Executive function as a mediator in the link between single or complex trauma and posttraumatic stress in children and adolescents

The association between school bullying and executive functions in children and adolescents: A three-level meta-analysis

INTRODUCTION

Even though existing amounts of results have shown that school bullying could be related to the main components of executive functions (EFs) (inhibitory control, working memory, and cognitive flexibility), research focused on this association yields inconsistent results.

METHOD

To address this research gap, the current study conducted a three-level meta-analysis approach and simultaneously considered the two perspectives of the bully and victim to clarify the relationship between school bullying experienced by children and EFs. It also explored the moderating variables that affect the relationship between school bullying and EFs.

RESULTS

Based on 18 studies reporting 73 effect sizes (N = 21,725), the results revealed that the overall effect size for the association between both the bullies and victims of school bullying incidents with EFs (rbullies = -0.154, p < .05; rvictims = -0.187, p < .001). Moderator analyses revealed that the negative correlation between bullies of school bullying and EFs was moderated by EF components, but it was not affected by gender, age, and the EF measurement method. Moreover, the negative correlation between victims of school bullying and EFs was not affected by the form of bullying, source of report, facet of EFs, EF measurement, gender, age, and culture.

CONCLUSIONS

The present meta-analysis revealed a relationship between school bullying and EFs. Both bullies and victims appear to have lower EF levels. The results also emphasized that lower inhibitory control was more likely to be a crucial risk factor for bullying behavior.

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.

FMR1 CGG Repeats and Stress Influence Self-Reported Cognitive Functioning in Mothers

Variation in the FMR1 gene may affect aspects of cognition, such as executive function and memory. Environmental factors, such as stress, may also negatively impact cognitive functioning. Participants included 1,053 mothers of children with and without developmental disabilities. Participants completed self-report measures of executive function, memory, and stress (i.e., life events, parenting status), and provided DNA to determine CGG repeat length (ranging from 7 to 192 CGGs). Stress exposure significantly predicted greater self-reported difficulties in executive function and the likelihood of memory problems. Cubic CGG effects independently predicted executive function and memory difficulties, suggesting effects of both genetic variation and environmental stress exposure on cognitive functioning.

Risk and resilience correlates of reading among adolescents with language-based learning disabilities during COVID-19

Students with language-based learning disabilities (LBLD) can face elevated socio-emotional well-being challenges in addition to literacy challenges. We examined the prevalence of risk and resilience factors among adolescents with LBLD (N = 93), ages 16-18, and the association with reading performance during the COVID-19 pandemic. Data were collected at the start and end of the first fully remote academic year of COVID-19 (2020-2021). Participants completed standardized word and text reading measures, as well as self-report surveys of executive functions (EF), and socio-emotional skills associated with resilience (grit, growth mindset, self-management, self-efficacy, and social awareness) or risk (anxiety, depression, COVID-19 related PTSD, and perceived COVID-19 impact). Survey data at the start of the school year (Time 1) captured three underlying factors associated with socioemotional risk, socioemotional resilience, and regulation (i.e., EF). Path analyses revealed that students' Time 2 oral reading scores were significantly and uniquely predicted by socioemotional resilience, even when controlling for word-level reading at Time 1. Socioemotional risk, EF, and perceived COVID-19 impact were not directly related to Time 2 oral reading scores; however, students' resilience mediated the associations between risk and reading outcomes. These results demonstrate that adolescents' mental health concerns, self-regulatory ability, and socioemotional resilience were all associated with their experiences of the COVID-19-related stress. However, despite the high-risk context of the pandemic, and socio-emotional challenges faced by students with LBLD, our findings indicate that resilience directly predicts end-of-year reading outcomes and mediates the impact of socioemotional risk on achievement.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11145-022-10361-8.

Parental Arrest and Child Behavior: Differential Role of Executive Functioning among Racial Subgroups

This study examines relations among parental arrest, child executive functioning (EF), and problem behaviors among youth who participated in the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) study (N = 11,875). Participants ranged in age from 9 to 10 (M = 9.91) years, and approximately half were girls (47.9%). Results of regression analyses that controlled for sociodemographic risk factors indicated that children who experienced parental arrest exhibited more internalizing and externalizing behaviors than comparison youth, particularly when their mother vs. father had been arrested. Results of analyses that were disaggregated by child race further revealed that EF appeared to play a differential role among White (n = 5851) and Black (n = 1451) children. Among White children, EF was associated with fewer internalizing and externalizing behaviors regardless of whether or not a parent had been arrested. Among Black children, low levels of EF were associated with more internalizing behaviors in the context of parental arrest vs. no arrest, but high levels of EF did not appear to confer benefits. EF was not significantly related to externalizing behaviors among Black children. Taken together, results suggest that parental arrests have adverse implications for child well-being that warrant continued theoretical and empirical attention. Findings also suggest that, although EF may be broadly beneficial among White children, there appear to be constraints on the extent to which high EF benefits Black children, a finding that is discussed through the lens of racial stratification and that has important implications for future theory, research, and practice.

Examining the effectiveness of trauma-focused cognitive behavioral therapy on children and adolescents' executive function

BACKGROUND

Children and adolescents impacted by childhood trauma often demonstrate executive function difficulties, which negatively affect self-regulation and potentiate the risk for trauma-related psychopathology and functional impairment. Evidence-based treatments for traumatized youth such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) aim to equip youth directly with skills for effective self-regulation and may thus also improve executive function. Moreover, adolescence is a sensitive period for executive function development, and interventions aimed at improving executive function may confer greater benefits for adolescents relative to school-aged children. No study has examined executive function improvements during TF-CBT or the potential differences in these outcomes between children and adolescents.

OBJECTIVE

In the current study, we examined changes in caregiver-reported executive function difficulties during TF-CBT among children ages 6 to 11 and adolescents ages 12 to 17.

PARTICIPANTS AND SETTING

Participants were 278 racially and ethnically diverse youth with interpersonal trauma histories and their caregivers enrolled in a community-based effectiveness trial of TF-CBT in an urban setting. Caregivers reported on youth executive function at pre, mid, and posttreatment assessments.

RESULTS

Both children and adolescents demonstrated reductions in global executive function difficulties during TF-CBT. Improvements were seen across domains of emotional, behavioral, and attentional control and problem solving, with larger effect sizes for adolescents. Follow-up analyses indicated that executive function improvements were positively associated with PTSD symptom reduction in adolescents, but not in children.

CONCLUSIONS

Findings add to the growing evidence of the effectiveness of TF-CBT among youth and highlight caregiver-reported executive function as a potential treatment target during TF-CBT.

Effects of childhood trauma in psychopathy and response inhibition

Childhood trauma is linked to impairments in executive function and working memory, thought to underly psychological disorders including depression and posttraumatic stress disorder. Research demonstrates that childhood trauma can partially mediate posttraumatic stress disorder in those with executive function deficits. Despite a link with executive function deficit, psychopathy as a consequence of trauma is yet to be studied in this context. The present study investigates the possibility of a relationship between childhood trauma, psychopathic traits, and response inhibition. Eighty participants were tasked to completed the Childhood Traumatic Events Scale (Pennebaker & Susman, 2013), Levenson’s Self-Report Psychopathy Scale (Levenson et al., 1995), and Flanker task of response inhibition (Eriksen & Eriksen, 1974). Scores of trauma exposure, psychopathic traits, and reaction times in the Flanker task were measured. Regression analysis revealed no significance for trauma exposure in predicting psychopathic traits (p = .201) and response inhibition (p = .183), indicating that childhood trauma does not strongly predict susceptibility to psychopathic traits or response inhibition deficits. These findings form an important basis on which to build a further understanding of the consequences of childhood trauma exposure, specifically in terms of understanding how specific cognitive functions may be influenced and providing a clearer understanding of how psychopathic traits develop.

Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study

BACKGROUND

Complex traumas are traumatic experiences that involve multiple interpersonal threats during childhood or adolescence, such as repeated abuse. Complex traumas are hypothesized to lead to more severe psychopathology and poorer cognitive function than other non-complex traumas. However, empirical testing of this hypothesis has been limited to clinical/convenience samples and cross-sectional designs.

AIMS

To investigate psychopathology and cognitive function in young people exposed to complex, non-complex, or no trauma from a population-representative longitudinal cohort, and to consider the role of pre-existing vulnerabilities.

METHOD

Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a population-representative birth-cohort of 2,232 British children. At age 18 years (93% participation), we assessed lifetime exposure to complex and non-complex trauma, past-year psychopathology, and current cognitive function. We also prospectively assessed early childhood vulnerabilities: internalizing and externalizing symptoms at age 5, IQ at age 5, family history of mental illness, family socioeconomic status, and sex.

RESULTS

Participants exposed to complex trauma had more severe psychopathology and poorer cognitive function at age 18 compared to both trauma-unexposed participants and those exposed to non-complex trauma. Early childhood vulnerabilities predicted risk of later complex trauma exposure, and largely explained associations of complex trauma with cognitive deficits, but not with psychopathology.

CONCLUSIONS

By conflating complex and non-complex traumas, current research and clinical practice under-estimate the severity of psychopathology, cognitive deficits, and pre-existing vulnerabilities linked with complex trauma. A better understanding of the mental health needs of people exposed to complex trauma could inform the development of new effective interventions.

Chronic early trauma impairs emotion recognition and executive functions in youth; specifying biobehavioral precursors of risk and resilience

Exposure to chronic early trauma carries lasting effects on children's well-being and adaptation. Guided by models on resilience, we assessed the interplay of biological, emotional, cognitive, and relational factors in shaping two regulatory outcomes in trauma-exposed youth: emotion recognition (ER) and executive functions (EF). A unique war-exposed cohort was followed from early childhood to early adolescence. At preadolescence (11-13 years), ER and EF were assessed and respiratory sinus arrhythmia (RSA), biomarker of parasympathetic regulation, was quantified. Mother-child dyadic reciprocity, child's avoidance symptoms, and cortisol (CT) were measured in early childhood. Trauma-exposed youth displayed impaired ER and EF abilities. Conditional process analysis described two differential indirect paths leading from early trauma to regulatory outcomes. ER was mediated by avoidance symptoms in early childhood and modulated by cortisol, such that this path was evident only for preadolescents with high, but not low, CT. In comparison, EF was mediated by the degree of dyadic reciprocity experienced in early childhood and modulated by RSA, observed only among youth with lower RSA. Findings pinpoint trauma-related disruptions to key regulatory support systems in preadolescence as mediated by early-childhood relational, clinical, and physiological factors and highlight the need to specify biobehavioral precursors of resilience toward targeted early interventions.