Targeting adolescent neurocognitive processes in depression to promote intervention response

Florin Tibu from the Department of Health and Human Development at the Stefan cel Mare University of Suceava recently gave us an insight into how CANTAB has impacted his research into targeting adolescent neurocognitive processes in depression to promote intervention response.

Can you tell us a bit about yourself?

I am a Developmental Psychologist and my current position is Associate Professor in the Department of Health and Human Development at the Stefan cel Mare University of Suceava, Romania. My main research interest is studying the risk and protective cognitive, neurophysiological and social factors that are key to understanding how young children and adolescents develop (or avoid developing) abnormal behaviour. I first became interested in how children are affected by psychopathology in 2003 when I started work as a Research Assistant in the Bucharest Early Intervention Project (BEIP), the first randomised controlled trial (RCT) on the effects of institutionalisation on children’s development and mental health. In 2010, I completed a Ph.D. at the University of Manchester, supervised by Professors Jonathan Hill and Andrea Pickles. My PhD research studied how the very young can develop neurocognitive and physiological vulnerabilities following exposure to prenatal stress. Upon return to Romania, I re-joined the BEIP, this time as a Research Fellow, with the aim of gaining a deeper understanding of how institutional care can impact children’s executive functioning (EF), autonomic functioning, and their levels of internalizing and externalizing psychopathology while receiving supervision from Professors Charles Nelson, Nathan Fox, and Charles Zeanah.

How did you come to develop an interest in cognitive assessments?

In my work with vulnerable populations of children, I learned that cognitive deficits (e.g., low IQ) can become key factors in transitioning to mental health problems during exposure to acute or chronic stress, while high levels of cognitive functioning can offer resilience to those who have lived in adverse environments. Often, these processes become evident very early in life, e.g., the first few months, and studying them from a developmental perspective offers unique benefits since some of our cognitive skills, particularly EFs, continue to develop until late adolescence. One of the key findings in my work with institutionalised and foster care children has been that early deprivation is associated with low IQ and deficits in multiple EF areas (i.e., working memory, planning, response inhibition) that often do not remediate after children are removed from institutions and placed in high-quality family environments. Additionally, certain EFs, like working memory and inhibition, play causal roles in the link between early institutional care and deprivation-specific ADHD during late childhood and adolescence (Tibu et al., 2016a^[1]; Tibu et al., 2016b^[2]). These findings imply that EF training can potentially decrease levels of ADHD in institutionalised adolescents, which may help clinicians develop new interventions for neglected children that involve cognitive components.

Which cognitive assessments have you used?

In the BEIP we used an IQ test and six CANTAB tests that allowed us to measure EFs in a comprehensive manner. The first test in the battery was Motor Screening (MOT) which is an easy to perform and relatively short task that measures hand-eye coordination and introduces the subject with the neuropsychological testing system. The Delayed Matching to Sample (DMS), Paired Associates Learning (PAL), and Spatial Working Memory (SWM) tests were chosen to measure working memory, then we used the Stockings of Cambridge (SOC) to assess the ability of planning and, finally, the Intra-Extra Dimensional Set Shift (IED) task was chosen to assess cognitive flexibility.

More recently, I completed a pilot pre-post investigation on the effects of a personality-targeted intervention on psychopathology and EF conducted with deprived adolescents, funded through the ERA-NET NEURON scheme. For this project, I have again used the MOT, SWM, PAL, and OTS (which replaced the SOC), and included two new CANTAB tests to measure emotion recognition (Emotion Recognition Task (ERT)) and sustained attention (Rapid Visual Information Processing (RVP)).

How has the experience of running the CANTAB tests been?

Although I have always been very pleased with the whole CANTAB experience throughout the +10 years of using these tests, I have been really impressed with how the cloud-based system works. In the recent NEURON project, we are using the Romanian version of the tests, and I find it an excellent choice for reasons of standardisation and participants' ease of use. I think that the company has done an excellent job with the voice-over system in Romanian by having paid great attention to details that involve interacting with the user, having used a voice that provides the instructions in a clear, warm, and firm manner, and having managed, overall, to provide a very user-friendly interacting experience, both as a participant and as an administrator. The cloud-based fully automated system has worked flawlessly during the 80-something assessments that we have conducted so far.

Do you have any future plans using CANTAB?

I have just sent a grant application for a new RCT study aiming at studying the effects of the above-mentioned personality-targeted intervention on EF and psychopathology in deprived adolescents. So, I plan on extending my current work by testing the efficacy of the intervention in a more rigorous manner than in the current pre-post NEURON study and by using the same measures, including the CANTAB tests. Until the next grant, I look forward to collecting and analysing all the data in the present investigation and, hopefully, reporting the results in a relevant journal.

References

Tibu, F., Sheridan, M., McLaughlin, K.A., Nelson, C.A., Fox, N.A., & Zeanah, C.H. (2016a). Disruptions of working memory and inhibition mediate the association between exposure to institutionalization and symptoms of attention-deficit/hyperactivity disorder. Psychological Medicine, 46(3), 529-541.
Tibu, F., Sheridan, M., McLaughlin, K.A., Nelson, C.A., Fox, N.A., & Zeanah, C.H. (2016b). Reduced working memory mediates the link between early institutional rearing and symptoms of ADHD at 12 years. Frontiers in Psychology, 7, 1850.

Florin Tibu - Department of Health and Human Development at the Stefan cel Mare University of Suceava