behavior in adolescents with DS. We hypothesized that the behavior profile would include internalizing behaviors that would increase with age and externalizing behaviors that would decline with age. We also hypothesized that performance on measures of EF would account for unique variance in maladaptive behaviors, beyond the effects of age, gender, and overall intelligence. Fifty-two adolescents with Trisomy 21 Down syndrome ages 12 to 18 (46% male) completed tasks that measured working memory, inhibition, problem solving, attention, and verbal fluency. Caregivers provided two standardized ratings of maladaptive behaviors. In the full sample, older age was associated with more internalizing behavior with a medium effect size. In females, older age was significantly related to parent report of more internalizing symptoms on both rating scales. Regression analyses indicated that both performance on a working memory task and a measure of internalizing behavior were significant independent predictors of externalizing behavior. Both externalizing behavior and performance on a semantic fluency task were independent predictors of internalizing behavior. Finally, there was a positive relationship between performance on a task measuring inhibition and measures of both internalizing and externalizing behavior. These data extend research findings in individuals with DS by suggesting a relationship between maladaptive behavior and cognition in adolescence. Our results have direct implications for study design, as little information is available about measures that have adequate psychometric properties in this population. These results are also clinically and theoretically important as they provide data regarding specific measures that may be used to document cognitive and behavioral development. |
