Longitudinal and concurrent links between memory span, anxiety symptoms, and subsequent executive functioning in young children

To be or not to be flexible: A hierarchical model of affective flexibility in typical development and internalizing problems

Affective flexibility is defined as a complex executive function which enables individuals to successfully alternate between distinct emotional and non-emotional features of a given situation in order to attain a specific goal. A large body of research has focused exclusively on flexibility in a non-emotional context, although most of our interactions with our environment are emotionally satiated. Our main aim was to propose a hierarchical framework to describe this construct from a macro-level perspective to a more nuanced and micro-level perspective, including three different levels of affective flexibility: elementary, shifting, and generative. Next, we employed this hierarchical framework to examine the role played by affective flexibility in typical development and different forms of developmental psychopathology. Lastly, we discuss how this knowledge could inform future prevention and intervention programs aimed at reducing cognitive vulnerability to developmental psychopathology.

The effect of anxiety on working memory and language abilities in elementary schoolchildren with and without Additional Health and Developmental Needs

Although excessive childhood anxiety is recognised as a significant public health, education and socioeconomic concern, the specific effects of such anxiety on language development and working memory, particularly visual working memory, are relatively unknown. Thus, this study aimed to examine parent-reported trait anxiety, parent-reported functional language (daily communication skills) and clinical measures of non-verbal intelligence, receptive and expressive vocabulary, phonological awareness, and visual and auditory-verbal short-term and working memory in elementary schoolchildren. The final sample included 41 children categorised as Additional Health and Developmental Needs (AHDN) due to medical, neurodevelopmental or educational concerns and 41 age- and IQ-matched neurotypical (NT) children, aged 5- to 9-years. Results showed that 26% of all children in our entire sample (AHDN and NT) experienced moderate, sub-clinical anxiety (as reported by parents), and that AHDN children were 10.5 times more likely to experience high anxiety than the NT group (odds ratio). Parents of AHDN children reported lower functional language in their children than parents of NT children. Cognitive testing indicated that the AHDN group also had poorer visual and auditory-verbal working memory than the NT group. Further, High Anxiety children (drawn from both AHDN and NT groups) showed poorer parent-reported functional language skills, and lower visual and auditory-verbal working memory capacities. Our findings are amongst the first to confirm that the presence of high parent-rated trait anxiety is associated with reduced visual working memory in children, which is consistent with biological and theoretical expectations of the impact of anxiety on visually driven, goal-directed attention and working memory. Our results regarding the high prevalence of sub-clinical anxiety in both ADHD and neurotypical children highlight the need for early assessment of anxiety in all schoolchildren, especially those classified as AHDN.

Executive functions mediate the association between ADHD symptoms and anxiety in a clinical adolescent population

Objective

Attention-deficit/hyperactivity disorder (ADHD) is associated with a high prevalence of anxiety disorders in children and adolescents. The reasons for this association are poorly understood. Preliminary findings with young adults have suggested that executive functions and functional impairment may mediate the relationship between symptoms of ADHD and mixed anxiety and depressive symptoms. The objective of this study was to explore whether ADHD symptoms, executive functions and functional impairment predict anxiety in a clinical adolescent population. In addition, we investigated the possible mediating role of executive functions and functional impairment in this relationship.

Method

One hundred adolescents with ADHD and their parents completed the ADHD Rating Scale IV (ADHD RS-IV), the Behavior Rating Inventory of Executive Function (BRIEF), and the Weiss Functional Impairment Rating Scale (WFIRS) in relation to an RCT study. The adolescents also completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED). Analyses were conducted using regression and a serial multiple mediator model.

Results

In the regression analyses, parent-rated ADHD symptoms were unable to predict anxiety, but ADHD inattention symptoms predicted anxiety in the self-ratings. Executive dysfunction and functional impairment predicted anxiety in both the parent- and self-reports. In the mediation analyses ADHD symptoms alone did not predict anxiety, but executive dysfunction mediated this relationship as expected. Functional impairment mediated this relationship indirectly through executive functions. The results were similar in the parent- and self- reports.

Conclusion

The results pinpoint executive dysfunction as an important treatment target for alleviating anxiety in adolescents with impairing ADHD symptoms.

The role of attention control in complex real-world tasks

Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.

Do Different Types of Intelligence and Its Implicit Theories Vary Based on Gender and Grade Level?

The current study investigated correlations among gifted students' academic performance; emotional, social, analytical, creative, and practical intelligence; and their implicit theories of intelligence. Furthermore, it studied the effect of gender and grade on these variables. The participants included 174 gifted fifth (41.4%) and sixth (58.6%) grade students, comprising 53.4% male and 46.6% female. The following analytical, creative, and practical intelligence tests were administered: Aurora Battery, the emotional intelligence scale, the implicit theories of intelligence scale, and an assessment scale of students' performances. The results revealed significant correlations among academic performance, kinds of intelligence, and implicit theories of intelligence. There were no significant differences between the male and female students in these measures. There were, however, significant differences between the fifth and sixth grade students, with the sixth-grade students showing higher levels of all kinds of intelligence, except emotional intelligence. Moreover, the results indicated that the intelligence measures were non-significantly affected by either gender or gender-grade interaction. Overall, our results showed that most types of intelligence are related to giftedness, and that there were no gender differences among gifted students on measures of intelligence.

Mental Health Therapist Perspectives on the Role of Executive Functioning in Children's Mental Health Services

Executive functioning is considered a key transdiagnostic factor underlying multiple mental health conditions. Evidence-based interventions targeting executive functioning skills exist and there are ongoing efforts to implement these interventions in routine community-based care. However, there is limited research characterizing therapist perspectives regarding addressing executive functioning within community-based mental health services. The current mixed-methods study aims to characterize mental health therapist perspectives regarding the role of executive functioning in youth clinical presentation and the psychotherapy process and outcomes as well as their experience and training related to executive functioning. Forty-three therapists completed a survey about their perspectives about executive functioning and 14 participated in subsequent focus groups to expand survey results. Results indicated that therapists perceive executive functioning challenges as impacting a large portion of children on their caseload, present across multiple mental health conditions, and that executive functioning is frequently a focus of psychotherapy. Therapists also identified executive functioning challenges as a barrier to therapy engagement and effectiveness. However, therapists reported limited knowledge and training as well as significant motivation for executive functioning training, including executive functioning interventions. Findings confirm the significant role of executive functioning in youth presenting for mental health services and the psychotherapy process and outcomes. Findings also highlight the need for further translation of evidence-based interventions and tools. Challenges as well as potential solutions to inform ongoing and future work seeking to translate and implement evidence-based executive functioning interventions in community mental health services are discussed.

Assessment of Attentional Processes in Patients with Anxiety-Depressive Disorders Using Virtual Reality

To characterize the attention deficits in one-hundred-fifteen participants, comprising two types of clinical profiles (affective and anxiety disorder), through a test of continuous VR execution. Method: Three tests (i.e., Nesplora Aquarium, BDI, and STAI) were used to obtain a standardized measure of attention, as well as the existence and severity of depression and anxiety, respectively. Results: Significant differences (CI = 95%) were found between the control group and the group with depression, in variables related to the speed of visual processing (p = 0.008) in the absence of distractors (p = 0.041) and during the first dual execution task (p = 0.011). For scores related to sustained attention, patients with depression and those with anxiety did not differ from controls. Our results suggest attentional deficits in both clinical populations when performing a continuous performance test that involved the participation of the central executive system of working memory.

Cognitive capacity in self-directed learning: Evidence of middle school students' executive attention to resist distraction

Self-directed learning (SDL) is a rapidly developing trend in schools, although its prerequisites, such as children's skills and abilities to plan and monitor their own learning, have not been investigated in detail. Due to additional cognitive load it induces, SDL has been in some cases found to be detrimental for learning, especially for students with a lower cognitive capacity. With this study, we explored some of the causes for the variability in learning gains. We examined 111 middle school students' self-directed category learning using an exploratory web-task for autonomous learning, focusing on their information search (browsing a taxonomy of unknown dinosaurs) and their memorization of respective category labels. We were interested to detect whether students' performance in a complex span task (Ospan) was also reflected in their search and learning behavior. Results revealed different learning gain trajectories in the latter task, where higher WMC students were more confident about their learning. Also, the students with lower WMC were found to search the taxonomy by repeatedly searching the same (basic type of) dinosaur exemplar. In line with prior findings about human mental capacity restrictions and cognitive load theory, the present work evidenced the important role of students' resistance to distraction, and its relation to differences in self-directed search and memorizing. The results imply the need to teach metacognitive skills and offer supportive scaffolding in order to avoid cognitive overload in SDL.

Illness Perception in Adolescent Patients With Anorexia: Does It Play a Role in socio-Emotional and Academic Adjustment?

People’s beliefs about their illness have been shown to affect their adjustment. The aim of this study was to describe illness perception in adolescent patients with anorexia nervosa (AN) and assess its relationship with socio-emotional and academic adjustment following Leventhal’s Self-Regulation Model. Thirty-four female AN patients, with a mean age of 15.76 (SD = 2.00), completed the Revised Illness Perception Questionnaire (IPQ-R), the Psychosocial Adjustment to Illness Scale (PAIS) and the Hospital Anxiety and Depression Scale (HAD). Adolescent anorexia patients perceived that they had control over their illness and treatment would improve their condition. However, they also believed that it was highly distressing, going to last a long time and would have serious consequences. As for the causes of the disorder, they were attributed primarily to a specific eating disorder and psychological factors. The results showed that anorexia patients’ illness perceptions were related to socio-emotional and academic adjustment. In this sense, identity with the illness was associated with a worse academic adjustment, while emotional representation was associated with a worse emotional and social adjustment. These findings highlight how important it is for patients’ beliefs about their disease to be considered in the treatment of anorexia. In this respect, clinicians treating these patients should consider how certain beliefs affect their academic and socio-emotional adjustment. It would be interesting for patients to become aware of how these beliefs influence the strategies they use to cope with their disease as well as their adjustment to it.

An Investigation of Executive Functioning in Pediatric Anxiety

Although science's understanding (e.g., etiology, maintaining factors, etc.) of pediatric anxiety and related problems has grown substantially over recent years, several aspects to anxiety in youths remain elusive, particularly with relation to executive functioning. To this end, the current study sought to examine several facets to executive functioning (i.e., cognitive flexibility, inhibition, planning, working memory) within a transdiagnostic sample of youths exhibiting varying degrees of anxiety symptoms. One hundred six youths completed a comprehensive battery, including several self-report measures (e.g., Multidimensional Anxiety Scale for Children [MASC] or MASC-2) and an automated neurocognitive battery of several executive functioning tasks (Intradimensional/Extradimensional [IDED], Stop Signal [SST], Spatial Span [SSP], Stockings of Cambridge [SOC] tasks). Regression analyses indicated that youths exhibiting marked anxiety symptoms demonstrated increased planning time and probability of inhibition compared with youths with minimal or no anxiety symptoms. Youths with marked anxiety symptoms similarly demonstrated better cognitive flexibility (i.e., set shifting) compared with youths with minimal anxiety. In addition, analyses indicated a trend such that youths exhibiting marked anxiety symptoms demonstrated poorer working memory compared with youths with no anxiety symptoms. Group classification did not predict remaining outcomes. Limitations and future areas of research are discussed.

Systematic Observation: Relevance of This Approach in Preschool Executive Function Assessment and Association with Later Academic Skills

Executive functions (EFs) are high-level cognitive processes that allow us to coordinate our actions, thoughts, and emotions, enabling us to perform complex tasks. An increasing number of studies have highlighted the role of EFs in building a solid foundation for subsequent development and learning and shown that EFs are associated with good adjustment and academic skills. The main objective of this study was to analyze whether EF levels in 44 Spanish children in the last year of preschool were associated with levels of literacy and math skills the following year, that is, in the first year of compulsory education. We used a multi-method design, which consisted of systematic observation to observe preschool children during play and selective methodology to assess their reading, writing, and math skills in the first year of compulsory primary education. General linear modeling was used to estimate the percentage of variability in academic skills in the first year of primary school that was explained by preschool EF abilities. The results showed that preschool EF level, together with participants and the instrument used to assess academic skills, explained 99% of the variance of subsequent academic performance. Another objective was to determine whether our findings were generalizable to the reference population. To make this determination, we estimated the optimal sample size for assessing preschool EFs. To do this, we performed a generalizability analysis. The resulting generalizability coefficient showed that our sample of 44 students was sufficient for assessing preschool EFs. Therefore, our results are generalizable to the reference population. Our results are consistent with previous reports that preschool EF abilities may be associated with subsequent literacy and math skills. Early assessment of EFs may therefore contribute to identifying children who are likely to experience later learning difficulties and guide the design of suitable interventions for the optimization of EFs.

A novel working memory task for preschoolers: sensitivity to age differences from 3-5 years

Working memory (WM) plays an important role in children's learning and is linked to later academic and occupational success. Understanding the early development of WM can provide critical clues regarding the underlying structure of executive functions and how they change over the life span. The main objectives of the present study were to (1) investigate age differences in the development of three components of WM (retrieval, substitution, transformation) on a novel preschool WM measure and (2) explore whether findings are consistent with the hierarchical model of WM development by examining perseverative and non-perseverative WM errors. Perseverative errors were hypothesized to be more strongly associated with problems substituting and transforming a representation held in mind, whereas non-perseverative errors were hypothesized to be associated with problems maintaining a representation in mind. Participants were 64 children ranging in age from 3.0 to 5.6 years. The results provide evidence for the sensitivity of the WM task to age differences from 3 to 5 years and support for the hierarchical model of WM development.

A FISTful of Emotion: Individual Differences in Trait Anxiety and Cognitive-Affective Flexibility During Preadolescence

Cognitive-affective flexibility represents the ability to switch between alternative ways of processing emotional stimuli according to situational demands and individual goals. Although reduced flexibility has been implicated as a mechanism for the development of anxiety, there is very limited data on this relationship in children and adolescents. The aim of the current study was to investigate cognitive-affective flexibility in preadolescents (N = 112, 50 girls, 11-12 and 13-14 years old) and to examine if this ability is related to individual differences in trait anxiety. Their interplay was assessed using the modified version of the Flexible Item Selection Task (FIST; Jacques and Zelazo 2001) with non-emotional stimuli (geometrical shapes) and the Emotional FIST (EM-FIST) with emotional stimuli (emotional facial expressions). Performance on the EM-FIST indicated that across the whole age range, trials requiring greater cognitive flexibility were more demanding than nonflexible ones, as revealed by both response time and accuracy performance. Moreover, flexibility demands were higher for younger children than for older ones but only in terms of response speed. Individual differences in trait anxiety moderated the impact of flexibility only on the EM-FIST. Being flexible on the EM-FIST was more demanding for high trait anxious children than for their low trait anxious peers. Lastly, overall girls responded faster than boys, but only in the EM-FIST. These findings extend the presently limited literature concerning variability in cognitive-affective flexibility during this sensitive developmental window.

Assessing Executive Functions in Preschoolers Using Shape School Task

Over the last two decades, there has been a growing interest in the study of the development of executive functions (EF) in preschool children due to their relationship with different cognitive, psychological, social and academic domains. Early detection of individual differences in executive functioning can have major implications for basic and applied research. Consequently, there is a key need for assessment tools adapted to preschool skills: Shape School has been shown to be a suitable task for this purpose. Our study uses Shape School as the main task to analyze development of inhibition, task-switching and working memory in a sample of 304 preschoolers (age range 3.25–6.50 years). Additionally, we include cognitive tasks for the evaluation of verbal variables (vocabulary, word reasoning and short-term memory) and performance variables (picture completion and symbol search), so as to analyze their relationship with EFs. Our results show age-associated improvements in EFs and the cognitive variables assessed. Furthermore, correlation analyses reveal positive relationships between EFs and the other cognitive variables. More specifically, using structural equation modeling and including age direct and indirect effects, our results suggest that EFs explain to a greater extent performance on verbal and performance tasks. These findings provide further information to support research that considers preschool age to be a crucial period for the development of EFs and their relationship with other cognitive processes.

Parent ratings of executive function in young preschool children with symptoms of attention-deficit/-hyperactivity disorder

BACKGROUND

Recent research has demonstrated that deficits in basic, self-regulatory processes, or executive function (EF), may be related to symptoms of attention-deficit/hyperactivity disorder (ADHD) already during the preschool period. As the majority of studies investigating these relations in young children have been based primarily on clinically administered tests, it is not clear how early symptoms of ADHD may be related to observations of EF in an everyday context. The preschool version of the Behavior Rating Inventory of Executive Function (BRIEF-P) was developed to provide information about EF through observable, behavioral manifestations of self-regulation, and is the most commonly used rating scale for EF assessment in children.

METHODS

Relations between symptoms of ADHD reported in the Preschool Age Psychiatric Assessment interview (PAPA), and EF as measured by the BRIEF-P (parent form), were investigated in a large, nonreferred sample of preschool children (37-47 months, n = 1134) recruited from the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The inventory's discriminative ability was examined in a subsample consisting of children who met the diagnostic criteria for either ADHD, oppositional defiant disorder (ODD) or anxiety disorder, and typically developing controls (n = 308). The four groups were also compared with regard to patterns of EF difficulties reported in the BRIEF-P.

RESULTS

Of the five BRIEF-P subscales, Inhibit and Working Memory were the two most closely related to ADHD symptoms, together explaining 38.5% of the variance in PAPA symptom ratings. Based on their scores on the Inhibit and Working Memory subscales (combined), 86.4% of the children in the ADHD and TD groups were correctly classified. ADHD symptoms were associated with more severe difficulties across EF domains, and a different EF profile in comparison to children with other symptoms (anxiety, ODD) and to typically developing controls.

CONCLUSIONS

Early symptoms of ADHD were linked to parent-reported difficulties primarily within inhibition and working memory, suggesting that deficiencies within these two EF domains characterize early forms of ADHD. Our findings support the clinical utility of the BRIEF-P as a measure of EF in young preschool children with symptoms of ADHD.