Executive Functions in Students With Depression, Anxiety, and Stress Symptoms

Mental health problems raise the odds of cognitive impairment in COVID-19 survivors

Background

COVID-19 survivors around the globe are suffering from mental health issues. While mental health problems can be an early warning sign of dementia, they may also increase the chances of developing the disease. In this study, we examined the mental health of COVID-19 survivors and mapped its associations with cognitive and demographic variables.

Method

COVID-19 survivors listed in the databases of three tertiary care hospitals in Kolkata were contacted sequentially. 376 willing patients were interviewed over the telephone. 99 COVID-19 patients and 31 matched controls participated in the in-person interviews that were arranged for a more detailed investigation. The participants were administered standardized tests that are widely used for the assessment of cognitive functioning and mental health status.

Result

64.89% of COVID-19 survivors reported a deterioration in physical functioning. 44.95% reported a decline in mental health, whereas 41.49% reported a drop in cognitive performance. Detailed investigations revealed that they had an increased risk of having depression, anxiety, and poor sleep quality by 91%, 68%, and 140%, respectively. 6.1% of the patients had mild cognitive impairment, and 4% had dementia. COVID-19 patients who had depression and anxiety were 8.6 and 19.4 times more likely to have cognitive decline, respectively. Compared to the matched controls, COVID-19 patients had greater depression (p<.001), anxiety (p<.001), stress (p =.003), and insomnia (p <.001). They also scored significantly lower on Addenbrooke's Cognitive Examination-III (p =.009) and Picture Naming Test (p =.005) and took significantly longer to complete Trail Making Test-A (p =.002).

Conclusion

COVID-19 survivors in this study had major mental health issues even one year after contracting the virus. They had significant cognitive deficits that might progress into dementia. Strict monitoring and systematic treatment plans should be implemented as soon as possible.

Cognitive deficits and course of recovery in transient global amnesia: a systematic review

OBJECTIVE

Published evidence suggests that cognitive impairment during a TGA (transient global amnesia) spell may not be confined to episodic memory. We undertook a systematic review to determine the pattern of cognitive deficits during a TGA episode. As a secondary objective, we aimed to delineate the course of cognitive recovery.

METHODS

MEDLINE, EMBASE, CENTRAL, and Google scholar were systematically searched up to October 2023. Observational controlled studies including 10 or more TGA patients (Hodges and Warlow criteria) were retrieved. Data from case-control, cross-sectional, and cohort studies were reviewed and qualitatively synthesized.

RESULTS

Literature search yielded 1302 articles. After the screening of titles and abstracts, 115 full texts were retrieved and 17 of them were included in the present systematic review. During the acute phase, spatiotemporal disorientation, dense anterograde and variable retrograde amnesia, semantic memory retrieval difficulties, and working memory deficits comprised the neuropsychological profile of patients with TGA. Visuospatial abilities, attention and psychomotor speed, semantic memory, confrontation naming, and other measures of executive function (apart from semantic fluency and working memory) were consistently found normal. In the course of recovery, after the resolution of repetitive questioning, the restoration of spatiotemporal orientation follows, working memory and semantic memory retrieval ensue, while episodic memory impairment persists for longer. Meticulous evaluations may reveal subtle residual memory (especially recognition) deficits even after 24 h.

CONCLUSIONS

Μemory impairment, spatiotemporal disorientation, and working memory deficits constitute the pattern of cognitive impairment during a TGA spell. Residual memory deficits may persist even after 24 h.

Cognitive function and work resilience of healthcare professionals: A comparative cross-sectional study

BACKGROUND

Healthcare professionals (HCPs) face a variety of work-related stressors that have impact on their mental health and cognitive performance. Work resilience is a psychological resource that helps workers cope with stress and prevents unfavorable psychological impact. The aim of this study was to assess the associations between working as HCPs and cognitive function as well as work resilience.

MATERIALS AND METHODS

This was a comparative cross-sectional study conducted among HCPs at Suez Canal University Hospital in Ismailia Governorate, Egypt, during April 2023 to August 2023. Two hundred and thirty-five HCPs and 107 administrative employees (Admins) were invited to participate in this study. A self-administered questionnaire was used to obtain sociodemographic and other relavent data. Cognitive function was assessed with the Mini-Mental State Examination test; work resilience was assessed with the Brief Resilience Scale; and psychological distress was measured with the Depression, Anxiety, and Stress Scale - 21-items (DASS-21) scale. Statistical significance was determined by Mann Whitney U-test for continuous variables, and Chi-square test or Fisher's exact, as appropriate, for categorical variables. Multiple logistic regression models were employed to determine associations between the main outcomes (cognitive impairment and low resilience) and the main covariate (working as HCPs vs. Admins), adjusting for all potential confounders.

RESULTS

HCPs showed a significantly greater cognitive impairment, less resilience, and DASS-21 than the Admins. The odds of impaired cognitive function in HCPs were significantly higher than the Admins (odds ratio [OR]: 4.45, 95% confidence interval [CI]: 1.27-15.67, P = 0.020), adjusted for all potential covariates. Similarly, the odds of low resilience in HCPs were significantly higher than Admins (OR: 5.81, 95% CI: 2.72-12.44, P < 0.001), adjusted for all potential covariates. However, the adjusted association between impaired cognitive function and low resilience was not statistically significant (OR: 0.55, 95% CI: 0.23-1.33, P = 0.185).

CONCLUSION

HCPs had significantly impaired cognitive function and low work resilience. Workplace policies and interventions to control depression, stress, and anxiety are required as it is the encouragement of physical activity. Programs that combine positive coping skills training (e.g., relaxation training, positive thinking, and problem solving) with resilience-building interventions (e.g., taking a proactive approach to solving problems, being flexible and adaptive) should be developed, with special attention to HCPs who have a higher sense of self-efficacy.

Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms

ABSTRACT

This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group ( p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD.

Abnormal Structure and Function of Parietal Lobe in Individuals With Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review Study

Introduction

Abnormal brain structure and function have been reported in individuals with attention deficit hyperactivity disorder (ADHD). This study investigated the parietal lobe structure and function alteration in individuals with ADHD.

Methods

In this systematic review, we searched English papers in accordance with the PRISMA (the preferred reporting items for systematic reviews and meta-analyses) approach. Studies were published between January 2010 and May 2021. Our search was conducted in two parts. Our first search was in July 2020, and our final search was in June 2021. A literature search identified 20 empirical experiments.

Results

Functional magnetic resonance imaging (MRI) studies generally reported low activity and poor connectivity; structural MRI studies reported less gray matter in this lobe, and an echo study reported atrophy. In addition, electroencephalographic studies reported less connectivity of the parietal lobes in ADHD. Furthermore, the transcranial direct current stimulation intervention has shown that activation of this lobe improves attention and executive functions in children with ADHD. Finally, a deep transcranial magnetic stimulation study has demonstrated that activation of this lobe improves working memory.

Conclusion

Functional and structural alteration of the parietal cortex has been reported in ADHD, which has a causal relationship with cognitive impairments. In sum, all included studies reported abnormal structure, function, or connectivity of the parietal lobe or improvement of cognitive functions with parietal lobe stimulation.

Implications of attention and executive functioning weaknesses in youth with Fontan circulation

Youth with Fontan circulation (Fontan) are at-risk for impairments in attention and executive functioning (EF) due to a confluence of genetic, prenatal, surgical, and medical risk factors. We sought to describe attention and EF in this population, measured via standardized performance-based tests and caregiver rating scales. We then examined how weaknesses in attention and EF were related to outcomes in other neurobehavioral domains, including adaptive behavior and academic achievement. Our sample included 93 youth with Fontan who were referred for neuropsychological evaluations as part of standard clinical care. The cohort as a whole measured between 0.18 to 0.99 standard deviations below normative means across domains of attention, EF, academic achievement, and intellectual ability. In addition, caregiver-reported concerns for attention, EF, anxiety, and depression were elevated, and approximately 0.35 to 0.85 standard deviations above normative means. Lastly, caregiver-reported adaptive behavior measured 0.93 to 1.24 standard deviations below normative values. Academic outcomes were differentially affected by demographic and attention/EF variables, while depression and caregiver-reported EF predicted adaptive behavior. Findings from this study underscore the importance of routine neuropsychological evaluation as part of comprehensive, multidisciplinary care for individuals with Fontan, with the goal of enhancing neurobehavioral and functional outcomes across the lifespan.

The Relationship between Trait Impulsivity and Everyday Executive Functions among Patients with Type 2 Diabetes Mellitus: The Mediating Effect of Negative Emotions

Background

In recent years, the incidence of type 2 diabetes mellitus (T2DM) has dramatically increased, imposing a heavy financial burden on society and individuals. The most cost-effective way to control diabetes is diabetes self-management, which depends on patients' executive functions (EFs). However, the level of EFs among patients with T2DM varies greatly. In addition to diabetes-related factors contributing to a decline in EFs, trait impulsivity as a relatively stable personality trait may explicate individual differences in EFs. The objective of this study was to verify the mediating effect of negative emotions on the relationship between trait impulsivity and EFs among patients with T2DM in China.

Methods

A total of 305 patients with T2DM were enrolled consecutively from the endocrinology departments of three tertiary hospitals in China using convenience sampling. The participants completed the Sociodemographic Questionnaire, Mini-Mental State Examination (MMSE), Barratt Impulsiveness Scale-Brief (BIS-Brief), Depression Anxiety and Stress Scales with 21 items (DASS-21), and Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) version. A structural equation modeling was used to verify the mediating effect of negative emotions on the relationship between trait impulsivity and EFs.

Results

A total of 32.46% of the participants experienced at least one aspect of daily EF decline. The mediating effect of trait impulsivity on the Behavioral Regulation Index (BRI) of EFs through negative emotions was significant, accounting for 29.57% of the total effect. The mediating effect of trait impulsivity on the Metacognitive Index (MI) of EFs through negative emotions was significant, accounting for 31.67% of the total effect.

Conclusions

Trait impulsivity can positively predict EF decline, which can be alleviated by improving the negative emotions of patients with T2DM. Future research exploring interventions to improve the EFs of patients with T2DM should therefore consider their trait impulsivity and negative emotions.

Cognitive functioning in anxiety and depression: results from the ALSPAC cohort

Anxiety and depression are associated with a range of impairments in cognitive functioning. Understanding the nature of these deficits may identify targets for intervention and prevent functional decline. We used observational and genetic methods to investigate the relationship of anxiety and depression with three cognitive domains: emotion recognition, response inhibition, and working memory, in the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined: (i) cross-sectional associations between anxiety, depression, and cognition at age 24 (n = 2187), (ii) prospective associations between anxiety and depression at age 18 and cognition at age 24 (n = 1855), and (iii) the casual effect of anxiety and depression on cognition using Mendelian randomization (MR). Both disorders were associated with altered emotion recognition; anxiety with decreased happiness recognition (b = -0.27 [-0.54,0.01], p = 0.045), and depression with increased sadness recognition (b = 0.35 [0.07,0.64], p = 0.016). Anxiety was also associated with poorer working memory (b = -0.14 [-0.24,0.04], p = 0.005). There was no evidence for an association with response inhibition. MR provided no clear evidence of causal relationships between mental health and cognition, but these analyses were underpowered. Overall, there was little evidence for impairments in executive functioning, but moderate alterations in emotion recognition. This may inform the development of psychosocial interventions.

Symptoms of depression and anxiety in Chinese adolescents: heterogeneity and associations with executive function

BACKGROUND

Depression and anxiety are common symptoms associated with significant morbidity in adolescents. Few studies have explored the relationship between latent profiles of adolescent depression-anxiety symptoms and executive function (EF), which is also a major pediatric public health concern.

METHODS

The sample included 1,306 participants who were recruited from two schools in Ningxia. The Depression Self-Rating Scale for Children (DSRSC) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the level of depression-anxiety symptoms in adolescents, and their executive function state was assessed using the Behavior Rating Inventory of Executive Function-Self-Report version (BRIEF-SR). Latent profile analysis (LPA) was carried out using Mplus 7.0 to explore the most likely number of profiles based on the subscales of DSRSC and SCARED. The relationship between adolescents' executive function and depression-anxiety symptoms were analyzed by multivariable logistic regression, and the odds ratio were used to test the impact of this relationship.

RESULTS

The LPA results show that the three-profile model was the best-fitting model for adolescent depression and anxiety symptoms. The proportions of Profile-1 ("Healthy Group"), Profile-2 ("Anxiety Disorder Group"), and Profile-3 ("Depression-Anxiety Disorder Group") were 61.4%, 23.9%, and 14.7%, respectively. Additional analyses using multivariable logistic regression suggested that poor shifting capacity and emotional control were significantly more likely to be classified into the depression and/or anxiety groups, and worse working memory, task completion, and better inhibition were significantly more likely to be classified into the anxiety group.

CONCLUSIONS

The findings contribute to our understanding of the heterogeneity of adolescents' depression-anxiety symptoms and highlight the important role of executive function in influencing mental health outcomes. These findings will guide the improvement and delivery of interventions for the treatment of anxiety and depression in adolescents, mitigating functional impairments in patients and reducing disease risk.

Differences in Selective Attention and Inhibitory Control in Patients with Major Depressive Disorder and Healthy Controls Who Do Not Engage in Sufficient Physical Activity

BACKGROUND

Patients with major depressive disorder (MDD) are characterized by neurocognitive impairments and show deficits in various cognitive performance indicators, including executive function. We examined whether sustained attention and inhibitory control differ between patients with MDD and healthy controls, and whether differences exist between patients with mild, moderate, and severe depression.

METHODS

Clinical in-patients (N = 212) aged 18-65 years with a current diagnosis of MDD and 128 healthy controls were recruited. Depression severity was assessed using the Beck Depression Inventory, and sustained attention and inhibitory control were assessed using the oddball and flanker tasks. The use of these tasks promises insights into executive function in depressive patients that are not biased by verbal skills. Group differences were tested via analyses of covariance.

RESULTS

Patients with MDD showed slower reaction times in both the oddball and flanker task, independent of the executive demands of the trial types. Younger participants achieved shorter reaction times in both inhibitory control tasks. After correcting for age, education, smoking, BMI, and nationality, only differences in reaction times in the oddball task were statistically significant. In contrast, reaction times were not sensitive to the symptom severity of depression.

CONCLUSION

Our results corroborate deficits in basic information processing and specific impairments in higher-order cognitive processes in MDD patients. As difficulties in executive function underlie problems in planning, initiating, and completing goal-directed activities, they may jeopardize in-patient treatment and contribute to the recurrent nature of depression.

Constitutive depletion of brain serotonin differentially affects rats' social and cognitive abilities

Central serotonin appears a promising transdiagnostic marker of psychiatric disorders and a modulator of some of their key behavioral symptoms. In adult male Tph2 -/- rats, constitutively lacking central serotonin, we tested individual's cognitive, social and non-social abilities and characterized group's social organization under classical and ethological testing conditions. Using unsupervised machine learning, we identified the functions most dependent on serotonin. Although serotonin depletion did not affect cognitive performances in classical testing, in the home-cage it induced compulsive aggression and sexual behavior, hyperactive and hypervigilant stereotyped behavior, reduced self-care and exacerbated corticosterone levels. This profile recalled symptoms of impulse control and anxiety disorders. Serotonin appeared essential for behavioral adaptation to dynamic social environments. Our animal model challenges the essential role of serotonin in decision-making, flexibility, impulsivity, and risk-taking. These findings highlight the importance of studying everyday life functions within the dynamic social living environment to model complexity in animal models.

Psychometric properties of the Teenage Executive Functioning Inventory in a Turkish sample of adolescents: deficits in working memory and inhibition among adolescents

The Teenage Executive Functioning Inventory (TEXI) is a measurement tool that consists of two subscales, working memory and inhibition, and allows both self and parent rating. This study aimed to examine the psychometric properties of the Turkish version of TEXI in a sample of 184 parents and 476 adolescents aged 11 and 18 years and to measure the relationship between executive functions and mental health problems, including attention deficit hyperactivity disorder and major depressive disorder and anxiety disorders. Confirmatory factor analyses showed acceptable/good fit indices and confirmed the two-factor structure for both the adolescent and parent forms. Test-retest results and Cronbach's alpha coefficient showed that the scale had high reliability. The results also showed that deficits in executive functions were associated with various mental health problems in adolescents. The findings demonstrated that a Turkish translation of the TEXI is a valid and reliable tool for evaluating the executive functions of adolescents.

The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems

Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, "Super Skills for Life" (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention.

Salivary Cortisol and Sustained Auditory Attention in Children with and without Cleft Lip and Palate

Introduction  Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress. Objectives  To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients. Methods  In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n  = 69) and the control group (CG; n  = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation. Results  The median level of salivary cortisol was of 0.03615 µl/dL and 0.18000 µl/dL respectively for the EG and CG, with a significant difference between the groups ( p  = 0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00). Conclusion  All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.

Reading mind from the eyes in individuals with attention deficit-hyperactivity disorder (ADHD): A meta-analysis

OBJECTIVES

Individuals with ADHD struggle with social impairments. The present study aimed to find out the inconsistent results of theory of mind skill in individuals with ADHD.

METHODS

The current meta-analysis reviewed 17 empirical studies that compared theory of mind in individuals with and without ADHD based on reading mind from the eyes test (RMET).

RESULTS

Finding from 1620 participants with ADHD and 1249 healthy controls showed a significant impairment in theory of mind in individuals with ADHD (Hedges' g = 0.66). Moderator analyses indicated that the impaired theory of mind was not affected by age and gender.

CONCLUSION

These findings describe impaired theory of mind in individuals with ADHD and provide an insight to pay attention to theory of mind in respective clinical assessments and treatments.

Executive function, repetitive behaviour and restricted interests in neurodevelopmental disorders

BACKGROUND

Individuals with genetic syndromes show unique profiles of repetitive behaviours and restricted interests (RRBs). The executive dysfunction account of RRBs suggests that in autistic (AUT) individuals executive function impairments underpin RRBs, but not communication and social interaction autistic characteristics.

AIMS

To 1) describe profiles of behavioural manifestations of executive function (EF behaviours) and 2) explore the relationship between EF behaviours and autistic traits across individuals with Cornelia de Lange (CdLS), fragile X (FXS) and Rubinstein-Taybi syndromes (RTS), and AUT individuals.

METHOD

Carers completed the Behavior Rating Inventory of Executive Function - Preschool Version and the Social Communication Questionnaire. Data reporting on 25 individuals with CdLS (Mage = 18.60, SD = 8.94), 25 with FXS (Mage = 18.48, SD = 8.80), 25 with RTS (Mage = 18.60, SD = 8.65) and 25 AUT individuals (Mage = 18.52, SD = 8.65) matched on chronological age and adaptive ability were included in analyses.

RESULTS

All groups showed impairments across EF behaviours compared to two-to-three-year-old typically developing normative samples with no differences between groups. Different EF behaviours predicted RRBs in the syndrome groups with no associations found in the AUT group.

CONCLUSIONS

Syndrome related differences should be considered when developing targeted interventions that focus on EF behaviours and/or RRBs in these groups.

Executive and Daily Life Functioning Influence the Relationship Between ADHD and Mood Symptoms in University Students

Objectives: Many studies have indicated a close relationship between ADHD and mood symptoms in university students. In the present study, we explore the role of daily functional impairments and executive functioning in the ADHD-mood relationship. Method: A total of 343 adults (126 males) filled out (a) the Conners' Adult ADHD Rating Scale, (b) the Depression Anxiety and Stress Scale, (c) the Weiss Functional Impairment Rating Scale, and (d) the Executive Function Index Scale. Results: The correlation between mood symptoms and ADHD was .48 (moderate correlation) and dropped to .15 (weak correlation) when controlling for functional problems and executive functioning. Hierarchical regression analyses showed that both functional impairments and executive functioning significantly explained 42% to 53% of the variance of mood symptoms. The addition of ADHD symptoms to the model slightly increased the explained mood variance by only 1%. Conclusion: These findings underline the role of experienced difficulties in triggering mood symptoms in ADHD symptomatology.

A Short Version of the EFECO Online Questionnaire for the Assessment of Executive Functions in School-Age Children

Executive function (EF) is a group of processes that allow individuals to be goal-oriented and to have adaptive functioning, so that adequate performance is essential for success in activities of daily living, at school and in other activities. The present study aims to create a short version of the Executive Functioning Questionnaire (EFECO) since there is a gap in the Spanish literature due to the lack of behavioural observation questionnaires at school age. A total of 3926 participants completed the online questionnaire. Subsequently, the validity and reliability of the data are analysed. The results show that the short version of the questionnaire, the EFECO-S, has a structure with five dimensions (emotional self-control, initiation, working memory, inhibition, and spatial organisation), as well as a second-order factor (global executive skill) and high reliability (ordinal Alpha = 0.68-0.88). The EFECO is composed of 67 items, while the EFECO-S has 20 items, four per factor, which turns it into a quick and easy to apply test. Therefore, it becomes an interesting alternative to be applied in screening processes with children who may be experiencing executive difficulties.

Specific patterns of executive functioning weaknesses among children after heart transplant

BACKGROUND

Children with a history of heart transplant (HT) are at risk of executive functioning weaknesses secondary to heart disease and associated morbidity. However, specific executive functioning weaknesses have not been identified.

METHOD

The present study, anchored in Anderson's (2002) Developmental Model of Executive Functioning, provides a detailed, retrospective analysis of executive functioning in the areas of goal setting, cognitive flexibility, attentional control, and information processing for a clinically referred sample of 53 pediatric HT recipients who underwent neuropsychological evaluations as part of typical clinical care.

RESULTS

Broadly, the sample demonstrated mild-to-moderate deficits across cognitive, adaptive behavior, executive functioning, and academic domains, as well as elevated parent-reported concerns for depression and anxiety. Executive functioning weaknesses, while global, persisted after controlling for the effects of depression and anxiety and were most prominent in cognitive flexibility. In addition, poor cognitive flexibility predicted lower adaptive behavior, IQ, and academic outcomes among this population, placing them at considerable risk of extensive impairment in several domains of their lives.

CONCLUSIONS

Taken together, children with a history of HT demonstrated broad difficulties across several areas of functioning, with particular concerns for working memory. As such, interventions and accommodations specifically targeting working memory may help provide the most optimal outcomes for this population.

Mindfulness and Other Simple Neuroscience-Based Proposals to Promote the Learning Performance and Mental Health of Students during the COVID-19 Pandemic

The COVID-19 pandemic has had a negative impact on education. The restrictions imposed have undoubtedly led to impairment of the psychological well-being of both teachers and students, and of the way they experience interpersonal relationships. As reported previously in the literature, adverse effects such as loneliness, anxiety, and stress have resulted in a decrease in the cognitive performance of school and higher education students. Therefore, the objective of this work is to present a general overview of the reported adverse effects of the COVID-19 pandemic which may potentially influence the learning performance of students. Some neuroscientific findings related to memory and cognition, such as neuroplasticity and long-term potentiation, are also shown. We also discuss the positive effects of the practice of mindfulness, as well as other simple recommendations based on neuroscientific findings such as restful sleep, physical activity, and nutrition, which can act on memory and cognition. Finally, we propose some practical recommendations on how to achieve more effective student learning in the context of the pandemic. The aim of this review is to provide some assistance in this changing and uncertain situation in which we all find ourselves, and we hope that some of the information could serve as a starting point for hypotheses to be tested in educational research and their association with neuroscience.

An investigation of working memory deficits in depression using the n-back task: A systematic review and meta-analysis

BACKGROUND

Depression is associated with cognitive deficits across multiple domains, including working memory. The n-back task, a convenient psychometric tool capable of computerised delivery and concurrent use with neuroimaging, can provide enhanced insight into working memory dysfunction in depression. This meta-analysis sought to investigate the n-back task under varying cognitive load conditions (i.e. different levels of 'n') to clarify the pattern of working memory deficits in depression.

METHODS

We conducted a systematic review and meta-analysis of studies involving unipolar depressed participants and matched controls utilising the n-back task. Meta-analyses were performed for accuracy and response times at four levels of cognitive load (0-, 1-, 2-, and 3-back).

RESULTS

31 studies (total 1,666 participants) met inclusion criteria and were included for quantitative analyses. Depressed individuals had significantly reduced accuracy compared to controls for 1-, 2-, and 3-back tasks, but not the attentional 0-back task. Likewise, response latencies were prolonged for all task levels (0-, 1-, 2-, and 3-back). Additional meta-regression analyses indicated that participant age and clinical status (i.e. inpatient/outpatient) may exacerbate working memory deficits associated with depression.

LIMITATIONS

Our results indicate high levels of heterogeneity between studies, particularly for response times.

CONCLUSIONS

Accuracy impairments were worse at higher levels of n, with the largest effect size obtained on the 2-back task, suggesting deficits to higher executive functions. Response times were consistently prolonged at all cognitive loads in agreement with a pattern of generalised psychomotor retardation.

Prevalence of Depression in Iranian College Students: A Systematic Review and Meta-analysis

Context: Depression is a common problem in students. The current study aimed to determine the prevalence of depression in Iranian college students. Evidence Acquisition: The study was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA). We searched both international (i.e. PubMed, Scopus, Science Direct, Web of Science, Embase, and Google Scholar) and national (i.e. SID, Magiran, Iranmedex, and IranDoc) databases from 1991 to June 2019 to identify relevant studies. Cochran’s Q test, I2 index, and τ2 index were used to assess the heterogeneity. A random-effects model was employed to combine the results using comparative meta-analysis software version 2.2. Results: Overall, 89 studies dealing with a total of 33,564 Iranian students were included. The prevalence of depression was estimated at 48.0% [95% confidence interval (CI): 43.6 - 52.5%]. The prevalence of depression was 51.3% (95% CI: 41.1 - 61.4%) and 48.9% (95% CI: 41.0 - 54.8%) in males and females, respectively. The prevalence of mild, moderate, and severe depression was estimated at 26.1% (95% CI: 23.8 - 28.6%), 15.5% (95% CI: 13.1 - 18.3%), and 6.4% (95% CI: 5.1 - 8%), respectively. The Beck-I Questionnaire and the GHQ-28 Questionnaire indicated the highest and the lowest prevalence of depression [68.4% (95% CI: 38.8 - 88.1%) vs. 39.2% (95% CI: 24.6 - 56.1%)], respectively. It was proved that the prevalence of depression among Iranian college students has significantly increased during the study period (P < 0.001). Interest in the field was significantly correlated with depression (P < 0.001). Conclusions: Given the high prevalence of depression among Iranian college students, prevention and treatment programs are strongly recommended.

The role of dorsolateral and ventromedial prefrontal cortex in the processing of emotional dimensions

The ventromedial and dorsolateral prefrontal cortex are two major prefrontal regions that usually interact in serving different cognitive functions. On the other hand, these regions are also involved in cognitive processing of emotions but their contribution to emotional processing is not well-studied. In the present study, we investigated the role of these regions in three dimensions (valence, arousal and dominance) of emotional processing of stimuli via ratings of visual stimuli performed by the study participants on these dimensions. Twenty- two healthy adult participants (mean age 25.21 ± 3.84 years) were recruited and received anodal and sham transcranial direct current stimulation (tDCS) (1.5 mA, 15 min) over the dorsolateral prefrontal cortex (dlPFC) and and ventromedial prefrontal cortex (vmPFC) in three separate sessions with an at least 72-h interval. During stimulation, participants underwent an emotional task in each stimulation condition. The task included 100 visual stimuli and participants were asked to rate them with respect to valence, arousal, and dominance. Results show a significant effect of stimulation condition on different aspects of emotional processing. Specifically, anodal tDCS over the dlPFC significantly reduced valence attribution for positive pictures. In contrast, anodal tDCS over the vmPFC significantly reduced arousal ratings. Dominance ratings were not affected by the intervention. Our results suggest that the dlPFC is involved in control and regulation of valence of emotional experiences, while the vmPFC might be involved in the extinction of arousal caused by emotional stimuli. Our findings implicate dimension-specific processing of emotions by different prefrontal areas which has implications for disorders characterized by emotional disturbances such as anxiety or mood disorders.

Differential and spatial expression meta-analysis of genes identified in genome-wide association studies of depression

Major depressive disorder (MDD) is the most prevalent psychiatric disorder worldwide and affects individuals of all ages. It causes significant psychosocial impairments and is a major cause of disability. A recent consortium study identified 102 genetic variants and 269 genes associated with depression. To provide targets for future depression research, we prioritized these recently identified genes using expression data. We examined the differential expression of these genes in three studies that profiled gene expression of MDD cases and controls across multiple brain regions. In addition, we integrated anatomical expression information to determine which brain regions and transcriptomic cell types highly express the candidate genes. We highlight 12 of the 269 genes with the most consistent differential expression: MANEA, UBE2M, CKB, ITPR3, SPRY2, SAMD5, TMEM106B, ZC3H7B, LST1, ASXL3, ZNF184 and HSPA1A. The majority of these top genes were found to have sex-specific differential expression. We place greater emphasis on ZNF184 as it is the top gene in a more conservative analysis of the 269. Specifically, the differential expression of ZNF184 was strongest in subcortical regions in males and females. Anatomically, our results suggest the importance of the dorsal lateral geniculate nucleus, cholinergic, monoaminergic and enteric neurons. These findings provide a guide for targeted experiments to advance our understanding of the genetic underpinnings of depression.

Clinical binge eating, but not uncontrolled eating, is associated with differences in executive functions: Evidence from meta-analytic findings

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To study the relationship between executive functions and binge eating behaviors.

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Executive functions do not differ along non-clinical binge eating patterns.

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Binge eating disorder might be related with small deficits in executive function.

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Mood disorders linked with severe binge eating might influence cognitive deficits.

Introduction

Binge eating disorder (BED) is a common psychiatric diagnosis characterized by the presence of episodes of loss of control over food consumption. Understanding the neurocognitive factors associated with binge eating pathology might help to design clinical strategies aimed at preventing or treating BED. However, results in the field are notably heterogeneous. In the current study, we aimed to establish whether binge eating behaviors (both at a clinical and at a non-clinical level) are associated with executive functions.

Methods

We performed a pre-registered meta-analysis to examine the link between executive functions, BED, and uncontrolled eating, a psychobiological construct closely associated with binge eating behaviors. Articles were searched on PubMed and the main exclusion criteria were lack of information about participants’ age or sex distribution or adiposity measurements, studies performed in older populations (age > 65 years old) or studies including participants with purging symptoms.

Results

Relative to healthy controls, patients with BED showed lower performance in executive functions, with a small effect size. At the same time, uncontrolled eating patterns were not associated with differences in executive functions. Neither age nor body mass index (BMI) influenced these results.

Conclusions

Our findings suggest that there is no association between performance in executive functions and variations along the non-clinical spectrum of binge eating behaviors. Small deficits in executive functions, however, seem to appear in individuals showing severe binge eating symptoms, that is, individuals meeting diagnostic criteria for BED. We speculate that the close links between BED and emotional distress could partly explain these results.

Quality of life, anxiety and depressive disorders in patients with extrasystolic arrhythmia

Introduction

The aim of this study was to perform a comparative and economic analysis of the degree of development of anxiety-depressive disorder in patients with different types of extrasystolic arrhythmia using different assessment scales.

Material and methods

The study was conducted in 2018-2019 at the premises of clinic No. 4, involving 450 patients (Moscow, Russia). Patients were divided into three groups: with coronary heart disease (CHD) (147 patients), with myocardiodystrophy (MCD) (113) and with cardiopsychoneurosis (CPN) (190). Everyone underwent round-the-clock electrocardiography (ECG) and echocardiography. If symptoms of depressive disorder are detected in a timely manner, the risk of adverse cardiovascular diseases may be reduced.

Results

Depression and anxiety indicators on all three scales differed significantly (p ≤ 0.05) in patients with supraventricular extrasystole (more than 40 points on the Zung scale, 14 points on the Montgomery-Asberg depression scale, more than 38 points on Zung and 3 points on Covi anxiety scales). For patients with ventricular extrasystole, a significant difference was established between groups 1 and 2 only in terms of the level of depression on the Zung scale. Factors of psychogenic origin determine the development of cardiac rhythm disturbances.

Conclusions

The study showed that for supraventricular extrasystoles, these factors determine the overall health of the patient. The differences between the three groups are significant on all scales of depression and anxiety (p ≤ 0.05). The most susceptible to depression and anxiety are patients with extrasystolic arrhythmias diagnosed with CHD, as well as MCD.

The impact of depression and anxiety on speed of academic performance and retrieval fluency in postsecondary students

OBJECTIVE

This study evaluated the functional effects of severe mental health symptoms on speed of academic performance to assist clinicians and educators in determining whether extra time accommodations are evidence-based for students with such diagnoses. Method: Using archival data from 1476 post-secondary students, we examined the performance of students with existing mental health diagnoses who were also reporting extremely high levels of symptoms. Their performance on timed academic achievement and cognitive processing measures was compared with performance of students with learning disabilities, Attention Deficit Hyperactivity Disorder, and clinical controls. Students failing stand-alone performance validity and/or symptom validity measures were excluded from this investigation. Results: Students diagnosed with anxiety and/or depression did not differ from clinical controls on any timed performance measure, typically performing academic tasks within a normal amount of time. By contrast, those with reading disabilities were typically the slowest on all academic tasks. Conclusion: Across the range of timed tests, students with mental health diagnoses did not show functional impairments in tests with a speed component. As such, they would not typically require increased time to perform speeded academic tasks, but they might require alternative accommodations in their post-secondary programmes in order to participate equally.

The Complex Role of Mental Time Travel in Depressive and Anxiety Disorders: An Ensemble Perspective

The ensemble hypothesis proposes that uniquely human cognitive abilities depend on more than just language. Besides overt language, inner speech, and causal interpretations, executive attention, mental time travel, and theory of mind abilities are essential parts that combine additively and even multiplicatively. In this review, we consider the implications of the ensemble hypothesis for the psychopathologies of anxiety and depression. Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are two of the most common mental disorders worldwide. The mechanisms that differentiate them are difficult to identify, however. Mental time travel has been implicated in models of depressive and anxiety disorders, but here we argue that at least two other ensemble components, namely, interpreter biases and executive attention, must also be considered. Depressive and anxiety disorders have both been found to show impairments in all three of these components, but the precise relationships seem to distinguish the two kinds of disorders. In reviewing the literature, we develop models for depression and anxiety that take into account an ensemble of mental components that are unique for each disorder. We specify how the relations among mental time travel, interpreter biases, and executive attentional control differ in depression and anxiety. We conclude by considering the implications of these models for treating and conceptualizing anxiety and depression.

Are Trait Emotional Competencies and Heart Rate Variability Linked to Mental Health of Coronary Heart Disease Patients?

PURPOSE

Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients.

METHODS

Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure.

RESULTS

Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies.

CONCLUSIONS

This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.

Acute anxiety and autonomic arousal induced by CO2 inhalation impairs prefrontal executive functions in healthy humans

Acute anxiety impacts cognitive performance. Inhalation of air enriched with carbon dioxide (CO2) in healthy humans provides a novel experimental model of generalised anxiety, but has not previously been used to assess cognition. We used inhalation of 7.5% CO2 to induce acute anxiety and autonomic arousal in healthy volunteers during neuropsychological tasks of cognitive flexibility, emotional processing and spatial working memory in a single-blind, placebo-controlled, randomized, crossover, within-subjects study. In Experiment 1 (n = 44), participants made significantly more extra-dimensional shift errors on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Intra-Extra Dimensional Set Shift task under CO2 inhalation compared with 'normal' air. Participants also had slower latencies when responding to positive words and made significantly more omission errors for negative words on the CANTAB Affective Go/No-go task. In Experiment 2 (n = 28), participants made significantly more total errors and had poorer heuristic search strategy on the CANTAB Spatial Working Memory task. In both experiments, CO2 inhalation significantly increased negative affect; state anxiety and fear; symptoms of panic; and systolic blood pressure/heart rate. Overall, CO2 inhalation produced robust anxiogenic effects and impaired fronto-executive functions of cognitive flexibility and working memory. Effects on emotional processing suggested a mood-congruent slowing in processing speed in the absence of a negative attentional bias. State-dependent effects of anxiety on cognitive-emotional interactions in the prefrontal cortex warrant further investigation.

Accuracy of self-reported physical activity in patients with anorexia nervosa: links with clinical features

BACKGROUND

High levels of physical activity (PA) have long been described in patients with Anorexia Nervosa (AN). Despite the importance of measuring PA in this population, there are two important factors that remain unknown. First, it is not clear how accurate self-report measures of PA are among patients. Second, little is known about how clinical characteristics are associated with the accuracy of self-reported PA. Therefore, this study aimed to examine the accuracy of self-reported PA compared to an objective measure of PA in patients with AN. It also investigated whether levels of accuracy/inaccuracy were associated with compulsive exercise, motivation to change, and psychological distress.

METHOD

Data were analysed from 34 adult outpatients with AN. Patients wore an accelerometer device (ActiGraph) for 4 days and completed a retrospective self-report measure of exercise (Exercise Participation Screening Questionnaire). They also completed measures of compulsive exercise (Compulsive Exercise Test), motivation to change (The Anorexia Nervosa Stages of Change Questionnaire), and psychological distress (Kessler-10).

RESULTS

On the self-report measure, patients accurately reported their time spent in moderate and vigorous intensity PA, however, they significantly under-reported their light physical activity (compared to the accelerometer data). Accurate reporting of total PA was positively associated with higher levels of compulsive exercise. There was evidence to suggest that clinical features, such as motivation to change and psychological distress, may be associated with inaccurate reporting at some levels of PA intensity and not others.

CONCLUSIONS

Results indicate that patients with AN are likely to under-report their light intensity PA. We also found preliminary evidence for how compulsive exercise, motivation to change, and distress are associated with self-reported PA accuracy. Clinical implications and directions for future research are considered.

TRIAL REGISTRATION

ACTRN12610000585022. Taking a LEAP forward in the treatment of anorexia nervosa: a randomized controlled trial. NHMRC grant: 634922.

New virtual reality tool (Nesplora Aquarium) for assessing attention and working memory in adults: A normative study

Attentional and working memory (WM) processes undergo significant changes during different stages of development. However, currently there are not many continuous performance tools based on virtual reality (VR) for measuring attentional capacity in adults. The present study aimed to obtain normative data for the Nesplora Aquarium VR test in a Spanish population, looking at sex and age variables. In addition, this study also aimed to analyze the psychometric properties of the tool such as scale, internal consistency, and item difficulty and discrimination indices. A total of 1,469 participants from different regions of Spain (57.6% female) with ages ranging from 16 to 90 years old took part in this normative study. Nesplora Aquarium was developed in order to support clinicians in the assessment of attentional processes and WM in adults over 16 years old. It is an 18-minute individual test performed through a VR system. The system provides better visual and auditory immersion in the task than computerized CPTs. This study revealed that the new VR tool, designed to measure adult attention and working memory levels, exhibited good psychometric properties related to reliability and internal consistency. In addition, item difficulty and discrimination values were also acceptable.

Impaired Executive Functioning of Sexual Assault Survivors with Acute Stress Disorder

This study aimed to examine the executive functioning of survivors exposed to recent sexual assaults. Twenty-seven female rape survivors who met the criterion for acute stress disorder (ASD) were enrolled and completed the assessment within 4 weeks after the traumatic experience. Additionally, 25 age-matched female health controls (HC) never exposed to such a traumatic event were enrolled. The assessments evaluated psychiatric symptoms including post-traumatic stress symptoms, depression, anxiety, and trait and state anger; general intelligence indexed by intellectual quotient (IQ); and executive functioning including set-shift/attention, planning, spatial working memory, and inhibition using the Cambridge Neuropsychological Test Automated Battery. The ASD group showed higher levels of depression, anxiety, and state anger, and lower IQ than the HC group. The ASD group also showed global impairment of executive functioning for set-shifting, attention, planning, and response inhibition compared to the HC group. Rather than being associated with low IQ and education levels, these results could be from trauma-related effects in survivors with ASD. Additionally, the state anger level was related to survivors’ deficient executive functioning. The findings indicate the importance of providing assessment and intervention efforts to sexual assault survivors soon after the trauma occurs.