The association of visuospatial working memory with dysthymic disorder in pre-pubertal children

Cognitive functioning in children and adolescents with depression: A systematic review and meta-analysis

Although cognitive dysfunction is associated with depression in adults, the link in children and adolescents is unclear. This systematic review and meta-analysis quantifies the association between depression and cognitive function in children and adolescents. Systematic searches were conducted in six databases: Child Development and Adolescent Studies, Ovid MEDLINE, Ovid Embase, Ovid APA PsycINFO, EBSCO CINAHL Plus, Scopus (last search: April 2023). Studies including measures of cognitive outcomes (memory, attention, executive function, processing speed, language) among children (≤18 years) with depression were included. The Joanna Briggs Institute Critical Appraisal Tools were used to determine study risk of bias. Random-effects meta-analyses of study outcomes were performed. Seventeen studies were included (15 were cross-sectional, 1 prospective, 1 randomized control trial). Participants (N = 13,567) were 10 to 17 years old (mean 13.8 ± 2.2 years; 60 % female). Compared with healthy controls, depressed participants had lower performance on tests of working memory (g = -0.40; 95 % CI: -0.67, -0.13), long-term memory (g = -0.48; 95 % CI: -0.72, -0.25), attention (g = -0.15; 95 % CI: -0.26, -0.04), executive function (g = -0.16; 95 % CI: -0.24, -0.08), and language (g = -0.23; 95 % CI: -0.36, -0.09). No performance differences were observed on tests of short-term memory or processing speed. Children and adolescents with depression demonstrated lower performance on tests of working and long-term memory, attention, executive function and language. These findings emphasize the importance of considering cognitive functioning among children with depression, and greater understanding of the effect of treatment on these outcomes. PROSPERO (CRD42022332064).

Distinct Neural Profiles of Frontoparietal Networks in Boys with ADHD and Boys with Persistent Depressive Disorder

Working memory deficits are common in attention-deficit/hyperactivity disorder (ADHD) and depression-two common neurodevelopmental disorders with overlapping cognitive profiles but distinct clinical presentation. Multivariate techniques have previously been utilized to understand working memory processes in functional brain networks in healthy adults but have not yet been applied to investigate how working memory processes within the same networks differ within typical and atypical developing populations. We used multivariate pattern analysis (MVPA) to identify whether brain networks discriminated between spatial versus verbal working memory processes in ADHD and Persistent Depressive Disorder (PDD). Thirty-six male clinical participants and 19 typically developing (TD) boys participated in a fMRI scan while completing a verbal and a spatial working memory task. Within a priori functional brain networks (frontoparietal, default mode, salience), the TD group demonstrated differential response patterns to verbal and spatial working memory. The PDD group showed weaker differentiation than TD, with lower classification accuracies observed in primarily the left frontoparietal network. The neural profiles of the ADHD and PDD differed specifically in the SN where the ADHD group's neural profile suggests significantly less specificity in neural representations of spatial and verbal working memory. We highlight within-group classification as an innovative tool for understanding the neural mechanisms of how cognitive processes may deviate in clinical disorders, an important intermediary step towards improving translational psychiatry.

Parent- and child-reported anxiety disorders differentiating major depressive disorder and dysthymic disorder in children and adolescents

OBJECTIVE

To date, specific parent- and child-defined anxiety disorders associated with dysthymic disorder (DD; DSM-5 persistent depressive disorder equivalent) with and without major depressive disorder (MDD) have not been investigated in children and adolescents.

METHOD

In a cross-sectional study, we compared point prevalence rates of parent- and child-reported anxiety disorders in DD alone (N = 154), MDD alone (N = 29), comorbid DD and MDD (N = 130) and anxiety disorders alone (N = 126) groups.

RESULTS

DD alone and MDD alone did not differ with respect to comorbid anxiety disorders from parent and child reports, while parent-reported panic disorder (PD) was significantly increased in the DD and MDD group compared to the other three groups as was child-reported post-traumatic stress disorder (PTSD) compared to the MDD alone and anxiety disorders alone groups. In contrast, specific phobia (SpPh) was significantly increased in the anxiety disorders alone group compared to the DD and MDD group.

CONCLUSION

The findings suggest that specific fear-related anxiety disorders, especially parent-reported PD and child-reported PTSD, may aid the early recognition of DD and MDD.

Irritability, Depressed Mood, Inattention and Spatial Working Memory in Children and Adolescents with Major Depressive Disorder With/Without Persistent Depressive Disorder

The specific relationships between sad/low mood, irritability, inattention and spatial working memory (SWM) have not been systematically examined in young people with major depressive disorder with and without persistent depressive disorder. 313 medication naïve young people (aged 6-16 years) with active major depressive disorder (MDD) alone, persistent depressive disorder (DD) alone and comorbid active MDD and DD were identified. Standard multiple regression was used to investigate how well SWM components-Spatial Span, Strategy and Between Search Errors (BSE)-predict 'sad/unhappy', 'irritable' mood and 'Inattention'. Spatial Span (4% of the variance-decreased), Strategy and BSE (both 1% of the variance increased) all made independent significant contributions to 'Inattention' while having no independent association with 'sad/unhappy' or 'Irritable' mood. These findings support the independence of depressive cognitive impairment from the two main components of depressive mood. Improving SWM and attention via targeted management approaches may aid young people with these depressive disorders.

Psychopathology mediates between maltreatment and memory functioning in Burundian refugee youth

BACKGROUND

The detrimental impact of child maltreatment on children and adolescents' academic achievement and later socioeconomic wellbeing is well known. However, it is still unclear (1) whether maltreatment is actually linked to youth's long- and short-term memory deficits and (2) whether potential impairments are due to maltreatment per se or related psychopathology.

OBJECTIVE

Based on the Attentional Control Theory, we investigated a mediational model in which maltreatment would be related to psychopathology (internalizing symptoms, posttraumatic stress symptoms, posttraumatic cognitions), which would in turn be related to impaired memory functioning.

PARTICIPANTS AND SETTING

We drew on a sample of 155 Burundian refugee youth (aged 11 to 15) currently living in refugee camps in Tanzania and at high risk of experiencing ongoing maltreatment by parents.

METHODS

Youth reported on their experiences of maltreatment and psychopathology in structured clinical interviews and completed visuospatial memory tasks involving a short-term and a working memory component (Corsi Block Tapping Test) and delayed recall from long-term memory (Rey-Osterrieth Complex Figure).

RESULTS

Structural equation modeling showed that psychopathology mediated the association between increased maltreatment and reduced working memory capacity (β = -0.07, p = .02), with a trend towards mediation for short-term memory (β = -0.05, p = .06). Higher levels of maltreatment, but not psychopathology, were directly linked to long-term memory deficits (β = -0.20, p = .02).

CONCLUSIONS

Preventive efforts targeting maltreatment and interventions focusing on related psychopathology are needed to counter memory deficits and their potential negative implications for academic and socioeconomic outcomes.

Spatial working memory performance in children and adolescents with major depressive disorder and dysthymic disorder

BACKGROUND

Spatial working memory (SWM) is known to be impaired in children with Major depressive disorder (MDD), and, separately, Dysthymic disorder (DD) (DSM V persistent depressive disorder equivalent). Yet, it remains unclear whether MDD or DD is associated with worse SWM impairment, whether DD adds to the SWM impairments evident in MDD and whether these findings are evident in children as well as adolescents with MDD and DD.

METHODS

The association of SWM and its strategy and spatial span components is explored in carefully defined children and adolescents (age 6-16 years) with MDD alone (N = 29), MDD and DD (N = 130), DD alone (N = 154) compared to healthy typically developing participants (N = 107), controlling for age, gender, full scale IQ and social adversity status. The relationship between SWM and its strategy and span components and anxious/depressed and inattentive symptoms were also examined.

RESULTS

MDD was associated with worse SWM impairment than DD and there was no evidence of an additive effect of MDD and DD on SWM, strategy and spatial span deficits. Further, these findings were age-independent.

LIMITATIONS

The data presented are cross sectional and limited to SWM deficits in MDD and/or DD.

CONCLUSIONS

This study concurs with and extends current influential models about the cognitive effects of MDD and DD. Clinical implications and future research directions are discussed.

Vulnerabilities in sequencing and task switching in healthy youth offspring of parents with mood disorders

INTRODUCTION

Visuospatial processing and task switching are impaired in individuals with mood disorders. It is unknown whether early deficits are present before mood symptom on set or are related to risk for a specific type of mood disorder. To investigate, we compared visual attention and task switching during sequencing among never-disordered youth with parental family histories of bipolar (BD) and major depressive disorders (MDD) and healthy controls (HC) with no personal or family history of psychopathology.

METHOD

8-17-year-old youth of parents with BD (n = 31, "BD-risk"), youth of parents with MDD (n = 49, "MDD-risk"), and demographically similar HC (n = 31, "HC") were examined using the Delis-Kaplan Executive Functioning System Trail Making Test. Seed-based resting-state functional connectivity (RSFC) was collected from a subset of 88 participants (25 BD-risk, 37 MDD-risk, 26 HC) to investigate group differences in RSFC related to visuospatial processing.

RESULTS

BD-risk and MDD-risk offspring had impaired sequencing and task switching, demonstrated by reduced scores on visual scanning, F(2, 108) = 4.12, p = .02, number sequencing, F(2, 88) = 4.75, p = .01, letter sequencing, F(2, 108) = 4.24, p = .02, and number-letter sequencing, F(2, 108) = 4.66, p = .01, compared to scores in HC. RSFC between the posterior cingulate (PCC) and clusters in the subcallosal cortex, amygdala, and hippocampus significantly differed among HC, BD-risk, and MDD-risk groups. PCC-subcallosal/limbic RSFC was positively coupled in the MDD-risk and BD-risk groups and negatively coupled in HCs.

CONCLUSIONS

Youth at familial risk for mood disorders demonstrate visuospatial deficits early in the processing stream. Improved methods for identifying at-risk children with the earliest possible neurocognitive impairments may inform remediation strategies that could prevent mood disorders.

Failure to maintain set as a predictor of childhood depression within a children's psychiatric inpatient sample

Despite a wealth of studies in adults and adolescents, only a handful of studies have examined executive function in childhood depression. This study utilized retrospective chart review of a children's psychiatric inpatient program to evaluate executive function via Wisconsin Card Sorting Test (WCST) in 33 children (6-12 years old) with a depressive disorder and 61 age/sex-matched children without a depressive disorder referred for neuropsychological evaluation. WCST categories, perseverative errors, and failure to maintain set errors were examined as potential predictors of depressive disorder diagnosis and self-reported depressive symptoms. After controlling for age, length of hospital stay, and ADHD, failure to maintain set significantly predicted depressive disorder diagnosis. Failure to maintain set was also significantly associated with self-reported depressive symptoms. Current findings provide preliminary evidence to suggest that failure to maintain set may reflect a core deficit of childhood depression. While findings are preliminary, this may have important implications for the diagnosis and treatment of childhood depression.

Latent profile analysis of working memory performance in a sample of children with ADHD

The current study used latent profile analysis (LPA) to ascertain distinct groups of children with ADHD (N = 701) in terms of performance on working memory (WM) tasks that tapped visuospatial sketchpad, spatial central executive, and verbal central executive functions. It compared the WM performances of these classes with a clinical comparison group (N = 59). The participants' age ranged from 7 to 16 years (586 males, 71 females). The results of the LPA supported three classes. For all three WM tasks, class 1 (N = 196) had more difficulties than classes 2 (N = 394) and 3 (N = 111), and the clinical comparison group. Class 2 had more difficulties than class 3 and the clinical comparison group, and there was no difference between class 3 and the clinical comparison group. Class 1 had lower IQ and academic abilities, and relatively more individuals with depressive disorders. The implications of the findings for understanding ADHD and its treatment are discussed.

Executive function and attention in children and adolescents with depressive disorders: a systematic review

Numerous studies have shown that Major Depressive Disorder (MDD) in adults is associated with deficits in cognitive control. Particularly, impairment on executive function (EF) tasks has been observed. Research into EF deficits in children and adolescents with MDD has reported mixed results and it is currently unclear whether paediatric MDD is characterised by impairments in EF and attention. PsycInfo, Scopus and Medline were systematically searched to identify all studies that have investigated EF and attention in paediatric depressive disorders between 1994 and 2014. 33 studies meeting inclusion/exclusion criteria were identified. While across different domains of EF some studies identified a deficit in the clinical group, the majority of studies failed to find deficits in response inhibition, attentional set shifting, selective attention, verbal working memory, and verbal fluency. More research is needed to clarify the relationship between depressive disorders in children and adolescents and spatial working memory processing, sustaining attention, planning, negative attentional bias and measures of 'hot' EF. There is little support for EF deficits in paediatric depression. However, there are numerous methodological problems that may account for null findings. Alternatively, chronicity and/or severity of symptoms may explain discrepancies between cognitive deficits in adult and paediatric MDD. Recommendations for future studies are discussed.

Concurrent and Short-Term Prospective Relations among Neurocognitive Functioning, Coping, and Depressive Symptoms in Youth

The present short-term longitudinal study examined the concurrent and prospective relations among executive functioning (i.e., working memory and cognitive flexibility), coping (primary and secondary control coping), and depressive symptoms in children. Participants were 192 children between 9 and 15 years old (M age = 12.36 years, SD = 1.77) recruited from the community. Youth were individually administered neuropsychological measures of executive functioning and intelligence and completed self-report measures of executive dysfunction, coping, and depressive symptoms in small groups; the latter two measures were completed again 4 months later (Time 2 [T2]). Linear regression analyses were used to examine direct associations among executive functions, coping, and depressive symptoms, and a bootstrapping procedure was used to test indirect effects of executive functioning on depressive symptoms through coping. Significant prospective relations were found between working memory measured at Time 1 (T1) and both primary and secondary control coping measured at T2, controlling for T1 coping. T1 cognitive flexibility significantly predicted T2 secondary control coping, controlling for T1 coping. Working memory deficits significantly predicted increases in depressive symptoms 4 months later, controlling for T1 depressive symptoms. Bootstrap analyses revealed that primary and secondary control coping each partially mediated the relation between working memory and depressive symptoms; secondary control coping partially mediated the relation between cognitive flexibility and depressive symptoms. Coping may be one pathway through which deficits in executive functioning contribute to children's symptoms of depression.

Tarefas que avaliam a memória operacional na infância e adolescência: uma revisão sistemática da literatura

A Memória Operacional (MO) é um componente das funções executivas essenciais para o desenvolvimento cognitivo da criança. Ela tem efeitos sobre a aprendizagem e as tarefas diárias. O objetivo foi revisar a literatura para identificar as principais tarefas que foram utilizadas para avaliar a MO e a qualidade psicométrica. Foi realizada uma revisão da literatura em bancos de dados (Pubmed, Medline, Lilacs, SciELO). Foram analisados 44 artigos que utilizaram tarefas que avaliaram a alça fonológica e/ou esboço visuoespacial. A partir das análises dos artigos foram descritas um total de 20 diferentes tarefas para avaliar a MO. Com a revisão sistemática foi possível descrever diferentes tarefas a partir de um modelo cognitivo. No entanto, são necessários estudos psicométricos, para validação das medidas dentro do modelo teórico e o refinamento sobre o entendimento da MO.

Frontoparietal function in young people with dysthymic disorder (DSM-5: Persistent depressive disorder) during spatial working memory

BACKGROUND

Dysthymic disorder (DD) is a depressive disorder characterised by persistent low and/or irritable mood and has been identified as a major risk factor for developing major depressive disorder (MDD). MDD and DD have been associated with executive function difficulties of working memory and attention. Little is known about how executive function networks in the brain are affected in children and adolescents with MDD and even less in DD. This study used fMRI and two spatial working memory paradigms to investigate associated brain function in young people with DD and an age-, gender- and IQ- matched typically developing group.

METHODS

Nineteen male patients with DD (mean age 11.2±1.5 years) diagnosed according to DSM-IV criteria and 16 typically developing boys (mean age 10.5±1.1 years) performed a mental rotation and a delay-match to sample (DMTS) task while undergoing fMRI. All participants were medication-naïve at the time of testing.

RESULTS

Compared to typically developing young people, the DD group showed less activation in left frontal regions including left ventro- and dorsolateral prefrontal cortices (PFC) during mental rotation. Medial frontal regions including dorsomedial PFC, anterior cingulate cortex and frontal pole also showed relatively reduced activation. During the DMTS task patients showed significantly more activation in the right precuneus and posterior cingulate cortex.

LIMITATIONS

This was a cross-sectional study with a small sample limiting the generalizability of the results.

CONCLUSIONS

The results complement previous findings in adults with MDD that have shown differential activation of left PFC regions during working memory tasks. Additionally, altered function of cortical midline structures in young patients with DD was identified. This supports findings in children, adolescents and adults with MDD suggesting that the pathophysiology of depressive disorders extends to DD as a risk factor for MDD and exhibits continuity over the lifespan.