The Characteristics Of Neurological Soft Signs And Their Relationship With Cluster B Personality Traits And Risk Behaviors In Adolescents

Objective:(1) The purpose of the current study was to investigate the prevalences of Neurological Soft Signs (NSS) in adolescents and to estimate the difference of neurological soft signs between different gender groups and among different age groups.(2) To examine the associations between NSS and executive function in adolescents.(3)To investigate the NSS in adolescents defined psychometrically as Cluster B Personality Disorders.(4) To examine whether NSS was a moderator in the relationship between stress and health-risk behaviors.Methods:NSS were assessed by the soft signs examinations of the Cambridge Neurological Inventory. Personality Diagnostic Questionnaire-4+(PDQ-4+) to assess Cluster B Personality Disorders, Barratt Impulsiveness Scale (BIS-11) to assess impulsive, Youth Risk Behavior Surveillance System (YRBSS) and Adolescent Health-risk Behavior Inventory (AHRBI) to assess health-risk behaviors, and Adolescent Self-Rating Life Events Check List (ASLEC) to assess stress. A total of3892adolescents were recruited from Beijing, Shanghai, Hangzhou, Suzhou, Changsha, Chengdu and Yinchuan. Meanwhile,100adolescents from each city were selected randomly to complete the arrows task (AT) and the Stroop color-word test (SCWT). After the initial assessment, a total of572adolescents participated in the longitudinal study for six months, with an interval of2months. At each of these follow-up assessments, adolescents completed ASLEC and AHRBI.Results:(1) The prevalences of individual NSS of adolescents ranged from1.3%to24.6%. The most common NSS in adolescents were finger agnosia of left hand (24.6%), finger agnosia of right hand (23.4%), abnormal left-right orientation (16.0%), abnormal graphesthesia of left hand (13.3%) and abnormal fist-edge-palm of right hand (12.3%). There were significant differences among different age groups (P<0.001) on scores for the motor coordination, sensory integration, disinhibition and total soft signs scale, younger age group had higher scores than older age group. In both14-and15-year age group, the sensory integration scores in boys were significant higher than those in girls (P<0.01). In14-year age group, the disinhibition scores in boys were significant higher than those in girls (P<0.01). In14-and15-year age group, the NSS total scores in boys were significant higher than those in girls (P<0.01). There were no gender difference on three subscales scores and total score of NSS in group with older than15.(2) Adolescents with high NSS scores exhibited significantly higher scores in AT and SCWT reaction time (P<0.05), AT and SCWT interference (P<0.05), and lower scores in AT and SCWT accuracy (P<0.01) than control adolescents.(3) Adolescents with Cluster B Personality traits shown higher scores on BIS than control adolescents (P<0.05). Both adolescents with antisocial personality traits and adolescents with borderline personality traits had significantly higher NSS scores than control adolescents (P<0.001).(4) Adolescents with high NSS scores showed significantly higher prevalences in physical fight, lifetime cigarette use, current cigarette use, current alcohol use, ever had more sexual intercourse and unprotected sex behaviors than control adolescents (P<0.05). Adolescents with high NSS scores shown significantly higher scores on factors reflecting aggression and violence, suicide and self-injurious behaviors, smoking and drinking, unprotected sex, health compromising behavior and rule breaking (P<0.05) than control adolescents. The HLM results showed significant main effects of NSS [b=1.23, F(1,563)=23.79, P<0.001], and a significant moderation effects of NSS:NSS X stress [b=0.02, F(1,2624)=7.56, P<0.01].Conclusion:(1) Adolescents showed some degrees of neurological soft signs. Before15years old, boys had significantly more NSS than girls. There was a tendency that NSS decrease with ages increasing.(2) Adolescents with high NSS scores exhibited more severe impairment in executive functions.(3) Both adolescents with antisocial personality traits and adolescents with borderline personality traits had significantly more and severe NSS than control adolescents, suggesting that both adolescents with antisocial personality traits and adolescents with borderline personality traits might have nonfocal central nervous system failures.(4) Adolescents with high NSS scores exhibited more health-risk behaviors. The NSS moderated the relationship between stress and health-risk behaviors. Two figures,30tables and171references were included in this study.