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      Is executive dysfunction a risk marker or consequence of psychopathology? A test of executive function as a prospective predictor and outcome of general psychopathology in the adolescent brain cognitive development study®

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          Highlights

          • Executive dysfunction may be a transdiagnostic cognitive deficit of psychopathology in youth.

          • Poorer executive function prospectively predicted two-year change in general psychopathology.

          • Greater general psychopathology prospectively predicted two-year change in executive function.

          • Executive function is both a risk marker and consequence of youth transdiagnostic psychopathology.

          Abstract

          A general psychopathology (‘p’) factor captures shared variation across mental disorders. One hypothesis is that poor executive function (EF) contributes to p. Although EF is related to p concurrently, it is unclear whether EF predicts or is a consequence of p. For the first time, we examined prospective relations between EF and p in 9845 preadolescents (aged 9–12) from the Adolescent Brain Cognitive Development Study® longitudinally over two years. We identified higher-order factor models of psychopathology at baseline and one- and two-year follow-up waves. Consistent with previous research, a cross-sectional inverse relationship between EF and p emerged. Using residualized-change models, baseline EF prospectively predicted p factor scores two years later, controlling for prior p, sex, age, race/ethnicity, parental education, and family income. Baseline p factor scores also prospectively predicted change in EF two years later. Tests of specificity revealed that bi-directional prospective relations between EF and p were largely generalizable across externalizing, internalizing, neurodevelopmental, somatization, and detachment symptoms. EF consistently predicted change in externalizing and neurodevelopmental symptoms. These novel results suggest that executive dysfunction is both a risk marker and consequence of general psychopathology. EF may be a promising transdiagnostic intervention target to prevent the onset and maintenance of psychopathology.

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          Most cited references84

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Executive Functions

            Executive functions (EFs) make possible mentally playing with ideas; taking the time to think before acting; meeting novel, unanticipated challenges; resisting temptations; and staying focused. Core EFs are inhibition [response inhibition (self-control—resisting temptations and resisting acting impulsively) and interference control (selective attention and cognitive inhibition)], working memory, and cognitive flexibility (including creatively thinking “outside the box,” seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). The developmental progression and representative measures of each are discussed. Controversies are addressed (e.g., the relation between EFs and fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention). The importance of social, emotional, and physical health for cognitive health is discussed because stress, lack of sleep, loneliness, or lack of exercise each impair EFs. That EFs are trainable and can be improved with practice is addressed, including diverse methods tried thus far.
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              Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.

              Little is known about lifetime prevalence or age of onset of DSM-IV disorders. To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.
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                Author and article information

                Contributors
                Journal
                Dev Cogn Neurosci
                Dev Cogn Neurosci
                Developmental Cognitive Neuroscience
                Elsevier
                1878-9293
                1878-9307
                22 July 2021
                October 2021
                22 July 2021
                : 51
                : 100994
                Affiliations
                [a ]Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
                [b ]Harvard Medical School, Belmont, MA, USA
                [c ]McLean Imaging Center, McLean Hospital, Belmont, MA, USA
                Author notes
                [* ]Corresponding author at: McLean Hospital, deMarneffe Building, Mailstop 331, 115 Mill St., Belmont, MA, 02478, USA. aromer@ 123456mclean.harvard.edu
                Article
                S1878-9293(21)00084-0 100994
                10.1016/j.dcn.2021.100994
                8340137
                34332330
                38d94a4e-ac27-48fe-8c1a-c24682a6b90f
                © 2021 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 31 March 2021
                : 8 July 2021
                : 19 July 2021
                Categories
                Original Research

                Neurosciences
                general psychopathology,p factor,executive function,longitudinal,risk factor,transdiagnostic

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