Consistent with our hypothesis, HIV infection was observed to have both direct and indirect effects via inflammation on complex motor performance, such that inflammation burden accounted for 15.1% of the effect of HIV infection on motor performance when controlling for relevant covariates. These results indicate that inflammatory processes may contribute to worse complex motor skills in the context of cART-treated HIV. Our sample consisted of virally suppressed, chronic HIV-positive patients; however, impairment in complex motor skills was still observed among 20% of the HIV-positive sample. This observed impairment rate is consistent with motor impairment rates reported in previous literature e.g.,.Some evidence indicates a higher impairment rate in complex motor performance among persons with chronic HIV compared to persons with acute or early HIV infection, which may reflect a history of immunosuppression and/or greater inflammation burden. For example, persons with AIDS performed significantly worse on a fine motor speed test than those without AIDS. Deficits in motor skills may indicate injury to the basal ganglia, which are part of the motor control pathways. The basal ganglia appears to be particularly vulnerable to alterations in BBB permeability,immune cellular infiltration, and accumulation of HIV viral RNA. Neuropathological studies have observed higher concentrations of macrophages, microglia, and viral proteins in the basal ganglia. Our path analyses indicate that inflammation burden may play a role in the association between HIV infection and worse complex motor performance. This finding is consistent with previous research demonstrating the detrimental impact of HIV and its proteins on the brain through peripheral and CNS pathways. Monocytes and macrophages are observed to infiltrate the CNS in HIV infection. 10 Elevations in soluble markers of monocyte and cytokine activation, including sCD14, MCP-1/CCL2 and IL-6, have been observed among HIV-positive adults with neurocognitive impairment.

Expression of MCP-1/CCL2 may contribute to upregulation of HIV-1 replication, thereby contributing to an increased risk of neurocognitive impairment.In addition to inflammation,led grow lights coagulation imbalance, which includes upregulation of D-dimer, is associated with global neurocognitive functioning among HIV-positive adults. 15 In the current analysis, D-dimer was included in the inflammation burden composite given the bidirectional relationship between inflammation and coagulation . Multiple factors likely contribute to activation of inflammatory and coagulation pathways observed among HIV-positive persons on cART, such as viral replication, excess levels of translocated microbial products and other chronic pathogens , and loss of immunoregulatory responses. HIV was observed to have both direct and indirect effects via inflammation burden on complex motor performance; however, inflammation burden only accounted for 15.1% of the effect of HIV on complex motor performance. These results suggest there are additional mechanisms by which HIV may have deleterious effects on complex motor performance. Other factors contributing to neurocognitive impairment may include vascular remodeling ,metabolic disorders ,and co-infections.The present study evaluated a model that identified one plausible indirect pathway between HIV and worse complex motor performance; future research may build upon this work by evaluating models with multiple pathways in order to estimate the relative contribution of various plausible mediators. A better understanding of the interplay of factors contributing to neurologic dysfunction in HIV may lead to more accurate prognosis and and/or risk stratification of HIV-positive adults in regard to neurologic dysfunction. Although some brain metabolite abnormalities may improve after initiating cART, some abnormalities persist, including ongoing inflammatory processes. A long-term prospective cohort study found interacting effects of aging and HIV disease stage, such that the magnitude of motor performance impairment was greater than the sum of the independent effects of age and HIV disease stage.The interaction between aging and HIV disease stage suggest that complex motor skills may be particularly susceptible to aging-related progression of neurocognitive impairment among HIV-positive adults. The Grooved Pegboard Test appears to be particularly sensitive to detecting neurocognitive decline among HIV-positive persons.

Our study findings should be considered in light of its limitations. First, although we used path analysis, this study was cross-sectional in nature, which precludes us from making inferences in regard to causation or mediation. Our results are also consistent with the alternative hypothesis that both inflammatory processes and complex motor skills may be mediated by an unobserved third variable. Given that the parent study involves repeated assessment of neurocognitive functioning and inflammation over five years, future analyses will examine whether changes in inflammation are associated with changes in complex motor functioning. Second, our study could not rule out other pathology underlying complex motor performance deficits . Third, it is unclear how to best conceptualize inflammation burden as normative standards regarding biomarker measurement and conceptualization have not been established. However, our calculation of a composite inflammation burden score may be a viable method compared to reliance on a single biomarker given our analysis indicated that complex motor performance was significantly associated with the composite but not any individual biomarker. Furthermore, conceptualization of an inflammation burden composite adds to the body of research aimed at developing clinically relevant risk indices . Fourth, our HIV-negative comparison group was relatively healthy and differed from the HIV-positive group on multiple characteristics. Fifth, our HIV-positive group consisted of mostly non-Hispanic white males with some college education, which is not fully representative of HIV-positive persons in the United States. Sixth, prior research indicates multitasks may better detect motor impairment compared to a single motor task; the Grooved Pegboard Test, however, involves the use of many complex operations and is correlated with a range of cognitive functions.In summary, HIV has a deleterious impact on complex motor skills, which may be partially explained by inflammatory processes. Future studies of strategies for managing chronic inflammation in HIV may consider using an inflammation burden composite and examining how changes in inflammation burden affect complex motor performance given this neurocognitive domain appears to be more strongly associated with inflammation relative to other domains.

Much research has focused on externalizing symptoms of juvenile males with a criminal record, and little is known about introverted personality types. Schizoid personality traits lie on the introversion personality dimension and have specific characteristics that represent potentially maladaptive intra- and interpersonal styles. A latent variable approach explored pathways between childhood trauma, schizoid personality traits, and substance problems among 1,029 juvenile males who committed an offense. Trauma, schizoid personality traits, and social support were specified as predictors, and substance problems represented the outcome of a structural equation model. The model tested whether or not social support was a mediator for the association between schizoid personality and substance problems. Moreover, I was interested in the association between trauma, schizoid personality, and substance problems. I found that childhood trauma was significantly and positively related to schizoid personality traits, and that it had an indirect, positive effect on substance problems. Specifically, schizoid personality mediated the relationship between trauma and substance problems. Trauma appeared to increase substance problems through the pathway it shared with schizoid personality traits, yet not through the pathway of social support. Results show that schizoid personality had a positive, significant association with substance problems,vertical grow system while social support was not significantly related to the outcome. There was no evidence that social support mediated the relation of schizoid personality and substance problems. Hence, a lack of social support did not explain why individuals higher on schizoid traits used alcohol or drugs in problematic ways. The study calls for intervention models that incorporate personality assessments for enhancing services to fit with interpersonal styles of clients. Screening for substance use behaviors is not sufficient when treating youths who committed crimes; assessing trauma history and personality style are important elements for treatment planning. Social support as a strength may not buffer the effects of trauma and schizoid personality traits, so that alternative or additional strengths should be assessed and incorporated into the treatment of adolescents who struggle with antisocial behaviors such as criminal activity and substance use. Juvenile crime challenges societal beliefs about children and their innocence. Juveniles who engage in criminal activity tend to disturb not only social order but existing concepts of how to address deviance among the very young and vulnerable, that is, among children. Policy makers struggle with how best to address this issue. Over the past decades criminal justice has moved into an interdisciplinary field that acknowledges the roles of psychology, sociology, economy, culture, and politics in the treatment of juveniles who commit crimes.

This study addresses the complex phenomenon of youth offending by enhancing the understanding of different intra- and extrapsychic variables that are associated with such behaviors. By helping develop a more intimate and nuanced understanding of youths who commit illegal acts, policymakers can be supported in making informed decisions and develop efficient interventions. The recidivism rate of juveniles as reported by the Division of Juvenile Justice was at 81% in terms of new arrests after release for the fiscal year of 2004-2005 in the state of California . Clearly, the processes and mechanisms of juvenile offending are not entirely understood and therefore not sufficiently addressed with current rehabilitation efforts. While this study is not aimed at replacing current, evidence-based treatment efforts, it strives to add to those treatments by contributing research on understudied personality types and traumagenic factors correlated with antisocial behavior.Youths in the juvenile justice system have high rates of victimization, emotional, and behavioral problems compared to youths who are not incarcerated . Abram et al. found that approximately one-third of juvenile detainees were suffering from post traumatic stress disorder. Past and ongoing traumatic experiences such as physical, sexual, and emotional abuse among individuals who abuse substances have been associated with avoidant, dependent, impulsive, sadistic, paranoid, schizoid, borderline, and narcissistic personality traits . Frequently reported high-risk personality characteristics for offending are impulsivity, sensation-seeking, irritability, and low empathy . The U.S. Department of Health and Human Services reports that adolescents who have been victimized or exposed to violence are more likely to aggress against others. Given the high rate of trauma among the offender population, more research is needed to explore the various pathways on which it operates . For example, more research is needed to explore how traumatic experiences influence substance problems, and whether there are developmental trajectories that increase the risk for problematic substance use. Similarly, research is needed to investigate how trauma affects personality development. Traumatic experiences have been associated with the development of personality disorders . A study by Johnson et al. on verbal abuse and PD found that verbal abuse was related to increased risks for developing borderline, narcissistic, obsessive-compulsive, and paranoid PDs during adolescence and early adulthood. Remarkably, verbal abuse was also associated with elevated schizoid and schizotypal PD symptom levels during adolescence and early adulthood . Before studying the effects of trauma on personality traits it is critical to define what personality is. Personality traits are defined as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts” . Therefore, personality carries intra- and extrapsychic qualities. For this study on adolescents personality is conceptualized as a fluid, dimensional construct consisting of propensities that undergo developmental changes and that are affected by stressors in the environment such as poverty and poor family relations . Personality emerges over time as a result of a combination of early caregiver relationships, biological manifestations, and social interactions. There are different approaches to studying personality that include categorical and dimensional ones. The DSM-IV-TRrelies on categorical classifications of personality that according to critics creates the illusion of an exclusive division between related personality constructs . In clinical reality patients present with many co-occurring and overlapping symptoms, which is why a dimensional approach is favored in this study. The five-factor model is a widely recognized dimensional model capturing five central personality dimensions that have been corroborated across many cultures . Because this study is concerned with personality traits and not disorders, the five-factor model is particularly suitable; it provides a dimensional model of normal personality traits that are grouped into neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness . The introversion dimension includes individuals with schizoid traits; it lies at the other end of the extraversion dimension that encompasses antisocial personality types. Individuals with schizoid traits prefer introspection and solitary activities .