Is executive dysfunction a risk marker or consequence of psychopathology? A test of executive function as a prospective predictor and outcome of general psychopathology in the adolescent brain cognitive development study®

Quadratic associations between cardiovascular stress reactivity and development of cool and hot executive functions in adolescents

Stress affects executive functions and exploring the association between stress-induced physiological reactivity and executive functions could highlight the potential mechanism of the stress-cognitive function link. Our study examined the linear and nonlinear associations between cardiovascular stress reactivity and cool and hot executive functions among adolescents. In November 2021 (T1), 273 Chinese adolescents between 11 and 14 (Mage = 12.93, SDage = 0.79) underwent a speech task during which their cardiovascular data were recorded, and they completed a Flanker task and an Emotional Stroop task. In May 2023 (T2), 253 adolescents again completed the Flanker and Emotional Stroop tasks. Cool and hot executive functions were assessed using the intra-individual reaction time variability of the Flanker task and Emotional Stroop task, respectively. Results showed that cardiovascular stress reactivity was positively linearly associated with cool executive functions at T1 and quadratically (inverted U-shaped) associated with cool executive functions at T1 and hot executive functions at T1 and T2. These findings suggest that compared to very high and very low cardiovascular reactivity, moderate to high cardiovascular reactivity to a structured social challenge is associated with better cool and hot executive functions.

Transfer Learning of Deep Neural Networks Pretrained using the ABCD Dataset for General Psychopathology Prediction in Korean Adolescents

BACKGROUND

This study examines whether a deep neural network (DNN), trained to predict the general psychopathology factor (p-factor) using functional magnetic resonance imaging (fMRI) data from adolescents in the Adolescent Brain Cognitive Development (ABCD) study, generalizes to Korean adolescents.

METHOD

We trained a scanner-generalization neural network (SGNN) to predict p-factor scores from resting-state functional connectivity (RSFC) data of 6,905 ABCD adolescents, controlling for MRI scanner-related confounds. We then transferred the pretrained SGNN to a DNN to predict p-factor scores for 125 adolescents, including healthy individuals and those with major depressive disorder, using data from Seoul National University Hospital (SNUH). We compared the transferred DNN's performance with that of kernel ridge regression (KRR) and a baseline DNN.

RESULTS

The transferred DNN outperformed KRR (0.17 ± 0.16; 0.60 ± 0.07) and the baseline DNN (0.17 ± 0.16; 0.69 ± 0.11), achieving a higher Pearson's correlation coefficient (0.29 ± 0.18) and lower mean absolute error (0.59 ± 0.09; p < 0.005). We identified the default mode network (DMN) and visual network (VIS) as crucial functional networks (FNs) for predicting p-factors across both datasets. The dorsal attention network was specific to ABCD, while the cingulo-opercular and ventral attention networks were specific to SNUH.

CONCLUSION

The transferred SGNN successfully generalized to Korean adolescents. Altered RSFC in the DMN and VIS may serve as promising biomarkers for p-factor prediction across diverse populations, addressing heterogeneity in demographics, diagnoses, and MRI scanner characteristics.

Longitudinal Relationship Between Parental Psychological Flexibility and Peer Victimization in Children: The Mediating Role of Executive Function and Social Anxiety

Prior research shows that parental psychological flexibility can benefit children's social adjustment, but its role in mitigating peer victimization remains unclear. This study addressed this gap by examining the potential mediating roles of executive function and social anxiety in the longitudinal relationship between parental psychological flexibility and peer victimization. The sample comprised 511 primary school students (grades 4-6; 46.58% girls; Mage = 9.34, SD = 1.10) and their parents, followed three waves across one year. Results showed that parental psychological flexibility was negatively correlated with low executive function, social anxiety, and peer victimization. Structural equation modeling revealed that parental psychological flexibility predicted lower peer victimization both directly and indirectly through two distinct pathways-social anxiety alone and a chained mediation link from executive function to social anxiety. These findings underscore the importance and key explanatory mechanisms of parental psychological flexibility in mitigating the risk of peer victimization among children and early adolescence, offering valuable insights for the development of prevention and intervention strategies.

Executive functions and ADHD symptoms predict educational functioning in children with ADHD: A two-year longitudinal study

The aim of this two-year longitudinal study was to investigate whether deficits in executive functions (EF) predict impaired everyday functioning after two years in children and adolescents with ADHD. A sample of 135 participants with and without ADHD were assessed with neuropsychological tests of EF and parent ratings of everyday functioning with the Child Behavior Checklist at baseline (Mage = 11.6, SD = 2.0), and after two years (Mage = 13.6, SD = 2.1). Results showed that ADHD symptoms and impaired EF at baseline predicted lower educational functioning when controlling for general cognitive ability (i.e. "IQ") at two-year follow-up. Furthermore, the results indicated that increased ADHD symptoms predicted problems both with social functioning and functioning in leisure activities (i.e. sport/hobbies/chores/jobs), whereas higher IQ predicted better functioning in leisure activities. The current study primarily highlights the importance of detecting and treating ADHD symptoms in order to prevent reduced functional outcomes, and that EF tests may contribute to identify children in need of educational interventions targeting EF deficits.

Beyond Cumulative Scores: Distinct Patterns of Adverse Childhood Experiences and Their Differential Impact on Emotion, Borderline Personality Traits, and Executive Function

Adverse childhood experiences (ACEs) are associated with long-lasting and multifaceted consequences for mental health. Despite established dose-response effects of ACEs on mental health, the specificity of ACE pattern effects remains understudied, especially on executive function. This study aims to explore how specific patterns of ACEs, beyond just cumulative scores, differentially impact emotional symptoms, personality and cognitive function. This study recruited 2515 college students from several universities in northern China. Demographic characteristics, depression, anxiety, borderline personality traits, and executive function (Wisconsin Card Sort Test) were assessed. Latent class analysis was used to identify patterns of ACEs. Data were analysed using χ2-test, ANCOVA, and multivariate linear regression methods. Pattern-oriented and cumulative-oriented approaches were compared to predict the effects of ACEs. Three distinct patterns of ACEs were identified: low adversity (LA), multiple adversity (MA), and family environment adversity (FA). FA with the highest number of ACEs was uniquely linked to executive function impairments, while both MA and cumulative ACEs significantly predicted higher anxiety, depression, and borderline personality traits. The pattern-oriented method was more sensitive to capturing the diverse outcomes of executive function impairment than cumulative scores. Our findings highlight the importance of moving beyond cumulative scores and considering specific ACEs patterns to understand their differential impact on mental health. Identifying FA as a distinct pattern with specific consequences for executive function offers valuable insights into developing targeted prevention strategies tailored to specific risk profiles.

Longitudinal analysis of the ABCD® study

The Adolescent Brain Cognitive Development® (ABCD) Study provides a unique opportunity to investigate developmental processes in a large, diverse cohort of youths, aged approximately 9-10 at baseline and assessed annually for 10 years. Given the size and complexity of the ABCD Study, researchers analyzing its data will encounter a myriad of methodological and analytical considerations. This review provides an examination of key concepts and techniques related to longitudinal analyses of the ABCD Study data, including: (1) characterization of the factors associated with variation in developmental trajectories; (2) assessment of how level and timing of exposures may impact subsequent development; (3) quantification of how variation in developmental domains may be associated with outcomes, including mediation models and reciprocal relationships. We emphasize the importance of selecting appropriate statistical models to address these research questions. By presenting the advantages and potential challenges of longitudinal analyses in the ABCD Study, this review seeks to equip researchers with foundational knowledge and tools to make informed decisions as they navigate and effectively analyze and interpret the multi-dimensional longitudinal data currently available.

Predicting Post-School Outcomes in Autistic Young Adults One Year after High School Graduation

The aim of the present longitudinal study was to identify malleable factors during the last year of high school that predicted post-school outcomes in autistic youth one year after high school graduation. We then explored whether depressive symptoms in high school mediated the associations between other malleable factors and post-school outcomes. Thirty-two autistic youth and a parent completed surveys during the youth's final year of high school (T1) and one-year post-high school graduation (T2). Malleable factors measured at T1 included social communication skills, executive functions, responsibility for daily tasks, and depressive symptoms. The T2 young adult outcome measure included both objective and subjective indicators of productivity, social well-being, and autonomy in living situation. All malleable factors except social communication skills were significantly correlated with young adult outcomes. T1 executive functions, responsibility for daily tasks, and depressive symptoms jointly predicted 40.2% of the variance in young adult outcomes. Only depressive symptoms explained a significant amount of unique variance in young adult outcomes. In addition, depressive symptoms mediated the predictive association between executive functioning and young adult outcomes. The findings suggest that depressive symptoms may be a key intervention target for autistic high school students. Adapting cognitive behavioral approaches to comprehensively address multiple transdiagnostic factors such as executive functions, responsibility for daily tasks, and mental health may be a promising avenue to promote positive post-school outcomes in this population.

Longitudinal Predictors of Adaptive Functioning in Emerging Adults with and without Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) display heterogeneity in adaptive functioning, underscoring the need to identify predictors to inform clinical and scientific interventions. We investigated the longitudinal associations between an autism diagnosis, co-occurring psychopathology symptoms, executive functions (EF) and subsequent adaptive functioning in individuals with and without ASD (IQ > 70). Sixty-six individuals (26 with ASD, 40 without ASD) were assessed at baseline (mean age = 11.8 years, SD = 2.1) and at 10-year follow-up (mean age 21.4, SD = 2.3). The diagnostic evaluation comprised a comprehensive assessment of autism symptoms and emotional and cognitive functioning. Co-occurring psychopathology symptoms were assessed with two measures: self-reported depressive symptoms with the Short Mood and Feelings Questionnaire and parent-reported total problems with the Child Behavior Checklist 6-18. Participants completed neuropsychological tests to evaluate EF. We investigated adaptive functioning by using the Weiss Functional Impairment Rating Scale (WFIRS) which is a self-report measure of impairment in the following domains: family, work, school, life skills, self-concept, social and risk-taking. Among the emerging adults previously diagnosed with ASD, 46% reported living independently, 75% had at least one friend, and 71% were employed or in education. Individuals with ASD reported significantly lower adaptive functioning compared to individuals without ASD (WFIRS Total, Hedges' g = 0.92). Greater EF difficulties in childhood/adolescence predicted lower adaptive functioning in emerging adulthood, surpassing the influence of autism diagnosis and co-occurring symptoms. The findings highlight the influential role of EF, implying that interventions targeting EF difficulties could improve long-term outcomes for individuals with ASD.

The relationship between cognitive and affective control and symptoms of depression and anxiety across the lifespan: A 3-wave longitudinal study

INTRODUCTION

The association between cognitive functioning and mental health symptoms across the lifespan remains poorly understood. Understanding the directionality of the association between mental health and cognition is important as most gold-standard psychological therapies, such as cognitive-behaviour therapy, are cognitively demanding. Here, we examined the directionality of the association between cognitive and affective control with symptoms of depression and anxiety across the lifespan.

METHODS

1002 participants (87.2 % female, age range: 11-89 years) completed self-report measures of depressive and anxiety symptoms and an affective backward digit span task thrice at 3-month intervals. Cross-lagged panel models (CLPMs) were used to model the longitudinal relationships between affective and cognitive control with depressive and anxiety symptoms. Multiple-group CLPMs were applied to test the model invariance between adolescents and adults.

RESULTS

The results supported a unidirectional relationship, where symptoms of depression and anxiety predicted impaired affective control across time points, over and above cognitive control. There was no evidence for affective or cognitive control capacity predicting emotional disorder symptomatology. In addition, multiple-group analysis revealed that depressive symptoms also predicted impaired cognitive control among adolescents only. There were no age-related differences in the associations between cognitive and affective control with anxiety symptoms.

CONCLUSIONS

Our findings support depression and anxiety as antecedents, but not consequences, of impaired affective control. This suggests that timely management of emotional disorders, in particular for adolescents, is essential to prevent deterioration in cognitive functioning. The results further signal that practitioners should consider impaired affective control capacity in therapeutic contexts.

The Memory and Affective Flexibility Task: a new behavioral tool to assess neurocognitive processes implicated in emotion-related impulsivity and internalizing symptoms

Background

Cognitive rigidity and working memory impairment are established features of internalizing syndromes. Growing evidence suggests that deficits in affective control -cognitive control in the context of emotion - may underpin elevated emotion-related impulsivity in various psychiatric disorders.

Objective

This study examines two components of affective control (affective flexibility and emotional working memory) as potential neurocognitive processes linking emotion-related impulsivity to internalizing psychopathology.

Method

Undergraduate participants (analysis n = 120) completed the Memory and Affective Flexibility Task (MAFT), a novel behavioral assessment designed to assess hot cognition in affective flexibility and emotional working memory performance, alongside self-report measures of impulsivity and symptoms of internalizing disorders.

Results

Structural equation modeling suggested that less accurate working memory during neutral trials (cool cognition) was associated with more symptoms of internalizing psychopathology. However, effects of hot working memory and affective flexibility were not significantly related to emotion-related impulsivity or psychopathology scores.

Conclusions

Although findings provide no support for the validity of MAFT indices of hot cognition, these results replicate and extend work on the importance of cool working memory and emotion-related impulsivity as correlates of psychopathology.

Stress generation and subsequent repetitive negative thinking link poor executive functioning and depression

BACKGROUND AND OBJECTIVE

Poor executive functioning (EF) has been consistently linked to depression, but questions remain regarding mechanisms driving this association. The current study tested whether poor EF is linked to depression symptoms six weeks later via dependent stressors (model 1) and stressors perceived to be uncontrollable (model 2) at week two (W2) and repetitive negative thinking (RNT) at W4 during early COVID-19 in college students.

DESIGN

This was a longitudinal study with four timepoints spanning six weeks (April-June 2020).

METHODS

Participants (N = 154) completed online questionnaires measuring EF, dependent stress frequency, stress controllability appraisals, brooding rumination, worry, and depression.

RESULTS

Supporting model 1, poorer baseline EF predicted higher dependent stress frequency at W2; W2 dependent stress frequency, in turn, predicted increases in W4 RNT, which predicted increases in W6 depression. Model 2 was not supported: Baseline EF did not predict W2 perceived stress uncontrollability, which did not predict W4 RNT; however, W4 RNT predicted increases in W6 depression.

LIMITATIONS

The sample was relatively small and EF was measured using only self-reports.

CONCLUSIONS

Findings supported a model in which poor EF conferred risk for depression via dependent stress and subsequent RNT, highlighting these processes as risk mechanisms for depression.

Differential Mapping of Psychopathic Traits and General Psychopathology in a Large Young Adult Sample

Psychopathy is a personality disorder characterized by affective-interpersonal features and an impulsive-antisocial lifestyle. Psychopathy commonly co-occurs with other forms of psychopathology, but current understanding of how behavioral features of psychopathy co-occur with, or are distinct from, other mental health problems is limited. In this study, we analysed data from a large sample of young adults to study the relationship between different facets of psychopathic traits and general psychopathology ("p"). Data were collected between 2010 and 2016 and included 1,324 U.S. undergraduate students (Mage = 19.7 years; 57% female). Linear regression models revealed that the antisocial facet of psychopathy was distinct from p, while the lifestyle facet was correlated with p and externalizing behavior. Interpersonal and affective facets were correlated with internalizing behaviors. Collectively, these findings suggest that psychopathic traits of severe, premeditated antisocial behavior are distinct from general psychopathology, whereas impulsive and uninhibited lifestyle traits are a shared feature of psychopathology.

Psychiatric Symptoms, Cognition, and Symptom Severity in Children

Importance

Mental illnesses are a leading cause of disability globally, and functional disability is often in part caused by cognitive impairments across psychiatric disorders. However, studies have consistently reported seemingly opposite findings regarding the association between cognition and psychiatric symptoms.

Objective

To determine if the association between general cognition and mental health symptoms diverges at different symptom severities in children.

Design, Setting, and Participants

A total of 5175 children with complete data at 2 time points assessed 2 years apart (aged 9 to 11 years at the first assessment) from the ongoing Adolescent Brain and Cognitive Development (ABCD) study were evaluated for a general cognition factor and mental health symptoms from September 2016 to August 2020 at 21 sites across the US. Polynomial and generalized additive models afforded derivation of continuous associations between cognition and psychiatric symptoms across different ranges of symptom severity. Data were analyzed from December 2022 to April 2024.

Main Outcomes and Measures

Aggregate cognitive test scores (general cognition) were primarily evaluated in relation to total and subscale-specific symptoms reported from the Child Behavioral Checklist.

Results

The sample included 5175 children (2713 male [52.4%] and 2462 female [47.6%]; mean [SD] age, 10.9 [1.18] years). Previously reported mixed findings regarding the association between general cognition and symptoms may consist of several underlying, opposed associations that depend on the class and severity of symptoms. Linear models recovered differing associations between general cognition and mental health symptoms, depending on the range of symptom severities queried. Nonlinear models confirm that internalizing symptoms were significantly positively associated with cognition at low symptom burdens higher cognition = more symptoms) and significantly negatively associated with cognition at high symptom burdens.

Conclusions and Relevance

The association between mental health symptoms and general cognition in this study was nonlinear. Internalizing symptoms were both positively and negatively associated with general cognition at a significant level, depending on the range of symptom severities queried in the analysis sample. These results appear to reconcile mixed findings in prior studies, which implicitly assume that symptom severity tracks linearly with cognitive ability across the entire spectrum of mental health. As the association between cognition and symptoms may be opposite in low vs high symptom severity samples, these results reveal the necessity of clinical enrichment in studies of cognitive impairment.

Is Bedtime Procrastination Related to Multidimensional Sleep Health? Evidence from Samples of Different Educational Stages (Aged 10-25) in China

Bedtime procrastination has been associated with poorer sleep health, but evidence for this association is not sufficient. This cross-sectional study aimed to investigate the relationship between bedtime procrastination and multidimensional sleep health among students at different educational stages (from elementary school to college) in China, and further examine the moderating role of psychological distress in the procrastination-sleep health link. A total of 3539 students (Mage = 15.6 [2.9] years) completed an online survey between December 17th and 31st, 2023. Sociodemographics, bedtime procrastination, chronotype, psychological distress, and sleep health indicators were assessed. Binary logistic regression was used to estimate the association of bedtime procrastination with sleep health. The moderating effects of psychological distress were examined using the Process macro. The results showed that, from elementary school to college, scores of bedtime procrastination displayed a gradually increasing trend. Greater bedtime procrastination across different educational stages was related to poorer sleep health, including satisfaction, alertness, timing, efficiency, and regularity. However, there was no significant association between bedtime procrastination and sleep duration among elementary, middle, and high school students. Moreover, the moderating effect of psychological distress was observed among middle and high school students. The negative association between bedtime procrastination and total sleep health was attenuated in students with high psychological distress than in students with low psychological distress. The findings underscore the importance of early prevention and intervention strategies targeting bedtime procrastination.

Exploring the relationship between cognition and mental health in intersex participants in the UK Biobank study

Objective: The physical and mental health of intersex individuals is woefully understudied. A recent survey of intersex individuals found high rates of self-reported cognitive issues such as difficulty remembering and concentrating as well as high rates of mental health issues, such as depression and anxiety. Method: The current study explores whether cognitive differences are observed between 353 intersex and over 400,000 non-intersex people using a latent model of cognitive tasks derived from measures in the UK (United Kingdom) Biobank study. Results: There were no differences in intelligence between intersex people and non-intersex people. We found significantly lower executive function and processing speed in intersex individuals versus non-intersex individuals. However, after accounting for mental health differences via regression and case-control matching, there were no significant differences in executive function or processing speed between intersex individuals and non-intersex individuals. Conclusion: Mental health differences between intersex and non-intersex individuals may account for differences in cognitive factor scores.

Effects of virtual reality-based cognitive training for adolescents with depressive episodes: A pilot randomized controlled study

Cognitive impairment is a common symptom in depression, yet few intervention strategies target adolescents. This study investigated the effects of an attention and working memory cognitive training system based on virtual reality (VRCT) in adolescents with mild to moderate depressive episodes. Adolescents with depression were randomized into a VR training group (VRG, n = 47) or a waitlist control group (WT, n = 46). The VR training consisted of three 10-min tasks per session, conducted three sessions per week for 20 sessions over 7 weeks. Forty-four healthy adolescents participated as a comparison group for baseline cognitive assessment. Cognitive functions and depressive symptoms were assessed using the Das-Naglieri cognitive assessment system, driven by the Planning, Attention, Simultaneous, and Successive (PASS) processing theory, and the Hamilton Depression Rating Scale-24 at pre- and post-intervention. Baseline results indicated significantly lower cognitive scores in patients compared to healthy adolescents. Post-intervention, the VRG demonstrated significant improvements in all four cognitive scales (effect sizes 0.56 to 0.76) and a significant reduction in depressive symptoms compared to the WT. These findings suggest that VRCT holds potential for improving cognitive impairments and alleviating depressive symptoms in adolescents with depression. Further large-scale and follow-up studies are necessary to confirm long-term benefits.

Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task

Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (BChilhood Maltreatment = 27.52, 95% CIs [5.63, 49.41], BFamily Cohesion = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum

Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a "neurodevelopmental spectrum" ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.

Ambient Air Pollution Exposures and Child Executive Function: A US Multicohort Study

BACKGROUND

Executive function, which develops rapidly in childhood, enables problem-solving, focused attention, and planning. Animal models describe executive function decrements associated with ambient air pollution exposure, but epidemiologic studies are limited.

METHODS

We examined associations between early childhood air pollution exposure and school-aged executive function in 1235 children from three US pregnancy cohorts in the ECHO-PATHWAYS Consortium. We derived point-based residential exposures to ambient particulate matter ≤2.5 µm in aerodynamic diameter (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ) at ages 0-4 years from spatiotemporal models with a 2-week resolution. We assessed executive function across three domains, cognitive flexibility, working memory, and inhibitory control, using performance-based measures and calculated a composite score quantifying overall performance. We fitted linear regressions to assess air pollution and child executive function associations, adjusting for sociodemographic characteristics, maternal mental health, and health behaviors, and examined modification by child sex, maternal education, and neighborhood educational opportunity.

RESULTS

In the overall sample, we found hypothesized inverse associations in crude but not adjusted models. Modified associations between NO 2 exposure and working memory by neighborhood education opportunity were present ( Pinteraction = 0.05), with inverse associations more pronounced in the "high" and "very high" categories. Associations of interest did not differ by child sex or maternal education.

CONCLUSION

This work contributes to the evolving science regarding early-life environmental exposures and child development. There remains a need for continued exploration in future research endeavors, to elucidate the complex interplay between natural environment and social determinants influencing child neurodevelopment.

Executive Functions and Social-Emotional Problems in Toddlerhood: Nature, Persistence, and Direction of Associations

Social-emotional problems can emerge as early as the first years of life and are associated with a broad range of negative outcomes throughout the lifespan. There is convincing evidence that poorer executive functions (EF) are associated with more social-emotional problems during childhood and adolescence. However, the nature, persistence, and direction of the associations between different components of EF and social-emotional problems in toddlerhood remain unclear. Using two complementary statistical approaches, the present study aimed to (a) identify the role of EF components (inhibitory control, cognitive flexibility, and working memory) in the emergence and maintenance of social-emotional problems during toddlerhood, and (b) explore potential bidirectional associations between toddlers' EF and social-emotional problems. EF and social-emotional problems were assessed around 13, 19, and 28 months of age in a sample of 133 typically developing toddlers (51% boys) from mostly White middle-class families. At each time point, EF were measured with three behavioral tasks and social-emotional problems with a well-validated questionnaire completed by mothers. Multilevel growth models revealed a significant increase in social-emotional problems across toddlerhood and a negative association between inhibitory control and social-emotional problems that persisted across time. Controlling for stability across time, cross-lagged panel models indicated that child inhibitory control at 19 months negatively predicted child social-emotional problems at 28 months, but not the reverse. This study highlights that toddlerhood is a period of significant increase in social-emotional problems and provides evidence for the protective role of early inhibitory control skills against the development of social-emotional problems during toddlerhood.

Decoding Cognitive Control and Cognitive Flexibility as Concomitants for Experiential Avoidance in Social Anxiety

Background and objectives: Avoidance is regarded as a central hallmark of social anxiety. Experiential avoidance is perilous for social anxiety, specifically among university students (young adults). Additionally, cognitive control and cognitive flexibility are crucial components of executive functions for a fulfilling and healthy lifestyle. The current research is a modest attempt to understand how cognitive flexibility and cognitive control affect the emergence of experiential avoidance in social anxiety in young adults. Methods: Using an ex-post facto design, the Social Phobia Inventory was employed to screen university students with social anxiety based on which one hundred and ninety-five were identified. Thereafter, participants completed the standardized measures on experiential avoidance, cognitive control and cognitive flexibility. Results: A stepwise multiple regression analysis was computed wherein the cognitive control predicts an amount of 5% of variance towards experiential avoidance, whereas a 10% of additional variance has been contributed by cognitive flexibility. Interpretation and Conclusions: The statistical outcome indicated that cognitive control is positively associated with experiential avoidance which is a negative correlate to cognitive flexibility among university students. Both also emerged as significant predictors of experiential avoidance and add a cumulative variance of 15% towards the same. This conclusion supports the need for improved and efficient management techniques in counseling and clinical settings.

Domain-specific associations between psychopathology and neurocognitive functioning

BACKGROUND

Neurocognitive dysfunction is a transdiagnostic finding in psychopathology, but relationships among cognitive domains and general and specific psychopathology dimensions remain unclear. This study aimed to examine associations between cognition and psychopathology dimensions in a large youth cohort.

METHOD

The sample (N = 9350; age 8-21 years) was drawn from the Philadelphia Neurodevelopmental Cohort. Data from structured clinical interviews were modeled using bifactor confirmatory factor analysis (CFA), resulting in an overall psychopathology ('p') factor score and six orthogonal psychopathology dimensions: dysphoria/distress, obsessive-compulsive, behavioral/externalizing, attention-deficit/hyperactivity, phobias, and psychosis. Neurocognitive data were aggregated using correlated-traits CFA into five factors: executive functioning, memory, complex cognition, social cognition, and sensorimotor speed. We examined relationships among specific and general psychopathology dimensions and neurocognitive factors.

RESULTS

The final model showed both overall and specific associations between cognitive functioning and psychopathology, with acceptable fit (CFI = 0.91; TLI = 0.90; RMSEA = 0.024; SRMR = 0.054). Overall psychopathology and most psychopathology dimensions were negatively associated with neurocognitive functioning (phobias [p < 0.0005], behavioral/externalizing [p < 0.0005], attention-deficit/hyperactivity [p < 0.0005], psychosis [p < 0.0005 to p < 0.05]), except for dysphoria/distress and obsessive-compulsive symptoms, which were positively associated with complex cognition (p < 0.05 and p < 0.01, respectively).

CONCLUSION

By modeling a broad range of cognitive and psychopathology domains in a large, diverse sample of youth, we found aspects of neurocognitive functioning shared across clinical phenotypes, as well as domain-specific patterns. Findings support transdiagnostic examination of cognitive performance to parse variability in the link between neurocognitive functioning and clinical phenotypes.

Protocol for the Development and Initial Validation of the COG-IMPACT Tool: A Purpose-Built Unmet Needs Assessment for Cancer-Related Cognitive Impairment

(1) Background: A significant proportion of cancer survivors report experiencing a cognitive 'fog' that affects their ability to think coherently and quickly, and reason with clarity. This has been referred to as cancer-related cognitive impairment (CRCI). CRCI has extensive impacts on the daily lives of people living with or beyond cancer, including occupational, social, and psychological functioning. Oncology health professionals report feeling under-resourced to effectively assess the needs of an individual with CRCI and then provide optimal care and referral. (2) Methods: The objective of this project is to develop and provide an initial validation of the first purpose-built unmet needs assessment for CRCI: the Unmet Needs Assessment of Cancer-Related Cognitive Impairment Impact (COG-IMPACT). We will use a multiple-stage, co-design, mixed-methods approach to develop and provide an initial validation of the COG-IMPACT. (3) Results: The primary anticipated result of this research is the production of the COG-IMPACT, the first purpose-built unmet needs assessment for CRCI. The assessment could be used by health professionals to understand the unmet needs and facilitate optimal care and referral for cancer survivors, by survivors to elucidate their supportive needs and advocate for their care, and by researchers to examine the correlates of unmet needs relating to CRCI, as well as how best to support people with CRCI.

Cancer-related cognitive impairment as a key contributor to psychopathology in cancer survivors: implications for prevention, treatment and supportive care

A significant proportion of cancer survivors will experience some form of mental health compromise across domains including mood, anxiety, psychosis, eating disorders, and substance use. This psychopathology within cancer survivors is related to a range of negative outcomes and can also have a substantial negative impact on quality of life. Along with psychopathology, cognitive impairments are also commonly experienced, resulting in deficits in memory, reasoning, decision-making, speed of processing, and concentration, collectively referred to as cancer-related cognitive impairment (CRCI). Within the non-oncology literature, cognitive deficits are consistently demonstrated to be a key transdiagnostic aetiological feature of psychopathology, functionally contributing to the development and perpetuation of symptoms. Whilst there is an acknowledgement of the role mental health concerns might play in the development of and perception of CRCI, there has been limited acknowledgement and research exploring the potential for CRCI to functionally contribute toward the development of transdiagnostic psychopathology in cancer survivors beyond simply psychosocial distress. Given the theoretical and empirical evidence suggesting cognitive deficits to be an aetiological factor in psychopathology, we provide a rationale for the potential for CRCI to be a factor in the development and perpetuation of transdiagnostic psychopathology in cancer survivors. This potential functional association has significant implications for risk identification, prevention, treatment, and supportive cancer care approaches regarding psychopathology in cancer survivorship. We conclude by providing directions for future research in this area.

Prenatal exposure to polycyclic aromatic hydrocarbons and executive functions at school age: Results from a combined cohort study

BACKGROUND

Executive functions develop rapidly in childhood, enabling problem-solving, focused attention, and planning. Exposures to environmental toxicants in pregnancy may impair healthy executive function development in children. There is increasing concern regarding polycyclic aromatic hydrocarbons (PAHs) given their ability to transfer across the placenta and the fetal blood-brain barrier, yet evidence from epidemiological studies is limited.

METHODS

We examined associations between prenatal PAH exposure and executive functions in 814 children of non-smoking mothers from two U.S. cohorts in the ECHO-PATHWAYS Consortium. Seven mono-hydroxylated PAH metabolites were measured in mid-pregnancy urine and analyzed individually and as mixtures. Three executive function domains were measured at age 8-9: cognitive flexibility, working memory, and inhibitory control. A composite score quantifying overall performance was further calculated. We fitted linear regressions adjusted for socio-demographics, maternal health behaviors, and psychological measures, and examined modification by child sex and stressful life events in pregnancy. Bayesian kernel machine regression was performed to estimate the interactive and overall effects of the PAH mixture.

RESULTS

The results from primary analysis of linear regressions were generally null, and no modification by child sex or maternal stress was indicated. Mixture analyses suggested several pairwise interactions between individual PAH metabolites in varied directions on working memory, particularly interactions between 2/3/9-FLUO and other PAH metabolites, but no overall or individual effects were evident.

CONCLUSION

We conducted a novel exploration of PAH-executive functions association in a large, combined sample from two cohorts. Although findings were predominantly null, the study carries important implications for future research and contributes to evolving science regarding developmental origins of diseases.

Can neurocognitive performance account for dimensional paranoid ideation?

OBJECTIVE

Paranoid ideation underlies numerous psychological disorders and has debilitating effects on daily life. Deficits in neurocognition are highlighted as a contributing factor to paranoid-related disorders, but the impact on the symptom-level experience of paranoid ideation is unclear. This study aimed to employ a dimensional approach to understand the association between neurocognition and the severity and presence of paranoid ideation.

METHODS

400 participants, representative of the general population of the USA, completed an online questionnaire consisting of the Brief Symptom Inventory-53, and demographic and clinical questions. The participants then completed four computerised neurocognitive tasks measuring working memory, shifting, inhibition, and speed of processing.

RESULTS

Speed of processing accounted for unique variance in the severity of paranoid ideation with a small effect size, after controlling for covariates. Working memory, shifting, and inhibition could not uniquely or collectively, account for paranoid ideation. Neurocognitive performance could not distinguish between individuals with and without paranoid ideation experiences.

CONCLUSIONS

This research supports the body of literature that speed of information processing may be a key feature of paranoid ideation. Future research should employ non-linear dynamic methods to better understand the potential interactions between neurocognitive components and how this may relate to paranoid ideation.

Brain Functional Connectome Defines a Transdiagnostic Dimension Shared by Cognitive Function and Psychopathology in Preadolescents

BACKGROUND

Cognitive function and general psychopathology are two important classes of human behavior dimensions that are individually related to mental disorders across diagnostic categories. However, whether these two transdiagnostic dimensions are linked to common or distinct brain networks that convey resilience or risk for the development of psychiatric disorders remains unclear.

METHODS

The current study is a longitudinal investigation with 11,875 youths from the Adolescent Brain Cognitive Development (ABCD) Study at ages 9 to 10 years at the onset of the study. A machine learning approach based on canonical correlation analysis was used to identify latent dimensional associations of the resting-state functional connectome with multidomain behavioral assessments including cognitive functions and psychopathological measures. For the latent resting-state functional connectivity factor showing a robust behavioral association, its ability to predict psychiatric disorders was assessed using 2-year follow-up data, and its genetic association was evaluated using twin data from the same cohort.

RESULTS

A latent functional connectome pattern was identified that showed a strong and generalizable association with the multidomain behavioral assessments (5-fold cross-validation: ρ = 0.68-0.73 for the training set [n = 5096]; ρ = 0.56-0.58 for the test set [n = 1476]). This functional connectome pattern was highly heritable (h2 = 74.42%, 95% CI: 56.76%-85.42%), exhibited a dose-response relationship with the cumulative number of psychiatric disorders assessed concurrently and at 2 years post-magnetic resonance imaging scan, and predicted the transition of diagnosis across disorders over the 2-year follow-up period.

CONCLUSIONS

These findings provide preliminary evidence for a transdiagnostic connectome-based measure that underlies individual differences in the development of psychiatric disorders during early adolescence.

Executive functioning in child victims of sexual abuse: A multi-informant comparative study

BACKGROUND

Research examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015).

OBJECTIVE

Using multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex.

METHODS

The sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning.

RESULTS

In comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls.

CONCLUSION

This study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.

Slow-wave brain connectivity predicts executive functioning and group belonging in socially vulnerable individuals

Important efforts have been made to describe the neural and cognitive features of healthy and clinical populations. However, the neural and cognitive features of socially vulnerable individuals remain largely unexplored, despite their proneness to developing neurocognitive disorders. Socially vulnerable individuals can be characterised as socially deprived, having a low socioeconomic status, suffering from chronic social stress, and exhibiting poor social adaptation. While it is known that such individuals are likely to perform worse than their peers on executive function tasks, studies on healthy but socially vulnerable groups are lacking. In the current study, we explore whether neural power and connectivity signatures can characterise executive function performance in healthy but socially vulnerable individuals, shedding light on the impairing effects that chronic stress and social disadvantages have on cognition. We measured resting-state electroencephalography and executive functioning in 38 socially vulnerable participants and 38 matched control participants. Our findings indicate that while neural power was uninformative, lower delta and theta phase synchrony are associated with worse executive function performance in all participants, whereas delta phase synchrony is higher in the socially vulnerable group compared to the control group. Finally, we found that delta phase synchrony and years of schooling are the best predictors for belonging to the socially vulnerable group. Overall, these findings suggest that exposure to chronic stress due to socioeconomic factors and a lack of education are associated with changes in slow-wave neural connectivity and executive functioning.

Randomized Feasibility Pilot of an Executive Functioning Intervention Adapted for Children's Mental Health Settings

The critical role of executive functioning in autism as well as the co-occurring mental health challenges common among autistic youth support to the immense value of interventions targeting executive functioning for enhancing mental health services for autistic children. The goal of the present study was to conduct a randomized feasibility trial of Unstuck and On Target, an executive functioning intervention, adapted for delivery in children's community mental health setting. Mental health therapists (n = 26) enrolled with participating autistic clients (n = 32) were randomized to receive training in and deliver the adapted Unstuck intervention or to deliver care as usual. We completed masked observational measures of Unstuck strategy use (fidelity) during recorded sessions of participating therapist-client dyads and collected measures of acceptability from participating clients and their caregivers. We also collected measures of pre-post changes in executive functioning and mental health symptoms. Therapists trained in Unstuck demonstrated significantly higher use of Unstuck strategies compared to usual care therapists. Caregivers and autistic clients perceive adapted Unstuck as highly acceptability and helpful. Autistic clients whose therapists were trained in adapted Unstuck demonstrated larger pre-post changes in executive functioning compared to usual care. Across all participating clients, changes in executive functioning were significantly related to changes in mental health symptoms. Finally, clients of therapists trained in adapted Unstuck demonstrated moderate improvements in overall mental health symptoms. The current study provides preliminary evidence of the feasibility and impact of Unstuck and On Target for children's community mental health settings.

Effortful Control Protects Against Familial Liability for ADHD: Longitudinal Results from the ABCD Study in the United States

Effortful control, the ability to regulate complex and goal-directed behavior, may protect individuals from developing mental health symptoms. This study tested the potential for child effortful control and executive functioning to buffer the effects of familial liability for attention deficit hyperactivity disorder (ADHD) problems across a one-year timeframe. Data from the prospectively-collected Adolescent Brain Cognitive Development (ABCD)® study were used to examine whether caregiver-rated child effortful control and executive functioning moderated the association between familial ADHD risk and later ADHD symptoms in a sample of children (N = 6,133; ages 9-10 years at baseline). Two independent variables were considered to compare the predictive powers of specific (family ADHD) and broad (family psychopathology) risk factors. Two additional moderating variables (surgency, negative affect) were tested to examine specificity of effortful control and executive functioning as moderators. All variables of interest were measured on a continuum and via caregiver report. At high levels of effortful control and executive functioning, there was no association between familial liability for ADHD or broad psychopathology and later child ADHD problems. The moderator effects were specific to effortful control and executive functioning domains. Etiological models of heritable psychiatric disorders, such as ADHD, should consider the risk and protective contributions of individual traits, such as effortful control and executive functioning. Clinical prevention and intervention efforts may target self-regulation skills in children to buffer against familial liability for ADHD problems.

In-vivo whole-cortex marker of excitation-inhibition ratio indexes cortical maturation and cognitive ability in youth

A balanced excitation-inhibition ratio (E/I ratio) is critical for healthy brain function. Normative development of cortex-wide E/I ratio remains unknown. Here we non-invasively estimate a putative marker of whole-cortex E/I ratio by fitting a large-scale biophysically-plausible circuit model to resting-state functional MRI (fMRI) data. We first confirm that our model generates realistic brain dynamics in the Human Connectome Project. Next, we show that the estimated E/I ratio marker is sensitive to the GABA-agonist benzodiazepine alprazolam during fMRI. Alprazolam-induced E/I changes are spatially consistent with positron emission tomography measurement of benzodiazepine receptor density. We then investigate the relationship between the E/I ratio marker and neurodevelopment. We find that the E/I ratio marker declines heterogeneously across the cerebral cortex during youth, with the greatest reduction occurring in sensorimotor systems relative to association systems. Importantly, among children with the same chronological age, a lower E/I ratio marker (especially in association cortex) is linked to better cognitive performance. This result is replicated across North American (8.2 to 23.0 years old) and Asian (7.2 to 7.9 years old) cohorts, suggesting that a more mature E/I ratio indexes improved cognition during normative development. Overall, our findings open the door to studying how disrupted E/I trajectories may lead to cognitive dysfunction in psychopathology that emerges during youth.

Effects of Goal Management Training on self-efficacy, self-esteem, and quality of life for persons with schizophrenia spectrum disorders

Persons with schizophrenia often show executive dysfunction assessed with both subjective (self-report) and objective (neuropsychological tests) measures. In a recent randomized controlled trial (RCT), subjective executive functioning in everyday life was improved following Goal Management Training (GMT). The aim of the current study is to investigate the potential of GMT to improve secondary well-being outcomes from that RCT, including self-esteem, self-efficacy, and quality of life in persons with schizophrenia spectrum disorders. Since well-being is frequently lower in persons with schizophrenia compared to healthy individuals, further knowledge about well-being as an outcome after cognitive remediation may have implications for clinical treatment. Sixty-five participants were randomly assigned to GMT (n = 31) or a waiting list control condition (n = 34). Assessments were conducted at baseline (T1), immediately after the intervention (T2-5 weeks), and at six-month follow-up (T3). Measures included the Rosenberg Self-Esteem Scale, the Perceived Quality of Life Scale, and the General Self-Efficacy Scale. Results were analyzed using a linear mixed model analysis for repeated measures. There were no significant effects of GMT on self-esteem or quality of life. Only the GMT group showed a significant increase in self-efficacy that was most evident at six months follow-up, F(1, 34) = 10.71, p = 0.002, d = 0.71. Improved self-efficacy was found to correlate significantly with a reduction in perceived executive dysfunction in an exploratory post hoc analysis. Our findings demonstrate the potential of GMT in improving self-efficacy in schizophrenia Clinical trial registration:https://clinicaltrials.gov, NCT03048695.

The relationship between cognitive and affective control and adolescent mental health

Background

Cognitive control problems have been implicated in the etiology and maintenance of mental health problems, including depression, in adults. Studies in adolescents have been more equivocal, with some showing changes in cognitive control in adolescents with mental health problems, whereas others fail to show an association. This study examines whether adolescent mental health is associated with affective control, the application of cognitive control in affective contexts, which shows more protracted development than cognitive control.

Methods

The present study investigated the association of cognitive and affective control with depressive symptomatology and self-reported diagnostic history of mental health problems in adolescents. The study included 1929 participants (M age = 13.89) from the Future Proofing Study (N = 6,388, 11-16 years), who completed affective (incl., affective stimuli) and/or cognitive (incl., neutral stimuli) versions of a working memory (backward digit-span) and/or shifting (card-sorting) task at least once within 3 weeks of assessing mental health.

Results

Poorer working memory was associated with greater depressive symptomatology in adolescents (β = -0.06, p = .004), similarly across cognitive and affective control conditions (β = -0.02, p = .269). Adolescents with self-reported diagnostic history of mental health problems had significantly poorer shifting ability in affective compared to cognitive control conditions (b = 0.05, p = .010), whereas for adolescents with no self-reported diagnoses, shifting ability did not differ between conditions (b = -0.00, p = .649).

Conclusions

The present analyses suggest that working memory difficulties, in particular, may be associated with the experience of current depressed mood in adolescents. Problems with affective shifting may be implicated in a range of mental health problems in adolescents. Given the ubiquitous need for efficient cognitive functioning in daily life, enhancing cognitive and affective control in adolescents may be a promising means of improving functioning across a range of domains, including affective functioning, and by extension, adolescent mental health.

Physical activity intervention improves executive function and language development during early childhood: The active early learning cluster randomized controlled trial

This study aimed to determine the effects of the Active Early Learning (AEL) childcare center-based physical activity intervention on early childhood executive function and expressive vocabulary via a randomized controlled trial. Three-hundred-and-fourteen preschool children (134 girls) aged 3-5 years from 15 childcare centers were randomly assigned to the intervention (8 centers; n = 170 children) or control group (7 centers, n = 144 children) in May 2019. Participants were mostly Australian (85%) and from slightly higher areas of socio-economic status than the Australian average. There was an AEL intervention effect on inhibition (β = 0.5, p = .033, d = 0.29) and expressive vocabulary (β = 1.97, p = .001, d = 0.24). Integration of the AEL physical activity intervention into the daily childcare routine was effective in enhancing children's executive function and expressive language development.

Executive Functioning, Internalizing and Externalizing Symptoms: Understanding Developmental Dynamics Through Panel Network Approaches

Objective

Early adolescence is a transition period during which many mental health disorders emerge. The interplay between different internalizing and externalizing mental health problems in adolescence is poorly understood at the within-person level. Executive functioning (EF) in early adolescence has been shown to constitute a transdiagnostic risk factor, but the specificity of the associations between different domains of EF and mental health problems remains unclear.

Method

Network dynamics (ie, temporal effects) of different internalizing and externalizing symptoms were investigated leveraging data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal panel study of adolescents (>1,641 participants) assessed at ages 11, 13, and 15. Two novel methodological panel network approaches were used: cross-lagged panel network models and graphical vector autoregressive models. Hierarchical regression models were used to investigate prospective associations between different measures of EF and broadband transdiagnostic dimensions.

Results

Depressive problems predicted a range of other internalizing symptoms (ie, panic, somatic problems, separation anxiety, general anxiety, social phobia) over time, particularly during early adolescence. Important feedback loops with reciprocal associations between different anxiety symptoms were identified. Different facets of EF assessed at age 11, particularly sustained attention, showed weak but significant prospective associations with internalizing and externalizing symptoms at age 13.

Conclusion

The present findings emphasize the importance of targeting depressive problems in early adolescence to prevent a spiral of different internalizing symptoms from arising later on.

Neural Correlates of the p Factor in Adolescence: Cognitive Control With and Without Enhanced Positive Affective Demands

BACKGROUND

Recent research has aimed to characterize processes underlying general liability toward psychopathology, termed the p factor. Given previous research linking the p factor with difficulties in both executive functioning and affective regulation, the present study investigated nonaffective and positive affective inhibition in the context of a sustained attention/inhibition paradigm in adolescents exhibiting mild to severe psychopathology.

METHODS

Functional magnetic resonance imaging data were collected during an integrated reward conditioning and go/no-go task in 138 adolescents assigned female at birth. We modeled the p factor using hierarchical confirmatory factor analysis. Positive affective inhibition was measured by examining responses to no-go stimuli with a history of reward conditioning. We examined associations between p factor scores and neural function and behavioral performance.

RESULTS

Consistent with nonaffective executive function as a primary risk factor, p factor scores were associated with worse behavioral performance and hypoactivation in the left superior frontal gyrus and middle frontal gyrus during response initiation (go trials). The p factor scores were additionally associated with increased error-related signaling in the temporal cortex during incorrect no-go trials.

CONCLUSIONS

During adolescence, a period characterized by heightened risk for emergent psychopathology, we observed unique associations between p factor scores and neural and behavioral indices of response initiation, which relies primarily on sustained attention. These findings suggest that shared variation in mental disorder categories is characterized in part by sustained attention deficits. While we did not find evidence that the p factor was associated with inhibition in this study, this observation is consistent with our hypothesis that the p factor would be related to nonaffective control processes.

Executive control training for adolescents with ADHD: Study protocol for a randomised controlled trial

BACKGROUND

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental conditions diagnosed during childhood and adolescence. In addition to the commonly observed symptoms of inattention, hyperactivity, and impulsivity, individuals with ADHD often experience impairments in executive functions (EFs). Goal management training (GMT) is a cognitive remediation intervention targeting EFs, with empirical support from studies with adult populations, including ADHD. The objective of the upcoming trial is to assess the effectiveness of GMT for adolescents with ADHD.

METHODS

This pre-registered protocol outlines a multi-centre randomised controlled trial (RCT) comparing GMT to treatment as usual (TAU) to improve EFs. We aim to recruit 120 participants, aged 12 to 18 years, recently diagnosed with ADHD. Participants will be randomly allocated to the group-based GMT intervention in addition to TAU, or the TAU condition, through block randomisation with site stratification. GMT will be delivered in groups of four to six participants, with weekly two-hour sessions for seven weeks, complemented by separate parent and teacher sessions. TAU is standard community mental health treatment. The primary outcome measure will be parent-reported EF assessed with the Behaviour Rating Inventory of Executive Function 2 (BRIEF-2). Secondary outcomes will include ADHD symptom measures, social functioning, quality of life, and neuropsychological tests (attention span, inhibition, working memory, and visuo-motor speed). The outcome assessments will be conducted at baseline, 12 weeks, 12 months, and 24 months post-treatment.

CONCLUSION

The study findings will contribute to determine the effectiveness of a non-pharmacological ADHD treatment, including outcome trajectories up to 24 months post-treatment.

The general psychopathology factor (p) from adolescence to adulthood: Exploring the developmental trajectories of p using a multi-method approach

Considerable attention has been directed towards studying co-occurring psychopathology through the lens of a general factor (p-factor). However, the developmental trajectory and stability of the p-factor have yet to be fully understood. The present study examined the explanatory power of dynamic mutualism theory - an alternative framework that suggests the p-factor is a product of lower-level symptom interactions that strengthen throughout development. Data were drawn from a population-based sample of girls (N = 2450) who reported on the severity of internalizing and externalizing problems each year from age 14 to age 21. Predictions of dynamic mutualism were tested using three distinct complementary statistical approaches including: longitudinal bifactor models, random-intercept cross-lagged panel models (RI-CLPMs), and network models. Across methods, study results document preliminary support for mutualistic processes in the development of co-occurring psychopathology (that is captured in p). Findings emphasize the importance of exploring alternative frameworks and methods for better understanding the p-factor and its development.

Reduced volume of the left cerebellar lobule VIIb and its increased connectivity within the cerebellum predict more general psychopathology one year later via worse cognitive flexibility in children

Predicting the risk for general psychopathology (the p factor) requires the examination of multiple factors ranging from brain to cognitive skills. While an increasing number of findings have reported the roles of the cerebral cortex and executive functions, it is much less clear whether and how the cerebellum and cognitive flexibility (a core component of executive function) may be associated with the risk for general psychopathology. Based on the data from more than 400 children aged 6-12 in the Children School Functions and Brain Development (CBD) Project, this study examined whether the left cerebellar lobule VIIb and its connectivity within the cerebellum may prospectively predict the risk for general psychopathology one year later and whether cognitive flexibility may mediate such predictions in school-age children. The reduced gray matter volume in the left cerebellar lobule VIIb and the increased connectivity of this region to the left cerebellar lobule VI prospectively predicted the risk for general psychopathology and was partially mediated by worse cognitive flexibility. Deficits in cognitive flexibility may play an important role in linking cerebellar structure and function to the risk for general psychopathology.

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.

Associations between psychiatric comorbid disorders and executive dysfunctions in hypocretin-1 deficient pediatric narcolepsy type1

OBJECTIVE/BACKGROUND

Psychiatric symptoms and cognitive deficits add significantly to impairment in academic achievement and quality of life in patients with narcolepsy. The primary aim of this study was to evaluate the prevalence of psychiatric disorders and executive dysfunctions, secondly to explore the association between psychiatric comorbidity, executive dysfunctions, subjective and objective sleep measures, and severity of cerebrospinal fluid (CSF) hypocretin-1 deficiency in pediatric narcolepsy type 1 (PNT1).

PATIENTS/METHODS

Cross-sectional study of 59 consecutively included PNT1 patients (age: 6-20 years; 34:25 girls: boys; 54/59 H1N1 (Pandemrix®)-vaccinated). Core narcolepsy symptoms including subjective sleepiness, polysomnography and multiple sleep latency test results, CSF hypocretin-1 levels, psychiatric disorders (by semistructured diagnostic interview Kaufmann Schedule for Affective Disorders and Schizophrenia Present and Lifetime version (KSADS)), and executive dysfunction (by Behavior Rating of Executive Function (BRIEF)) were assessed.

RESULTS

52.5% of the patients had one or more psychiatric comorbid disorder, and 64.7% had executive dysfunction in a clinically relevant range, with no sex difference in prevalence, while older age was associated with poorer executive function (p=0.013). Having any psychiatric comorbid disorder was associated with poorer executive functions (p=0.001). CSF hypocretin-1 deficiency severity was significantly associated with presence of psychiatric comorbidity (p=0.022) and poorer executive functions (p=0.030), and poorer executive functions was associated with subjective sleepiness (p=0.009).

CONCLUSIONS

The high occurrence of, and association between, psychiatric comorbidity and executive dysfunction underlines the importance of close attention to both these comorbidities in clinical care of NT1.

Early executive control buffers risk for adolescent psychopathology during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on youth mental health, and there is a critical need for research examining individual factors that contribute to increased psychopathology during the pandemic. The current study explored whether executive control (EC) abilities in early childhood interact with COVID-related stress to attenuate risk for adolescent psychopathology during the first 6 months of the pandemic.

METHODS

Participants were 337 youth (49% female) living in a small midwestern city in the United States. Participants completed EC tasks when they were approximately 4.5 years old as part of a longitudinal study investigating cognitive development. At annual laboratory visits during adolescence and before the pandemic, participants (Mage  = 14.57) reported on mental health symptoms. In July and August of 2020, participants (Mage  = 16.57) reported on COVID-related stress and depression, anxiety, and trauma symptoms.

RESULTS

COVID-related stress was associated with increased internalizing problems after controlling for prepandemic symptom levels. Further, the impact of COVID-related stress on adolescent internalizing problems was moderated by preschool EC, with higher levels of EC buffering the effects of COVID-related stress on adolescent internalizing problems.

CONCLUSIONS

Findings highlight the importance of promoting EC early in development, as well as screening for EC deficits and implementing targeted intervention strategies across the lifespan to help reduce the impact of stress on adolescent internalizing problems.

Pathways to Psychopathology Among Autistic Adults

PURPOSE OF REVIEW

Autistic adults frequently require treatment of mental health problems. Increased rates of suicidality and diminished quality of life among autistic people may be partially attributable to psychiatric symptoms. Some risk factors for mental health problems in autistic people are likely the same as risk factors present in neurotypical individuals, but unique factors that are specific to neurodivergent individuals, and some even more specific to autistic people, may exist. Understanding pathways from autism to mental health problems could inform intervention efforts at the individual and societal levels.

RECENT FINDINGS

We review a growing body of research identifying risk processes across the affective, cognitive, and social domains. Consistent with the principle of equifinality, different processes appear to independently and jointly lead to heightened risk for the onset of mental health problems. Autistic adults frequently utilize mental healthcare services, and experience heightened risk for chronic impairment as a result of mental health problems. Understanding causal and developmental risk processes in autism should inform personalized treatment. We synthesize extant research on these processes and offer suggestions for addressing them therapeutically and societally.

Executive Functions and Public Health: A Narrative Review

Executive functions (EFs) skills are necessary for regulating the thoughts, emotions, and actions which are associated with many aspects of daily functioning. Executive dysfunction (EDFs) is present in a wide range of mental disorders. New study indicates that EFs may predict health behavior and make it easier to engage in a variety of healthy activities. In this narrative review, EFs and public health are briefly discussed. In general, 133 articles met the inclusion criteria (published 2018-2023) which were reviewed. EFs affect the mental and physical health. Besides individual problems, people with mental problems have heavy costs to society. Mental health cannot be considered separately from general health. Consequently, preventive and therapeutic approaches to mental health should be considered not only at the level of the whole society, but also at the global level.

Brain Structure Relations With Psychopathology Trajectories in the ABCD Study

OBJECTIVE

A general psychopathology (p) factor captures shared variation across mental disorders. Structural neural alterations have been associated with the p factor concurrently, but less is known about whether these alterations relate to within-person change in the p factor over time, especially during preadolescence, a period of neurodevelopmental changes.

METHOD

This study examined whether baseline brain structure was prospectively related to the trajectory of the p factor and specific forms of psychopathology over 2 years in 9,220 preadolescents (aged 9-10 at baseline) from the Adolescent Brain Cognitive Development Study (ABCD). Longitudinal multilevel models were conducted to determine whether baseline brain structure (volume, surface area, thickness) was associated with between-person differences and within-person change in the p factor (from a higher-order confirmatory factor model) and internalizing, externalizing, neurodevelopmental, somatization, and detachment factor scores (from a correlated factors model) over 3 study waves.

RESULTS

Smaller global volume and surface area, but not thickness, were associated with higher between-person levels of the p factor scores, which persisted over time. None of the brain structure measures were related to within-person change in the p factor scores. Lower baseline cortical thickness was associated with steeper decreases in internalizing psychopathology, which was driven by lower thickness within sensorimotor and temporal regions.

CONCLUSION

These novel results identify specific brain structure features that might contribute to transdiagnostic psychopathology development in preadolescence. Children with smaller total brain volume and surface area may be vulnerable to persistent general psychopathology during preadolescence. Cortical thinning reflective of pruning and myelination in sensorimotor and temporal brain regions specifically may protect against increases in internalizing, but not general psychopathology, during preadolescence.

Neurocognitive and self-reported psychosocial and behavioral functioning in siblings of individuals with neurodevelopmental conditions: a study using remote self-administered testing

OBJECTIVE

This study compared and explored the neurocognitive profiles of siblings of persons with and without neurodevelopmental conditions (NDCs) and associations between objective test performance and self-reported psychosocial functioning.

METHODS

Siblings of persons with and without NDCs (64 NDC and 64 control siblings; mean age 19.88 years, range 11-27 years, 73.44% female, 75.78% White Caucasian) completed self-report questionnaires and self-administered computerized neurocognitive tests of executive functioning (EF). Using Bayesian analyses, we examined cross-sectional associations between self-reported psychosocial functioning and cognitive test performance, and predictors of EF over 15 months.

RESULTS

NDC siblings had poorer working memory, inhibition, attention, and shifting compared to controls, as measured by experimental paradigms on the backward Corsi span, N-Back 2-back task, Stop Signal Task, Sustained Attention to Response Task, and the Wisconsin Card Sorting Test (effect size δ ranging 0.49 to 0.64). Bayesian cross-sectional networks revealed negative emotion reactivity and working memory difficulties were central to the NDC sibling network. Over 15 months, poorer EF (k low test scores) was predicted by negative emotion reactivity, sleep problems, and anxiety, over and above effects of age and subclinical autistic and ADHD traits. Siblings of autistic individuals and persons with fetal alcohol spectrum disorder had higher rates of neurocognitive and psychiatric difficulties than other NDCs and controls (Bayes factors >20).

CONCLUSIONS

Neurocognitive difficulties were associated with transdiagnostic vulnerability to poorer wellbeing in NDC siblings. These findings demonstrate the feasibility of remote online cognitive testing and highlight the importance of individualized prevention and intervention for NDC siblings.

Psychosocial and neurocognitive correlates of suicidal thoughts and behaviours amongst siblings of persons with and without neurodevelopmental conditions

OBJECTIVE

Siblings of individuals with neurodevelopmental conditions (NDCs) have greater incidence of neuropsychiatric diagnoses and neurocognitive difficulties compared to siblings of persons without NDCs. Despite suicidality being labelled a global health crisis (WHO, 2014) and NDC siblings experiencing risk factors implicated in suicidality, no previous studies examined suicidality amongst adolescent and young adult siblings of persons with NDCs. Our study aimed to bridge this gap.

METHOD

The present study used Bayesian analyses and risk classification models to examine individual and environmental risk factors associated with suicidal thoughts and behaviours amongst siblings of persons with and without NDCs (n = 267; 132 NDC, 135 control group, mean age 20.61, range 14-27, 76.40% female, 76.78% White Caucasian), as measured using self-report survey data and remote self-administered cognitive tests.

RESULTS

NDC siblings had higher rates of current nonsuicidal self-injury (NSSI; 18.94% versus 14.07%, δ = -0.32), suicidal ideation (25.76% versus 8.89%, δ = -0.40) and history of suicide attempts (18.18% versus 4.44%, δ = -0.43) compared to controls. Classification models using boosting and random forest demonstrated adequate performance: positive predictive value 0.86-0.91, negative predictive value 0.81-0.90, false negative rates 0.11-0.24. Cognitive inflexibility, alexithymia, inattention, bullying, depression, NSSI, and eating or psychotic disorder history had the highest relative importance in predicting lifetime suicidality. Poorer executive functioning (measured by the Wisconsin Card Sorting Task, Sustained Attention to Response Task, Stop Signal Task, and N-Back 2-back task) was strongly correlated with suicidality.

CONCLUSIONS

Screening for proximal and modifiable risk factors is critical to inform suicidal behaviour intervention and prevention programs for at-risk siblings.