Executive function deficits associated with current and past major depressive symptoms

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.

Conceptualizing avoidant/restrictive food intake disorder via an executive functioning lens

Avoidant/restrictive food intake disorder (ARFID) is a heterogeneous disorder wherein restrictive eating is primarily attributed to non-shape/weight-based reasons (e.g., sensory sensitivity) that empirical research continues to explore. Mounting evidence suggests that ARFID often presents alongside neurodevelopmental diagnoses (NDs) or divergent neurodevelopment broadly. Executive functioning (EF) differences often characterize divergent neurodevelopmental trajectories. Additionally, restrictive eating in anorexia nervosa has been conceptualized as related to EF factors (e.g., set shifting). Given the neurodevelopmental phenotype that may be associated with ARFID and the role of EF in anorexia nervosa, this paper proposes EF as a potentially important, yet understudied factor in ARFID pathology. We posit that various observed ARFID behavioral/cognitive tendencies can be conceptualized in relation to EF differences. We contextualize commonly observed ARFID presentations within "core" EF components (i.e., cognitive flexibility, working memory, inhibitory control), leading to hypotheses about EF in ARFID. Finally, we offer additional considerations/directions for future research on EF in ARFID. Increased research on EF in ARFID is needed to consider this potential common factor in the etiology and maintenance of this heterogeneous disorder. We aim to promote further consideration of EF in ARFID etiology, maintenance, and treatment-outcome research. PUBLIC SIGNIFICANCE: This article proposes that aspects of executive functioning (EF) may play a role in the onset and maintenance of avoidant/restrictive food intake disorder (ARFID), although this notion is largely untested by existing research. Further research on the role of EF in ARFID may assist with refining models and treatments for this heterogeneous disorder.

Effects of Exercise Training on Executive Functioning in Adults with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Exercise is a promising nonpharmacological intervention to improve executive function (EF). However, results from randomized trials and meta-analyses examining the effects of exercise on working memory in adults with depression are mixed, and the influence of exercise on EF, as well as the key moderators of the relationship, remain inconclusive.

OBJECTIVE

The present systematic review with meta-analysis examined the influence of exercise interventions on EF in adults with depression, and the influence of key moderating variables.

METHODS

Electronic searches were conducted using Embase, Cochrane Central, Scopus, Ovid MEDLINE, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Weipu Database up to 25 June 2022, and updated on 16 January 2023. Randomized controlled trials (RCTs) examining the effects of exercise training on EF in adults with depression were included. A three-level meta-analysis based on a random-effects model was applied in R. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

A total of 14 RCTs that evaluated 1201 adults with depression were included. The results indicated that exercise significantly improved global EF [g = 0.180; 95% confidence intervals (CI) = 0.038, 0.323], and the subdomains of working memory (g = 0.182; 95% CI = 0.015, 0.350), cognitive flexibility (g = 0.222; 95% CI = 0.048, 0.395), and reasoning/planning (g = 0.889; 95% CI = 0.571, 1.206). In subgroup analyses, significant improvements in EF were only observed for aerobic exercise (g = 0.203; 95% CI = 0.023, 0.382), moderate-to-vigorous intensity exercise (g = 0.200; 95% CI = 0.022, 0.379), exercise performed three or more times per week (g = 0.207; 95% CI = 0.026, 0.388), in sessions ≤ 60 min (g = 0.173; 95% CI = 0.003, 0.343), and in program durations lasting at least 13 weeks (g = 0. 248; 95% CI = 0.034, 0.462).

CONCLUSIONS

This meta-analysis demonstrates the benefits of exercise training for improving EF and the subdomains of working memory, cognitive flexibility, and reasoning/planning in adults with depression. Future randomized clinical trials are warranted to determine the therapeutic effects of exercise training on EF and cognitive symptoms in depressed patients.

What do we know about pseudodementia?

Depression and dementia can lead to generalised cognitive and memory dysfunction. Thus, differentiating these disorders is important and challenging. Pseudodementia is a term used clinically to describe symptoms that resemble dementia but are caused by other conditions (most frequently depression), rather than being recognised as an official diagnosis. Pseudodementia is characterised by a cognitive impairment that mimics dementia but which does not have its origin in neurological degeneration, deriving instead from functional psychiatric conditions. This condition is more commonly observed in older adults (particularly those over the age of 50 or 60 years), and its risk factors overlap with those for depression. Pseudodementia is essentially characterised by deficits in memory, executive function and speech and, therefore, can easily be confused with dementia, although there are aspects that allow its differentiation. Diagnosing pseudodementia can be difficult, especially as there is significant overlap between its symptoms and those of other conditions. However, it is important to recognise characteristic aspects of this disorder, as its correct identification is essential for proper treatment.

The Influence of Emotional Regulation and Cognitive Flexibility on Sleep Habits in Spanish Children and Adolescents through the Lens of Parents

BACKGROUND

Previous research studies have suggested the importance of studying the relationship between emotional regulation and sleep habits. Some investigations have especially focused on how emotional regulation could impact sleep habits in children and adolescents. Therefore, these researchers have stated there exists a two-way direction in this relationship.

OBJECTIVE

This study aimed to analyze the influence of emotional regulation on sleep habits in Spanish children and adolescents and the mediating role of anxiety in this relationship.

METHOD

Participants were 953 Spanish parents who completed the assessment protocol according to their children and adolescents' information.

RESULTS

The results revealed moderate-strong correlations between emotional regulation problems and sleep habit disturbances (r = 0.375, p < 0.001), trait (r = 0.488, p < 0.001) anxiety, and state (r = 0.589, p < 0.001) anxiety. Additionally, emotional regulation showed a direct impact on sleep habits (β = 0.011, p = 0.005). Trait and state anxiety demonstrated a significant mediating role in the relationship between emotional regulation and sleep habits.

CONCLUSIONS

Emotional regulation may have an impact on sleep habits during childhood and adolescence, suggesting the importance of early intervention focused on the emotions management and the prevention of sleep habit disturbances.

Mild Depressive Symptoms in Airline Pilots Associated With Impaired Executive Functions

INTRODUCTION

While significant efforts have been made to understand the influence of depression-related impairments on executive functioning within the general population, the specific impact on airline pilots remains largely unexplored. Considering the crucial role that cognitive abilities play in the realm of aircraft piloting, it is imperative to probe into the potential repercussions of depressive symptoms on executive functions (EFs) among this professional cohort.

OBJECTIVES

 This study aims to explore the associations between depressive symptoms and EFs in a convenience sample of airline pilots.

METHODS

 Male airline pilots (n = 100) underwent the Beck Depression Inventory II (BDI-II) to gauge both the presence and intensity of depressive symptoms. The Stroop Color and Word Test (SCWT), the Digit Span Task (DST), and the Wisconsin Card Sorting Test (WCST) were used to assess EFs.

RESULTS

 Of the entire sample of pilots, 88% (n = 88) demonstrated minimal depressive symptoms with a BDI-II score ranging from 0 to 13. The remaining 12% (n = 12) exhibited mild depression, with scores between 14 and 19. Pilots suffering from mild depression demonstrated prolonged color and word times and a higher time interference (TI) score on the SCWT. Moreover, these individuals exhibited lower scores on the DST across both the forward digit span (FDS) and backward digit span (BDS) subtests. Finally, the presence of mild depression correlated with an increased number of total errors, encompassing both perseverative and non-perseverative errors, in the WCST. After adjusting for potential confounding variables, we found an independent association between BDI-II scores and total errors in the WCST.

CONCLUSION

Our research points to substantial differences in EFs between airline pilots demonstrating mild depression and those exhibiting minimal depressive symptoms. This information can catalyze heightened consciousness about the psychological welfare of pilots.

Predictive utility of symptom measures in classifying anxiety and depression: A machine-learning approach

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent, co-occurring disorders with significant symptom overlap, posing challenges in accurately distinguishing and diagnosing these disorders. The tripartite model proposes that anxious arousal is specific to anxiety and anhedonia is specific to depression, though anxious apprehension may play a greater role in GAD than anxious arousal. The present study tested the efficacy of the Mood and Anxiety Symptom Questionnaire anhedonic depression (MASQ-AD) and anxious arousal (MASQ-AA) scales and the Penn State Worry Questionnaire (PSWQ) in identifying lifetime or current MDD, current major depressive episode (MDE), and GAD using binary support vector machine learning algorithms in an adult sample (n = 150). The PSWQ and MASQ-AD demonstrated predictive utility in screening for and identification of GAD and current MDE respectively, with the MASQ-AD eight-item subscale outperforming the MASQ-AD 14-item subscale. The MASQ-AA did not predict MDD, current MDE, or GAD, and the MASQ-AD did not predict current or lifetime MDD. The PSWQ and MASQ-AD are efficient and accurate screening tools for GAD and current MDE. Results support the tripartite model in that anhedonia is unique to depression, but inclusion of anxious apprehension as a separate dimension of anxiety is warranted.

Frozen in (e)motion: How reactive motor inhibition is influenced by the emotional content of stimuli in healthy and psychiatric populations

Efficient inhibitory control is vital. However, environmental cues can influence motor control especially in an emotional context. One common task to measure inhibitory control is the stop-signal task (SST), which asks participants to respond to go stimuli knowing that on some trials a stop signal will be presented, requiring them to inhibit their response. This paradigm estimates the ability to inhibit already-initiated responses by calculating participants' stop-signal reaction times (SSRT), an index of inhibitory control. Here, we aim to review the existing, often contradictory, evidence on the influence of emotional stimuli on the inhibitory process. We aim to discuss which factors may reveal an interference as well as an advantage of emotional stimuli on action inhibition performance. Finally, we review the existing evidence that has investigated the effect of such stimuli on action inhibition in the psychiatric population. Important factors are the relevance, the intensity and the valence of the emotional stimulus, as well as the affected component of the motor control. From all this evidence, it is clear that understand precisely how emotion is integrated into core executive functions, such as inhibitory control, is essential not only for cognitive neuroscience, but also for refining neurocognitive models of psychopathology.

Decision Making under Risk in Patients Suffering from Schizophrenia or Depression

Studies have reported difficulties in decision making for patients with schizophrenia or depression. Here, we investigated whether there are differences between schizophrenia patients, depressed patients, and healthy individuals (HC) when decisions are to be made under risk and cognitive flexibility is required. We were also interested in the relationships between decision making, cognitive functioning, and disease severity. Thirty HC, 28 schizophrenia patients, and 28 depressed patients underwent structured clinical assessments and were assessed by the Positive and Negative Syndrome Scale or Hamilton Rating Scale. They performed the Probability-Associated Gambling (PAG) Task and a neuropsychological test battery. Both patient groups obtained lower scores than HC in memory and executive function measures. In the PAG task, relative to HC, depressed patients made slower decisions but showed a comparable number of advantageous decisions or strategy flexibility. Schizophrenia patients were slower, riskier, and less flexible compared to HC. For them, the decision making behavior correlated with the symptom severity. In both groups, decision making scores correlated with memory and executive function scores. Patients with schizophrenia or depression may have difficulties under risk when quick and flexible decisions are required. These difficulties may be more pronounced in patients who have marked cognitive deficits or severe clinical symptoms.

Neurocognitive Impairment in Severe Mental Illness. Comparative study with Spanish Speaking Patients

BACKGROUND

Serious mental illness (SMI) represents a category of psychiatric disorders characterized by specific difficulties of personal and social functioning, derived from suffering severe and persistent mental health problems.

AIMS

We wanted to look into differences in cognitive performance among different SMI patients.

METHODS

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) screening was applied in one sample of SMI patients (n = 149) and another of healthy comparison participants (n = 35). Within the SMI sample, three different subsamples were formed: one with 97 patients with schizophrenia, a second with 29 patients with mood disorders, and a third with 23 patients with personality disorder. We performed a comparative study within and between groups.

RESULTS

Analysis of covariance was performed. Significant differences were found for cognitive functioning including attention and memory.

CONCLUSIONS

RBANS can be recommended for the detection of neurocognitive deficits in psychiatric disorders, especially in Schizophrenia.

Factor Structure, Measurement Invariance, and Concurrent Validity of the Penn State Worry Questionnaire Across Development, Psychopathology, and Culture

The Penn State Worry Questionnaire (PSWQ) is a widely used assessment of excessive worry. American undergraduate samples have predominately been used to evaluate its factor structure, which may not generalize to other developmental, cultural, and psychopathology populations. The present study tested the PSWQ's factor structure across three diverse samples: American undergraduate students (n = 3,243), Dutch high school students (n = 3,906), and American adults with psychopathology (n = 384). Exploratory, confirmatory, and multigroup confirmatory factor analyses were conducted. Measurement invariance and concurrent validity were also tested. Method-factor and two-factor models were largely equivalent and superior to a one-factor model. Invariance tests supported configural and metric invariance but only partial scalar invariance. Positively worded items but not negatively worded items demonstrated concurrent validity with anxiety and depression symptom measures and diagnoses. Overall, the PSWQ appears to measure a unitary construct. Present results warrant further testing of the PSWQ across diverse samples.

Examining the latent structure of emotional awareness and associations with executive functioning and depression

Emotional awareness is comprised of dispositions towards and knowledge about one's emotions. Executive functions (EF) are cognitive processes that organise and guide behaviour towards one's goals. Both emotional awareness and EF play a role in processes such as emotion regulation and are risk factors for the development and maintenance of depression. Although previous research suggests that aspects of emotional awareness are related to EF, methodological and measurement limitations within the available literature make it difficult to clearly understand how they are associated. In this registered report, we examined the extent to which task-based measures of a specific EF process, shifting, are differentially related to unique facets of emotional awareness (i.e. emotional clarity of type, emotional clarity of source, voluntary attention to emotions, and involuntary attention to emotions), and to what extent EF and emotional awareness are related to depression. Using structural equation modelling, we found evidence that emotional clarity of type was associated with greater shifting cost. Shifting was not associated with any other facet of emotional awareness. Depression was linked to lower emotional clarity of type, higher involuntary attention to emotions, but not poorer EF performance. We discuss how emotional awareness and EF may be uniquely related to depression.

The Structure of Executive Dysfunction in Depression and Anxiety

BACKGROUND

Although research has demonstrated that depression and anxiety are associated with problematic executive function (EF), results are often inconsistent and underspecified. Delineating specific EF impairments in depression and anxiety has the potential to provide a mechanistic account of symptom presentation and course in these highly co-occurring disorders. The present study evaluated associations between components of EF and symptom dimensions of depression (depressed mood) and anxiety (anxious apprehension, anxious arousal) using factor analyses and structural equation modeling.

METHODS

Undergraduates (N = 1,123) completed self-report measures of EF in everyday life and of psychopathology. Based on a three-factor model (Miyake et al., 2000), item-level exploratory (n = 561) and confirmatory (n = 562) factor analyses were conducted on inhibition, shifting, and working memory scales chosen from the EF measure. Structural equation modeling tested the relationship of EF factors to dimensions of psychopathology using the total sample.

RESULTS

A three-factor model of EF best fit the data and was replicated via confirmatory factor analysis. Depressed mood and anxious arousal evidenced broad deficits across all EF domains, whereas anxious apprehension evidenced shifting disruptions.

LIMITATIONS

Perceived EF may not index the same constructs as performance-based EF tests. Further, the present study was restricted to college students, warranting replication in other samples.

CONCLUSIONS

Findings suggest that depressed mood and anxious arousal are characterized by a general disruption in the ability to maintain task goals, whereas anxious apprehension is characterized by cognitive inflexibility. EF impairments are likely contributory factors in the maintenance of affective disorders.

Testing the Mechanism of Action of Computerized Cognitive Training in Young Adults with Depression: Protocol for a Blinded, Randomized, Controlled Treatment Trial

Background:

Depression is associated with a broad range of cognitive deficits, including processing speed (PS) and executive functioning (EF). Cognitive symptoms commonly persist with the resolution of affective symptoms and increase risk of relapse and recurrence. The cognitive control network is comprised of brain areas implicated in EF and mood regulatory functions. Prior research has demonstrated the effectiveness of computerized cognitive training (CCT) focused on PS and EF in mitigating both cognitive and affective symptoms of depression.

Methods:

Ninety participants aged 18–29 with a current diagnosis of major depressive disorder or persistent depressive disorder, or a Hamilton Depression Rating Scale score ≥12, will be randomized to either PS/EF CCT, verbal CCT, or waitlist control. Participants in the active groups will complete 15 min of training 5 days/week for 8 weeks. Clinical and neuropsychological assessments will be completed at baseline, week 4, week 8, and 3-month follow-up. Structural and functional magnetic resonance imaging (fMRI) will be completed at baseline and week 8. We will compare changes in mood, cognition, daily functioning, and fMRI data. We will explore cognitive control network functioning using resting-state and task-based fMRI.

Results:

Recruitment began in October 2019; we expect to finish recruitment by April 2022 and subsequently begin data analysis.

Conclusions:

This study is innovative in that it will include both active and waitlist control conditions and will explore changes in neural activation. Identifying the neural networks associated with improvements following CCT will allow for the development of more precise and effective interventions.

Trial Registration:

ClinicalTrials.govNCT03869463; https://clinicaltrials.gov/ct2/show/NCT03869463.

Emotionally valenced stimuli impact response inhibition in those with substance use disorder and co-occurring anxiety and depression symptoms

BACKGROUND

Substance use disorder (SUD) is associated with impaired response inhibition. Given the deficits in emotion regulation associated with SUD, it is unclear if this impairment is exacerbated by emotionally valenced stimuli. Co-occurring conditions may further exacerbate these impairments as many co-occurring conditions further impact emotion regulation. It was hypothesized that negative stimuli may further impact response inhibition for this population.

METHODS

The current study used the stop-signal task to examine response inhibition to negative, neutral and positive stimuli in a sample of those with a history of SUD and co-occurring depression and anxiety symptoms.

RESULTS

Response inhibition was poorer for negative stimuli relative to neutral stimuli. There was no difference between negative and positive stimuli. Depression severity moderated the difference between response inhibition for negative and neutral stimuli. At elevated depression, response inhibition was worse and there was no difference across emotional stimuli. At low depression, there was a significant difference between negative and neutral stimuli. This effect was not found for anxiety symptoms.

LIMITATIONS

Study participants presented with polysubstance use of varying duration and amount. It is unclear whether findings are attributed to specific substances, or substance use broadly. Additionally, happy, angry, and calm facial emotions were used to represent positive, negative, and neutral valences respectively. It is unclear whether these findings are generalizable to other emotional expressions.

CONCLUSION

Results suggested that emotionally valenced stimuli affected response inhibition among those with low symptom severity. At elevated symptom severity, response inhibition to all stimuli were impaired.

Inflammatory Biomarkers, Microbiome, Depression, and Executive Dysfunction in Alcohol Users

Alcohol-related disorders (ARD) are highly prevalent among Latin American-Caribbean countries. Mental disorders are common comorbidities in individuals with ARD. However, the etiology of the association between ARD and mental disorders remains unclear. We examined the association of inflammatory cytokines, microbiome, and other biomakers with measures of depression, social anxiety, and executive functions. We observed a significant increase in cytokine and chemokine expression levels in saliva and plasma in the alcohol group (AG) samples. Also, the salivary bacterial composition in the AG revealed an abundance of Prevotella. Depression symptomatology was markedly higher in the AG, but social anxiety levels were negligible. AG also exhibited executive dysfunctions, which negatively correlated with increased plasma levels of pro-inflammatory cytokines and increased salivary concentrations of Prevotella bacteria. Our study suggests that chronic alcohol use correlates with executive dysfunction, immune system dysregulation, and dysbiosis of the salivary microbiota. Additional studies are needed to understand the role of the microbiome and inflammation in alcohol use and mental comorbidities.

Comprehensive self-control training benefits depressed college students: A six-month randomized controlled intervention trial

BACKGROUND

Depressive disorder was associated with dysfunctional self-regulation. The current study attempted to design and test a comprehensive self-control training (CSCT) program with an overall emphasis on behaviral activation in depressed Chinese college students.

METHODS

Participants included 74 students who had diagnosed with major depression, they were randomly assigned to one of the two groups: intervention group (n=37), and control group (n=37). The intervention participants received an eight-week CSCT and four-month follow-up consolidation program, as compared to the control group who received only pre-post-and-follow-up measurements. All participants measured Beck Depression Inventory (BDI-Ⅱ) and Self-control Scale (SCS) at three time points: baseline, post-training, and four-month follow-up.

RESULTS

The dropout rates were 6 (8.1%) in the intervention group and 3 (4.1%) in the control group at the end of six-month intervention. The general linear model repeated measures analysis of variance revealed that comparing with the control group, the intervention group participants had more increase in their trait self-control score, at the meantime, their depressive symptoms had significantly improved. Univariate and logistic regression analyses revealed that participants with milder baseline depressive symptoms were more likely to benefit from CSCT interventions; depression improvement was also associated with the number of sessions attended.

LIMITATIONS

The main limitation was related to the small sample size which consisted of college students who were relatively young and well educated.

CONCLUSIONS

The current study demonstrates that CSCT program could temporarily enhance self-control capacity as well as improve depressive symptoms; participants who are mildly to moderately depressed, and who could adhere to the training protocol are more likely to benefit from the intervention.

Hubness of strategic planning and sociality influences depressive mood and anxiety in College Population

Depressive mood and anxiety can reduce cognitive performance. Conversely, the presence of a biased cognitive tendency may serve as a trigger for depressive mood-anxiety. Previous studies have largely focused on group-wise correlations between clinical-neurocognitive variables. Using network analyses for intra-individual covariance, we sought to decipher the most influential clinical-neurocognitive hub in the differential severity of depressive-anxiety symptoms in a college population. Ninety college students were evaluated for depressive-anxiety symptoms, Minnesota multiphasic personality inventory-2(MMPI-2), and neuro-cognition. Weighted and undirected version of the intra-individual covariance networks, comprised of 18 clinical-neurocognitive variables satisfied small-worldness and modular organization in the sparsity range of K = 0.20-0.21. Furthermore, betweenness centrality of perseverative error for the Wisconsin card sorting test was reduced in more depressive individuals; higher anxiety was related to the increased betweenness centrality of MMPI-2 clinical scale 0(Si). Elevated edge-betweenness centrality of covariance between the MMPI-2 clinical scale 7(Pt) versus commission error of the continuous performance test predicted more anxiety higher than depressive mood. With intra-individual covariance network of clinical-neurocognitive variables, this study demonstrated critical drivers of depressive mood[attenuated influence of strategic planning] or anxiety[domination of social introversion/extroversion, in addition to the influence of compulsivity-impulsivity covariance as a shortcut component among various clinical-neurocognitive features].

An Evaluation of the Specificity of Executive Function Impairment in Developmental Psychopathology

OBJECTIVE

Deficits in executive function (EF) are common in neuropsychiatric disorders, but the specificity of these deficits remains unclear. The aim of the present study was to elucidate the pattern of EF impairment across psychopathologies in children and adolescents. Associations among components of EF with dimensions of psychopathology, including an overall psychopathology factor, were assessed.

METHOD

Participants (8-21 years) were from the Philadelphia Neurodevelopmental Cohort (N = 9,498). Data from a structured clinical screening interview were reduced to 5 dimensional domains using factor analyses: overall psychopathology, anxious-misery, fear, externalizing, and psychosis. EF components of attentional vigilance, response inhibition, conceptual flexibility, and working memory were assessed. Associations of clinical dimensions with general EF ability and with specific EF components were examined.

RESULTS

EF ability showed common and domain-specific associations with clinical symptoms. General EF was directly associated with the general psychopathology, anxious-misery, and psychosis domains but not with the fear or externalizing domains. For the EF subcomponents, differences emerged in the magnitude and direction of the association between components and clinical domains. Poorer EF was typically associated with increased symptoms across clinical domains; however, in some instances, better EF ability was associated with greater symptom burden, particularly in the fear domain.

CONCLUSION

EF has widespread associations with psychopathology in youth. Findings showed some overlap in the type of EF impairment across clinical phenotypes, as indicated by similar patterns of associations between some clinical symptoms and EF. However, findings also showed domain-specific associations with EF that differed across EF components and clinical domains.