Executive function as a mechanism linking socioeconomic status to internalizing and externalizing psychopathology in children and adolescents

Prenatal Adversity and Neonatal Brain Connectivity Relate to Emerging Executive Function at Age 2 Years

OBJECTIVE

Early life adversity alters the structure and function of higher-order brain networks that subserve executive function (EF). The extent that prenatal exposure to adversity and neonatal white matter (WM) microstructure and resting-state functional connectivity (rs-fc) underlie problems in emerging EF remains unclear.

METHOD

This prospective study includes 164 infants (45% female, 85% term-born) who were recruited prenatally and underwent neonatal diffusion and rs-fc magnetic resonance imaging scans. Social disadvantage and maternal psychosocial stress were assessed in the prenatal period. At age 2 years, children completed the Minnesota Executive Function Scale. Multivariable regression, moderation, and mediation analyses examined associations between prenatal adversity, neonatal WM microstructure and rs-fc, and emerging EF outcome.

RESULTS

Prenatal social disadvantage (PSD), but not maternal psychosocial stress, was associated with poorer emerging EF. After multiple comparison correction, higher mean diffusivity (MD) and lower fractional anisotropy (FA) in the corpus callosum, as well as higher MD in the inferior fronto-occipital fasciculus and corticospinal tract and lower FA in the uncinate, related to poorer emerging EF. In moderation analysis, associations between neonatal WM microstructure and emerging EF did not vary as a function of PSD. In mediation analyses, neonatal WM microstructure did not attenuate the association between PSD and emerging EF. The rs-fc findings did not pass multiple comparison correction.

CONCLUSION

PSD was related to poorer emerging EF outcomes. Neonatal WM microstructure was also related to emerging EF, with similar associations for children with lower or higher PSD. Prenatal social welfare programs may support neonatal brain development and early neurodevelopmental outcomes.

DIVERSITY & INCLUSION

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.

Identifying cognitive, affective, and developmental mechanisms linking threat and deprivation with adolescent psychopathology

BACKGROUND

The mechanisms linking early-life adversity with psychopathology over the life-course are complex. In this prospective study, we collectively examined cognitive, affective, and developmental mediators previously found to individually link childhood threat and deprivation experiences to adolescent psychopathology to identify the most potent mechanisms.

METHODS

Data came from a community sample of 227 children (mean child age 11.5 ± 0.5 years, 48.5% female) from the Seattle metro area with recruitment designed to reflect diversity in family income. Candidate mechanisms included self-rated pubertal development and task-measured attention bias to threat, emotion regulation, theory of mind, fear learning, inhibitory control, language ability, reasoning, and reward sensitivity. Using a high-dimensional mediation approach, we determined which mediating pathways linking threat and deprivation to psychopathology persisted after controlling for all candidate mechanisms associated with psychopathology. Models additionally controlled for the child's age, sex, early-childhood emotional and behavioral symptoms, poverty, and maternal depression.

RESULTS

Blunted reward sensitivity mediated the prospective relationship between threat and internalizing psychopathology, explaining 17.25% (95% CI 1.08%, 69.96%) of this association. Advanced pubertal development was associated with increases in internalizing and externalizing symptoms (standardized associations of 0.16 (95% CI 0.03, 0.29) and 0.17 (95% CI 0.05, 0.29), respectively), but not with adversity. Although deprivation was strongly related to psychopathology, no mechanisms were empirically identified.

CONCLUSIONS

In a well-characterized community sample, we isolated reward sensitivity as a robust mediator of the prospective association between early-life threat and adolescent internalizing psychopathology. Interventions aimed at bolstering reward sensitivity may mitigate the impact of early-life threat experiences on internalizing problems.

Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

Hot and cool executive function in the development of behavioral problems in grade school

Despite the well-established link between children's executive function and behavioral adjustment, it remains unclear whether the hot and cool aspects of executive function are uniquely associated with children's behavioral problems. Using longitudinal data spanning in the grade school (N = 1,140), this study aimed to examine whether hot and cool executive function skills may be uniquely related to the development of behavioral problems. Hot and cool executive function skills were measured with tasks, standardized tests, and questionnaires at 54 months and in the first grade, respectively. Internalizing and externalizing problems were evaluated by teachers using questionnaires throughout the grade school. The results indicated that, independent of each other, hot and cool executive function skills were uniquely and negatively related to the development of internalizing and externalizing problems over time at the between-individual level, adjusting for within-individual fluctuations. Moreover, internalizing and externalizing problems were positively related at the between-individual level across the grade school. Findings provide needed evidence to clarify the relations between hot and cool executive function and children's behavioral problems, emphasizing the importance of both aspects of executive function in understanding the development of behavioral problems in school-age children.

Callous-unemotional traits, cognitive functioning, and externalizing problems in a propensity-matched sample from the ABCD study

BACKGROUND

Many studies show that both callous-unemotional (CU) traits (e.g., low empathy, lack of guilt) and cognitive difficulties increase risk for externalizing psychopathology across development. However, other work suggests that some aggression (e.g., relational, proactive) may rely on intact cognitive function, which could vary based on the presence of CU traits. Moreover, no prior research has adequately accounted for common risk factors shared by CU traits, cognitive difficulties, and externalizing problems, which confounds conclusions that can be drawn about their purported relationships. The current study addressed these knowledge gaps by leveraging rigorous propensity matching methods to isolate associations between CU traits and different dimensions of cognitive function and externalizing problems.

METHODS

Associations between CU traits, cognitive functioning, and externalizing outcomes were tested within dimensional (n = 11,868) and propensity-matched group-based (n = 1,224) models using data from the Adolescent Brain Cognitive Development Study®, with rigorous statistical control for shared sociodemographic risk factors. Cross-sectional outcomes were parent-reported symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), and attention deficit hyperactivity disorder (ADHD). Longitudinal outcomes were child-reported overt and relational aggression.

RESULTS

CU traits were uniquely related to more parent-reported CD, ODD, ADHD symptoms, as well as more child-reported aggressive behaviors. Effects of cognitive difficulties were domain specific and were not consistent across dimensional and propensity matched models. There was minimal evidence for divergent associations between CU traits and externalizing outcomes as a function of cognition (i.e., no moderation).

CONCLUSIONS

Rigorous control for sociodemographic factors within propensity-matched models establish CU traits as a robust and unique risk factor for externalizing psychopathology, over and above difficulties with cognitive functioning.

Balancing Data Quality and Bias: Investigating Functional Connectivity Exclusions in the Adolescent Brain Cognitive Development℠ (ABCD Study) Across Quality Control Pathways

Analysis of resting state fMRI (rs-fMRI) typically excludes images substantially degraded by subject motion. However, data quality, including degree of motion, relates to a broad set of participant characteristics, particularly in pediatric neuroimaging. Consequently, when planning quality control (QC) procedures researchers must balance data quality concerns against the possibility of biasing results by eliminating data. In order to explore how researcher QC decisions might bias rs-fMRI findings and inform future research design, we investigated how a broad spectrum of participant characteristics in the Adolescent Brain and Cognitive Development (ABCD) study were related to participant inclusion/exclusion across versions of the dataset (the ABCD Community Collection and ABCD Release 4) and QC choices (specifically, motion scrubbing thresholds). Across all these conditions, we found that the odds of a participant's exclusion related to a broad spectrum of behavioral, demographic, and health-related variables, with the consequence that rs-fMRI analyses using these variables are likely to produce biased results. Consequently, we recommend that missing data be formally accounted for when analyzing rs-fMRI data and interpreting results. Our findings demonstrate the urgent need for better data acquisition and analysis techniques which minimize the impact of motion on data quality. Additionally, we strongly recommend including detailed information about quality control in open datasets such as ABCD.

Executive functioning as a prospective moderator of the relations between maltreatment in childhood and externalizing symptoms and wellbeing from adolescence to young adulthood

Although childhood maltreatment is associated with externalizing symptoms, not all individuals with these experiences develop externalizing behaviors and some exhibit positive adjustment. To address this multifinality, we used latent growth curve modeling to identify trajectories of (a) externalizing symptoms and (b) subjective wellbeing from late adolescence through young adulthood, determine whether types of childhood maltreatment and domains of executive functioning (EF) are associated with initial levels and growth (slopes) of externalizing symptoms or subjective wellbeing, and investigate whether EF moderates these relations. Participants were youth recruited at ages 10-12 (N = 775; 69% male, 31% female; 76% White, 21% Black/African American, 3% multiracial). We examined EF at ages 10-12, childhood maltreatment reported retrospectively at age 25, and externalizing symptoms and subjective wellbeing at multiple points between ages 16 and 28. Experience of childhood maltreatment and certain EF domains were associated with externalizing symptoms and subjective wellbeing at age 16. EF domains were associated with rate of change in externalizing problems, though not in expected directions. EF variables moderated the relation between maltreatment and initial levels of both outcomes and change in externalizing symptoms. Findings have implications for intervention efforts to mitigate externalizing problems and bolster positive adjustment.

What do we mean when we talk about socioeconomic status? Implications for measurement, mechanisms and interventions from a critical review on adolescent mental health

Low socioeconomic status (SES) is a well-established risk factor for general and mental health problems. However, there is no widely accepted definition or operationalisation for SES, leading to varied interpretations in research. In a critical review of the child and adolescent mental health literature, we map how SES is defined and measured. We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES. Our analysis revealed fundamental problems such as the lack of clear definitions, insufficient detail on variables used and limited measures directly reported by adolescents. We discuss issues related to measurement techniques and their impact on reproducibility, policy development and intervention design. Based on our findings, we recommend using SES measures that directly assess the socioeconomic position of children and adolescents. Additionally, we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection. The wide range of distinct measures used to represent SES, coupled with insufficient reporting, likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships. This, in turn, makes the path to effective health interventions more challenging.

Effect of COGNI-MACHINE computational thinking training on executive functions in children aged 9 to 11: Protocol of a cluster randomized controlled trial

We designed a controlled trial protocol that seeks to contribute to cognitive science by studying the effect of thought training on children's executive functions. The study design is a cluster randomized controlled trial, with intra-subject and inter-subject evaluation, with two parallel groups: an experimental group and a TAU control group. With three measures, pre-test, post-test, and follow-up after three months. The participants will be children aged 9 to 11. The allocation will be randomized by groups and not individually. The sample will be a minimum of 44 participants. The primary measures will be neuropsychological tests to assess executive functions. Secondary measures will be a computational thinking test, neuropsychological tests to assess metacognition and attention, and an acceptability scale. The experimental group will participate in the COGNI-MACHINE computational thinking training designed by the first author. The training frequency will be twice a week in 60 min sessions for 12 weeks. The TAU control group will receive computer science classes as usual during the same time as the experimental group. The evaluators taking the measurements will be blinded to the assignment. The investigators in charge of the intervention will be blinded to the results of the evaluations.

How Self-Regulation and Executive Functions Deficits Affect Quality of Life of Children/Adolescents with Emotional Regulation Disorders

BACKGROUND

Deficits in self-regulation and executive functions (EFs) frequently characterize children/adolescents with emotional regulation disorders and restrict their daily function and quality of life (QOL). These deficits are mainly manifested by neuropsychological measures in laboratory settings. This study aimed to compare self-regulation and EFs by ecological measures to reflect the implications in daily life between children with emotional regulation disorders and healthy controls and examine the relations between self-regulation, EFs and QOL in the study group.

METHODS

the participants were 49 children aged 8-18: 25 children/adolescents with emotional regulation disorders and 24 healthy children. The parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL), the Behavior Rating Inventory of Executive Functions (BRIEF) and the Pediatric Quality of Life Inventory (Peds-QL).

RESULTS

The study group had greater self-regulation difficulties (internalization and externalization problems), executive dysfunctions (EFdys) (including metacognition difficulties) and a lower QOL. Their internalization and externalization problems correlated with reduced EFs and QOL. Internalization predicted the physical and emotional QOLs, while metacognition predicted social and school-related QOLs.

CONCLUSIONS

Deficits in self-regulation and EFs are prevalent in children/adolescents with emotional disorders and restrict their daily function and QOL. Therefore, they should be routinely evaluated by ecological instruments to reflect daily restrictions.

Contributions of socioeconomic status and cognition to emotion processes and internalizing psychopathology in childhood and adolescence: A systematic review

This systematic review evaluated evidence from 25 manuscripts regarding three possible relationships of socioeconomic disadvantage (SESD) and cognition to emotion knowledge (EK), emotion regulation (ER), and internalizing psychopathology (IP) across development; a) independent contributions of disadvantage and cognition; b) cognition mediates relations of disadvantage; or c) cognition moderates' relations of disadvantage. Results support associations between SESD and cognition to emotion that differ by cognitive domain and developmental epoch. For EK, in early and middle childhood language and executive functions contribute to EK independent of SESD, and early childhood executive functions may interact with socioeconomic status (SES) to predict prospective EK. Regarding ER, language contributes to ER independent of SES across development and may mediate associations between SES and ER in adolescence. Regarding IP, SES, language, executive function, and general ability have independent contributions to IP across development; in adolescence executive function may mediate or moderate associations between SES and IP. Findings highlight the need for nuanced and developmentally sensitive research on the contributions of SESD and domains of cognition to emotion.

Childhood trauma and internalizing and externalizing behavior problems among adolescents: Role of executive function and life events stress

INTRODUCTION

Exposure to childhood trauma is found to increase internalizing and externalizing behavior problems in adolescents, however, the potential mechanism of this link remains underexplored. This study investigated the associations between childhood trauma and internalizing and externalizing behavior problems among adolescents, and tested the mediating role of executive function and the moderating role of life events stress in this relationship.

METHODS

Questionnaire data were collected from 952 junior students in Northwest China. Participants ranged in age from 11 to 15 years old (M = 12.88 years, SD = 0.72; 53% females). SPSS 26.0 was used to analyze the relationship between variables and examine the mediation model and the moderated mediation model.

RESULTS

Childhood trauma was positively associated with internalizing and externalizing behavior problems among adolescents. In addition, executive function partially mediated the relations between childhood trauma and internalizing and externalizing behavior problems. Life events stress was observed to moderate the relations between childhood trauma and executive function, as well as executive function and internalizing and externalizing behavior problems, but the effect sizes were relatively small.

CONCLUSIONS

These findings underscore the role of executive function and life events stress in the association between childhood trauma and behavioral problems among adolescents.

Fractionation of executive functions in adolescents from Iran: invariance across age and socioeconomic status

Executive functions (EFs) are cognitive skills that regulate thoughts and behavior. The seminal EF unity and diversity theoretical framework proposes the existence of three correlated EF latent domains (inhibition, updating, and switching) that become distinguishable from a certain moment during adolescence, but it is unclear how age and socioeconomic status (SES) affect these abilities. Here, we assessed 407 9-15-year-old Iranians of variable SES using an open-access battery of executive function tests that includes two tasks of each EF domain and allows for sociocultural adaptations regarding language and stimuli. Various EF model configurations proposed in the literature were tested (one, two and three EF latent factor, nested and bifactor-S-1 models) using confirmatory factor analyses. In addition, to explore the unbiased effects of age and SES, we performed invariance testing (across age and SES) using multiple indicators multiple causes (MIMIC) model to the best fitting model solution. The three-correlated EF factor model had the best fit and was mostly invariant across age and SES, with all three EF latent traits improving with age, while SES exerted only minimal positive effects on shifting and updating. We concluded that the three separable EF domains, found in adults and adolescents of other ages from different populations, can already be detected from the beginning of adolescence when culturally and psychometrically appropriate EF tasks are used. Additionally, these abilities continue to improve with age and are little affected by SES, suggesting that the unity and diversity framework is useful to study the cross-country generality of EF development.

Development of cognitive control during adolescence: The integrative effects of family socioeconomic status and parenting behaviors

Cognitive control is of great interest to researchers and practitioners. The concurrent association between family socioeconomic status (SES) and adolescent cognitive control is well-documented. However, little is known about whether and how SES relates to individual differences in the development of adolescent cognitive control. The current four-year longitudinal investigation (N = 167, 13-14 years at Wave 1) used multi-source interference task performance (reaction time in interference correct trials minus neutral correct trials) and corresponding neural activities (blood oxygen level dependent contrast of interference versus neutral conditions) as measures of cognitive control. SES and parenting behaviors (warmth, monitoring) were measured through surveys. We examined direct and indirect effects of earlier SES on the development of cognitive control via parenting behaviors; the moderating effect of parenting also was explored. Results of latent growth modeling (LGM) revealed significant interactive effects between SES and parenting predicting behavioral and neural measures of cognitive control. Lower family SES was associated with poorer cognitive performance when coupled with low parental warmth. In contrast, higher family SES was associated with greater improvement in performance, as well as a higher intercept and steeper decrease in frontoparietal activation over time, when coupled with high parental monitoring. These findings extend prior cross-sectional evidence to show the moderating effect of the parenting environment on the potential effects of SES on developmental changes in adolescent cognitive control.

Family Socioeconomic Status and Attention Deficit/Hyperactivity Disorder in Preschool Children: The Mediating Role of Executive Function

This study aimed to explore the relationship between family socioeconomic status (SES) and attention deficit/hyperactivity disorder (ADHD) symptoms in preschool children and the mediating role of executive function (EF). A total of 361 parents of preschool children were surveyed using the self-reported Family Situation Questionnaire, the Child Executive Functioning Inventory, and the Child Strengths and Difficulties Questionnaire. The results revealed that (1) there were significant pairwise correlations between SES, EF and its dimensions, and ADHD, except for a non-significant correlation between SES and regulation ability; (2) after controlling for preschool children's age and sex, SES directly predicted preschoolers' ADHD and EF partially mediated the association between SES and ADHD; and (3) among the EF dimensions, working memory and inhibitory ability significantly mediated the association between SES and ADHD, whereas the mediating effect of regulatory ability was not significant. These results suggest that SES can affect the ADHD of preschoolers both directly and through EF, especially through working memory and inhibitory ability. This supports the family stress model and family investment model of the relationship between SES and the development of children to some extent, and provides a reference for the early prevention of ADHD in children with low SES.

The Influence of Socioeconomic Status (SES) and Processing Speed on the Psychological Adjustment and Wellbeing of Pediatric Brain Tumor Survivors

Simple Summary

Processing speed (PS) is one of the most impaired functions in pediatric brain tumor survivors (PBTSs) and it has been linked to difficulties in their psychological functioning, together with other non-insult-related risk factors, such as socio-economic status (SES). Given the psychological adjustment difficulties observed in PBTS, the aim of the current study was to explore the relationship between SES and psychological functioning, measured with the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire, and considering the contribution of PS as a mediator. The results demonstrated that the influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the SES–internalizing problems relationship but not on the SES–externalizing problems relationship. These findings suggest that PS may be a rehabilitation target to prevent psychological distress and should be addressed, especially for PBTSs who live in a disadvantaged situation.

Abstract

(1) Background: The relationship between processing speed (PS) and psychological adjustment in the healthy population is well established, as is that between low socio-economic status (SES) and psychological distress. While PS is one of the most impaired functions in pediatric brain tumor survivors (PBTSs), previous research has demonstrated that low SES may be a predictor of increased psychosocial risk in PBTSs. Given the psychological adjustment difficulties observed in PBTS, in the current study we aimed to explore the relationship between SES and psychological functioning, considering the contribution of PS as a mediator. (2) Methods: demographic and clinical data of 80 children (age range: 4–17 y.o.) were retrospectively collected. Psychological measures were the parent-compiled versions of the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis models were performed on psychological measures with and without the inclusion of covariates. (3) Results: The influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the relationship between SES and internalizing problems but not on the relationship between SES and externalizing problems. (4) Conclusions: The results suggest that PS may be a rehabilitation target for the prevention of psychological distress and should be addressed especially for PBTSs who live in a disadvantaged situation.

Family Socioeconomic Status and Internalizing Problem Behavior Among Chinese Adolescents: The Chain Mediation Effect of Academic Performance and Peer Conflict

This study aims to provide a new perspective on the relationship between family socioeconomic status (SES) and internalizing problem behavior (IPB) among adolescents. Many studies have focused on the relationship between family SES and IPB among adolescents; however, research on the underlying mechanism is still insufficient, and peer conflict has been ignored as a crucial social relationship factor for adolescents. This study identifies two new mediating variables and a chain mediating mechanism model between them. Using national longitudinal data from 2,467 adolescents aged 10–15 published in the China Family Panel Studies of wave 2018, this study found the following: (1) higher family SES can significantly reduce peer conflict and IPB among adolescents; (2) adolescents with better academic performance were less likely to be involved in peer conflict; (3) peer conflict mediated 30.41% of the relationship between family SES and adolescent’s IPB; and (4) there was a chain mediating mechanism, and the mediating effect of peer conflict was much stronger than the mediating effect of both academic performance and the chain mediation pathways. This is the first study to develop a chain mediation model to examine the roles of academic achievement and peer conflict in the relationship between family SES and IPB. These findings are significant in that they highlight the importance of providing adolescents with proper emotional de-escalation and peer conflict resolution strategies, contributing to the management of adolescent mental health in urban governance and rural development.

Thriving despite Parental Physical Abuse in Adolescence: A Two-Wave Latent Transition Analysis on Hedonic and Eudaimonic Violence-Resilience Outcome Indicators

Internationally, about 25% of all children experience physical abuse by their parents. Despite the numerous odds against them, about 30% of adolescents who have experienced even the most serious forms of physical abuse by their parents escape the vicious family violence cycle. In this study, we analyzed longitudinally the data from a sample of N = 1767 seventh-grade high school students in Switzerland on physical abuse by their parents. We did this by conducting an online questionnaire twice within the school year. We found that in our sample, about 30% of the participating adolescents’ parents had physically abused them. We considered violence resilience a multi-systemic construct that included the absence of psychopathology on one hand and both forms of well-being (psychological and subjective) on the other. Our latent construct included both feeling good (hedonic indicators, such as high levels of self-esteem and low levels of depression/anxiety and dissociation) and doing well (eudaimonic indicators, such as high levels of self-determination and self-efficacy as well as low levels of aggression toward peers). By applying a person-oriented analytical approach via latent transition analysis with a sub-sample of students who experienced physical abuse (n_w2 = 523), we identified and compared longitudinally four distinct violence-resilience patterns and their respective trajectories. By applying to the field of resilience, one of the most compelling insights of well-being research (Deci & Ryan, 2001), we identified violence resilience as a complex, multidimensional latent construct that concerns hedonic and eudaimonic well-being and is not solely based on terms of psychopathology.