Executive Function Difficulties Research Articles

Self-Reported Executive Functioning in Young Adult Survivors of Childhood Bacterial Meningitis.

This study investigated executive functions (EFs) in young adult survivors of childhood bacterial meningitis (BM). These skills are important for normal development, and their potential vulnerability in early years suggests that childhood BM could affect executive functions in the longer term. The adult self-report Behavior Rating Inventory of Executive Function was administered to 474 young adult survivors of childhood BM who participated in the 20|30 Dutch Postmeningitis study. Average scores were compared to population-norm group scores. Subgroup scores were compared according to causative pathogen and age at onset. Young adult survivors of childhood BM scored lower on overall metacognition than the age-matched population norm group. Young adult survivors of childhood BM caused by Streptococcus pneumoniae, S. agalactiae, or Escherichia coli had lower scores than cases caused by Neisseria meningitidis. Survivors with age-at-onset below 12 months had a higher (worse) overall EF score than survivors with age-at-onset above 12months. Young adult survivors of childhood BM experience difficulties in EF. However, most of the self-reported EF scores were within the norm. Future studies need to additionally assess EF in adult survivors of childhood BM using performance-based tests.

Exploring early life social and executive function development in infants and risk for autism: a prospective cohort study protocol of NICU graduates and infants at risk for cerebral palsy

BackgroundDelays in early social and executive function are predictive of later developmental delays and eventual neurodevelopmental diagnoses. There is limited research examining such markers in the first year of life. High-risk infant groups commonly present with a range of neurodevelopmental challenges, including social and executive function delays, and show higher rates of autism diagnoses later in life. For example, it has been estimated that up to 30% of infants diagnosed with cerebral palsy (CP) will go on to be diagnosed with autism later in life.MethodsThis article presents a protocol of a prospective longitudinal study. The primary aim of this study is to identify early life markers of delay in social and executive function in high-risk infants at the earliest point in time, and to explore how these markers may relate to the increased risk for social and executive delay, and risk of autism, later in life. High-risk infants will include Neonatal Intensive Care Unit (NICU) graduates, who are most commonly admitted for premature birth and/or cardiovascular problems. In addition, we will include infants with, or at risk for, CP. This prospective study will recruit 100 high-risk infants at the age of 3–12 months old and will track social and executive function across the first 2 years of their life, when infants are 3–7, 8–12, 18 and 24 months old. A multi-modal approach will be adopted by tracking the early development of social and executive function using behavioural, neurobiological, and caregiver-reported everyday functioning markers. Data will be analysed to assess the relationship between the early markers, measured from as early as 3–7 months of age, and the social and executive function as well as the autism outcomes measured at 24 months.DiscussionThis study has the potential to promote the earliest detection and intervention opportunities for social and executive function difficulties as well as risk for autism in NICU graduates and/or infants with, or at risk for, CP. The findings of this study will also expand our understanding of the early emergence of autism across a wider range of at-risk groups.

The relationship between objective and subjective executive function in Parkinson’s disease

ABSTRACT Introduction Difficulties in executive functioning (EF) are common in PD; however, the relationship between subjective and objective EF is unclear. Understanding this relationship could help guide clinical EF assessment. This study examined the relationship between subjective self-reported EF (SEF) and objective EF (OEF) and predictors of SEF-OEF discrepancies in PD. Method One-hundred and sixteen non-demented PD participants completed measures of OEF (i.e. problem-solving, cognitive flexibility, inhibition, and working memory) and SEF (Frontal Systems Behavior Scale-Self Executive Dysfunction Subscale). Pearson bivariate correlations and linear regressions were performed to examine the relationship between SEF and OEF and the non-motor symptoms (e.g. mood, fatigue), demographic, and PD characteristic (e.g. MCI status) predictors of discrepancies between OEF and SEF (|OEF minus SEF scores|). Correlates of under-, over-, and accurate-reporting were also explored. Results Greater SEF complaints and worse OEF were significantly associated (β =.200, p = .009) and 64% of participants accurately identified their level of OEF abilities. Fewer years of education and greater symptoms of depression, anxiety, and fatigue significantly correlated with greater discrepancies between OEF and SEF. Fatigue was the best predictor of EF discrepancy in the overall sample (β = .281, p = .022). Exploratory analyses revealed apathy and fatigue associated with greater under-reporting, while anxiety associated with greater over-reporting. Conclusions SEF and OEF are significantly related in PD. Approximately 64% of non-demented persons with PD accurately reported their EF skill level, while 28% under-reported and 8% over-reported. SEF-OEF discrepancies were predicted by fatigue in the overall sample. Preliminary evidence suggests reduced apathy and fatigue symptoms relate to more under-reporting, while anxiety relates to greater over-reporting. Given the prevalence of these non-motor symptoms in PD, it is important to carefully consider them when assessing EF in PD.

Processing Speed Partially Mediates Executive Function Impairments in Adolescents with Congenital Heart Disease: Results from a Prospective Cohort Study

To assess processing speed, fine motor function, attention, and executive function (EF) impairments in adolescents with complex congenital heart disease (CHD) who underwent open-heart surgery during infancy. We administered a comprehensive neuropsychological test battery evaluating 5 EF domains: working memory, inhibition, cognitive flexibility, fluency, and planning and primary neurodevelopmental processes (PNPs): processing speed, fine motor function, and attention. The sample included 100 adolescents with complex CHD from a previous University Children's Hospital Zurich study, with 104 healthy controls for comparison. We generated scores for each EF domain and computed an EF summary score. Group comparisons and associations were analyzed with multiple regression, accounting for parental education. Mediation analysis explored how PNPs mediate the effect between a CHD diagnosis and EF. In adolescents with complex CHD all EF domains and the EF summary score were impaired (β=0.20 to 0.37, all P<0.05). Furthermore, they exhibited slower processing speed (β=0.27, P<0.01) than healthy controls, with no differences in attention (β=-0.07, P=0.34) and fine motor function (β=0.08, P=0.34). Processing speed showed a strong association with the EF summary score (β=0.60, P<0.001) and partially mediated the relationship between CHD diagnosis and the EF summary score (β=0.37, 95% CI [0.24, 0.50], P<0.001). Adolescents with complex CHD show difficulties in EFs and processing speed. Notably, processing speed is strongly associated with EFs and partly accounts for EFs disparities between patients and healthy controls. Early detection and interventions for processing speed difficulties may improve EF outcomes in these patients.

Relationships between emotion regulation strategies and executive functions in adolescence: Exploring the effects of discrete emotions and age.

Emotion regulation (ER) develops during adolescence and contributes to psychosocial adjustment. Individual differences in the development of ER strategies may be related to cognitive processes responsible for managing goal-directed behaviors, namely executive functions (EFs). This study examined (1) examined how difficulties in specific EFs (i.e., inhibition, flexibility and working memory) predict the use of ER strategies (i.e., reappraisal, distraction, expressive suppression, rumination, support-seeking) in an emotion-specific approach and (2) investigated these links across three different age groups (corresponding to early, middle and late adolescence), considering the nonlinear evolution of the relationships between EF and ER strategies during adolescence. The sample was composed of 1076 adolescents aged from 12 to 19 years old who completed questionnaires on EF difficulties (i.e., inhibition, flexibility, and working memory) and ER strategies (i.e., distraction, reappraisal, expressive suppression, social support-seeking, and rumination). Results showed various complex relationships between EFs and ER. Flexibility issues were related to rumination at all ages, while inhibition and flexibility difficulties were negatively linked to reappraisal in mid- to late adolescence. Many relationships were emotion- and age-dependent. These findings support the link between cognitive and emotional regulatory processes. Its complex evolution during adolescence opens a new avenue for future research.

The implication of sleep disturbances on daily executive functioning and learning problems in children with autism without intellectual disability

BackgroundIndividuals with autism spectrum disorder (ASD) often have sleep disturbances, executive functioning difficulties, and learning problems. The aim of this study was twofold. First, to examine the quality of sleep in children with ASD without intellectual disability and typically developing (TD) children. Second, to explore the implication of sleep disturbances in the association between daily executive functioning and learning problems in children with ASD without intellectual disability. MethodThe sample included 47 children with autism without intellectual disability and 32 TD children. Parent-reported questionnaires were used to assess participants' sleep disturbances, daily executive functions, and learning problems. All statistical analyses performed were adjusted for age, IQ, and medication. ResultsAs expected, the prevalence of sleep disturbances was significantly higher in the ASD group than in the TD group. Regarding the second aim of the study, the total score of sleep disturbances was significantly associated with learning problems and the metacognition subdomain of executive functioning in children with autism without intellectual disability. In turn, executive functions and learning problems were also significantly associated. Finally, sleep disturbances were found to mediate the relationship between global executive functioning and learning problems in children with ASD without intellectual disability. ConclusionsThe findings suggest that sleep disturbances are common in children with autism, and that they play a mediating role in the association between executive functions and learning problems. Therefore, sleep should be a crucial aspect of interventions to improve the learning and academic performance of school-aged children with ASD without intellectual disability.

Longitudinal relations of screen time duration and content with executive function difficulties in South Korean children

ABSTRACT Research has consistently shown that excessive screen time (ST) is harmful to children’s cognitive development including executive function (EF). Most studies have investigated the long-term consequences of excessive ST and have not explored how content impacts cognitive development. Thus, the current study aimed to examine (1) the associations among the duration and content of ST and EF difficulties and (2) the interaction effect of ST duration and content on EF difficulties. A total of 1,484 third-grade children participated in the study and were followed up one year later. ST duration was measured by the average daily hours on smart devices and computers, and ST content was assessed by the extent to which children engaged in educational or recreational ST. EF difficulties were measured by parental reports of their child’s EF-related behaviors. The results showed ST duration did not predict EF difficulties one year later. However, higher levels of educational ST predicted fewer EF difficulties. A significant interaction effect between ST duration and educational ST demonstrated the benefits of educational ST were not present in children with higher levels of duration. These findings provide a foundation to develop more practical, efficient, and specific ST guidelines considering both ST content and duration.

Carer-reported sleep disturbance and carer- and teacher-rated executive functioning in children with prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder

ABSTRACT Children with prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD) have high rates of sleep disturbance and marked difficulties with executive functioning (EF). Sleep disturbance has been associated with poorer EF across development in typically developing children. The contribution of insomnia symptoms and nightmares to EF difficulties in children with PAE and FASD is unclear. The current study examined whether caregiver-reported insomnia symptoms and nightmares predicted difficulties with EF in children with PAE who were assessed at FASD diagnostic clinics. Archival data on 116 children with PAE assessed at FASD diagnostic clinics were extracted from databases. Children were assigned to a preschool-age group (3.1 to 5.9 years, n = 40) and a school-age group (5.9 to 10.9 years, n = 76). Insomnia symptoms and nightmares were measured using items extracted from the Child Behavior Checklist (CBCL) while EF was measured using the caregiver and teacher Behavior Rating Inventory of Executive Function (BRIEF) rating forms. Bootstrapped regression models were used examine the effects of insomnia symptoms and nightmares on domains of EF in each group while adjusting for potential confounds. For preschool children, insomnia symptoms were associated with greater daytime tiredness while nightmares were associated with greater difficulties with Emergent Metacognition according to their teachers. For school-age children, insomnia symptoms predicted greater EF difficulties across most domains according to their caregivers but not teachers. Sleep disturbance may compound EF impairments in children with PAE and should be screened for as part of FASD diagnostic assessment.

An Initial Feasibility Trial of Providing Yoga in School for Children with Additional Support Needs.

Yoga is used widely as a therapeutic tool for physical and mental well-being. However, greater understanding of the effect yoga may have on young people who require additional support for learning is warranted. Therefore, the aim of the present study was to assess the feasibility of delivering and evaluating an 8-week school-based yoga program targeted to children with additional support needs in a mainstream primary school. Data were collected from 11 pupils (aged 4-12) with additional support needs. The Behavior Rating Inventory of Executive Function and Strengths and Difficulties Questionnaire were completed pre- and postintervention by parents and the pupil's schoolteachers. Observation of the yoga class engagement was conducted at baseline, midway through, and at the end of the intervention. A visual adaptation of the Children's Feeling Scale was completed each week pre- and post-yoga class by each student. Qualitative measures, including a parent feedback questionnaire, interview with the yoga instructor, and focus group with the pupil support assistants, were undertaken. The program was delivered as planned. The yoga instructor, parents, and pupil support assistants found the program to be beneficial to the students and a feasible part of their school week. There were no significant differences pre- to postintervention in any scores of the Strengths and Difficulties Questionnaire or Behavior Rating Inventory of Executive Function. Some positive changes in mood were found, although effect sizes were small. This study demonstrates the feasibility of delivering a school-based yoga program for children with additional support needs, as well as a feasible evaluation approach. The overall experiences for pupils, pupil support assistants, and the yoga teacher were positive and suggest that wider implementation and evaluation of the school-based yoga program would be of value.

Executive functioning in child victims of sexual abuse: A multi-informant comparative study

BackgroundResearch examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015). ObjectiveUsing multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex. MethodsThe sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning. ResultsIn comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls. ConclusionThis study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.

부⋅모⋅자녀의 스마트 기기 의존, 가족과 함께하는 시간의 양, 아동 집행기능 곤란의 구조적 관계 탐색

Objectives The purpose of this study was to explore the structural relationships among fathers', mothers', and children's smart devices dependence, the amount of family time spent together, and executive functioning difficulties.&#x0D; Methods Data from 548 pairs of parents and children who responded to all relevant factors in the 13th Korean Child Panel Survey(2020) were analyzed. Reliability analysis for scales, correlation analysis between variables, and descriptive statistics analysis were conducted. Validity was confirmed through measurement model validation, and structural model analysis was conducted by applying the maximum likelihood method (MLB) to the theory-based research model. Afterward, a mediation effect test based on bootstrapping and an individual indirect effect test using phantom variables were conducted.&#x0D; Results The results showed that mothers' dependence on smart devices increased children's dependence on smart devices, and the amount of family time spent together reduced both dependence on smart devices and executive functioning difficulties. In addition, children's smart device dependence increased executive functioning difficulties and mediated the relationship between maternal smart device dependence and children's executive functioning difficulties.&#x0D; Conclusions Exploration of the structural relationships among the study variables confirmed that maternal and child dependence on smartphones and the amount of family time spent together influenced children's executive functioning difficulties.&#x0D;

Effects of Media Device Use on Executive Function Difficulties of Children

Effects of Media Device Use on Executive Function Difficulties of Children

Growing through adversity: the relation of early childhood educator post-traumatic growth to young children's executive function.

Early childhood educators (ECEs) play a critical role in supporting the development of young children's executive functions (EF). EF, in turn, underpins lifelong resilience and well-being. Unfortunately, many ECEs report adverse childhood experiences (ACEs) that may compound high stress levels associated with an emotionally and physically demanding profession. ACEs have well-established negative implications for adult well-being and may dampen ECEs' capacities to engage in emotionally responsive interactions with children. However, many individuals who experience ACEs also report post-traumatic growth experiences that foster empathy, self-determination, and resilience. Such post-traumatic growth may equip teachers with skills to engage in responsive interactions with children that support children's EF. The aim of this study was to explore the relations of ECE ACEs and post-traumatic growth to the EF of children in their classrooms. Fifty-three female ECEs self-reported on their ACEs and post-traumatic growth. Parents of 157 children (53% male, 47% female, M age = 4.38 years) rated children's EF. In a set of linear mixed models that accounted for multiple demographic factors and ECE perceived workplace stressors, ECE ACEs were not significantly related to children's EF scores. However, controlling for ACEs, higher levels of ECE post-traumatic growth were associated with fewer parent-reported EF difficulties in children. ECEs may draw on the coping skills they have developed in times of adversity to model and promote healthy EF for children. Mental health supports to facilitate ECEs' processing of their own trauma may be a fruitful means to foster positive early childhood environments that nurture the well-being and resilience of future generations.

The Synergistic Effects of Preterm Birth and Parent Gender on the Linguistic and Interactive Features of Parent-Infant Conversations.

To investigate the language environments experienced by preterm-born infants, this study compared the linguistic and interactive features of parent-infant conversations involving 2-year-old preterm- and term-born infants. The study also explored how mother-infant and father-infant conversations may be differentially affected by preterm/term birth status. Twenty-two preterm-born (< 37 weeks' gestation) and 25 term-born (≥ 37 weeks' gestation) 2-year-old infants engaged in dyadic mother/father-infant free-play interactions that were transcribed to quantify the linguistic (parental volubility, speech rate, lexical diversity, and morphosyntactic complexity) and interactive (infant/parent responsiveness, turn-taking, and conversational balance) features of parent-infant conversations. Language, cognitive, socioemotional, and executive function skills were assessed via standardized tools. Compared to the term group, the preterm group was characterized by lower maternal speech rate, parental lexical diversity, and parent-infant turn-taking, as well as greater mother-infant conversational balance. The preterm group presented poorer language and executive function skills when compared to the term group. Both similarities and differences exist between the language environments of preterm and term groups. Similarities may be due to the partial developmental catch-up of preterm-born infants (cognitive and socioemotional skills) and parental scaffolding. Differences may partly reflect a parental adaptation to the language and executive function difficulties of preterm-born infants. These findings suggest that researchers/clinicians should appraise the language environment with respect to the unique developmental needs of preterm/term-born infants. Future research directions are provided to advance a more holistic characterization of the language environment and a deeper understanding of the developmental significance of preterm-term differences in such environments. https://doi.org/10.23641/asha.25021931.

Stability of executive function in children born at risk of neonatal hypoglycemia

ABSTRACT Executive function plays an important role in promoting learning and social-emotional development in children. Neonatal hypoglycemia associates with executive function difficulties at 4.5 years, but little is known about the development of executive function over time in children born at risk of neonatal hypoglycemia. We aimed to describe the stability of executive function from early to mid-childhood in children born at risk of neonatal hypoglycemia and its association with neonatal hypoglycemia. Participants in a prospective cohort study of infants born at risk for neonatal hypoglycemia were assessed at ages 2, 4.5, and 9–10 years. We assessed executive function with batteries of performance-based and questionnaire-based measures, and classified children into one of four stability groups (persistent typical, intermittent typical, intermittent difficulty, and persistent difficulty) based on dichotomized scores (typical versus low at each age). Multinomial logistic regression was used to determine the associations between neonatal hypoglycemia and executive function stability groups. Three hundred and nine children, of whom 197 (64%) experienced neonatal hypoglycemia were assessed. The majority of children had stable and typical performance-based (63%) and questionnaire-based (68%) executive function across all three ages. Around one-third (30–36%) of children had transient difficulties, and only a few (0.3–1.9%) showed persistent difficulties in executive function at all ages. There was no consistent evidence of an association between neonatal hypoglycemia and the stability of executive function. Neonatal hypoglycemia does not appear to predict a specific pattern of development of executive function in children born at risk.

Speech Acts as a Window to the Difficulties in Instrumental Activities of Daily Living: A Qualitative Descriptive Study in Mild Neurocognitive Disorder and Healthy Aging.

Executive functions (EF) are central to instrumental activities of daily living (IADL). A novel approach to the assessment of the impact of EF difficulties on IADL may be through the speech acts produced when performing IADL-inspired tasks in a laboratory-apartment. Speech acts may act as a window to the difficulties encountered during task performance. We aim to 1) qualitatively describe the speech acts produced by participants with mild neurocognitive disorder (mild NCD) and healthy controls (HC) as they performed 4 IADL-inspired tasks in a laboratory-apartment, and to then 2) compare their use in both groups. The participants' performance was videotaped, and speech acts produced were transcribed. Qualitative description of all speech acts was performed, followed by a deductive-inductive pattern coding of data. Statistical analyses were performed to further compare their use by mild NCD participants and HC. Twenty-two participants took part in the study (n mild NCD = 11; n HC = 11). Meta-categories of data emerged from pattern coding: strategies, barriers, reactions, and consequences. Mild NCD participants used significantly more strategies and barriers than did HC. They were more defensive of their performance, and more reactive to their difficulties than HC. Mild NCD participants' verification of having completed all tasks was less efficient than controls. An assessment of speech acts produced during the performance of IADL-inspired tasks in a laboratory-apartment may allow to detect changes in the use of language which may reflect EF difficulties linked to cognitive decline.

Martial Arts as a Tool for Enhancing Attention and Executive Function: Implications for Cognitive Behavioral Therapy – A Literature Review

ABSTRACT With a focus on its implications for cognitive behavioral therapy (CBT), this review study seeks to investigate the possible advantages of martial arts training on attention and executive function. Common cognitive impairments seen in a variety of psychiatric diseases, such as depression and attention deficit hyperactivity disorder, include difficulties in attention and executive function. Training in martial arts, which is known for its demanding physical and mental requirements, has drawn interest as a potential intervention for improving cognitive function. An overview of the most recent research on how martial arts training affects focus and executive function is given in this publication. The results demonstrate the potential of martial arts as a strategy for enhancing executive function and attention-related cognitive functions. The article also explores the implications of adding martial arts instruction to CBT therapies, arguing that doing so might be a beneficial supplementary strategy to improve treatment outcomes. With information on the possible advantages of martial arts training for attention and executive function, this review paper adds to the expanding corpus of research on non-pharmacological therapies for cognitive enhancement.

맞벌이 부모의 일-가정 양립 이점과 갈등이 아동의 집행기능곤란과 자아존중감을 통해 그릿에 미치는 영향: 자기회귀교차지연모델을 적용한 종단연구

맞벌이 부모의 일-가정 양립 이점과 갈등이 아동의 집행기능곤란과 자아존중감을 통해 그릿에 미치는 영향: 자기회귀교차지연모델을 적용한 종단연구

Cognitive-Motor Training Improves Reading-Related Executive Functions: A Randomized Clinical Trial Study in Dyslexia.

Children with developmental dyslexia (DD) often struggle with executive function difficulties which can continue into adulthood if not addressed. This double-blinded randomized clinical trial study evaluated the short-term effects of the Verbal Working Memory-Balance (VWM-B) program on reading-related executive functions, reading skills, and reading comprehension in Persian children with DD. The active control group [12 children with DD with a mean age of 9 years (SD = 0.90)] received training using the single-task VWM program, while the experiment group [15 children with DD with a mean age of 8 years (SD = 0.74)] received training with the dual-task VWM-B program. Both groups received fifteen training sessions, and assessments were conducted before and after the intervention. The groups were homogenized for possible confounders of age, gender, IQ level, and attention level. The study employed separate mixed ANOVA analyses to estimate the impact of training programs on various measured functions. Significant improvements were observed in the outcome measures of backward digit span, text comprehension, verbal fluency, Stroop color-word test and interference, and the reading subtests. Additionally, significant correlations were found between reading skills and backward digit span, text comprehension, verbal fluency, and Stroop variables. In conclusion, the dual-task VWM-B program was found to be more effective than the single-task VWM program in improving selective attention, cognitive inhibition, verbal working memory capacity, information processing speed, naming ability, and lexical access speed. These enhanced executive functions were associated with improved reading skills in children with DD.

Patterns of executive functions and theory of mind in adults with a family history of alcohol use disorder: Combined group and single-case analyses.

Impairments in executive function and social cognition are highly prevalent in individuals with an alcohol use disorder (AUD). Some studies show that similar difficulties are displayed by individuals with a positive family history of AUD (FH+) compared with individuals with a negative family history (FH-). Yet, no studies have jointly investigated cognitive and affective theory of mind at the behavioral level. Moreover, some studies show preserved executive and socioemotional functioning in FH+ participants. One possible explanation for these divergent results is that FH+ individuals are cognitively heterogeneous. In this study, we examined the frequency and co-occurrence of difficulties in executive function and social cognition among FH+ individuals at the individual level. Sixty FH+ and 60 FH- participants matched on age, sex, and education level were included. They completed tasks assessing executive functions (Stroop, Trail Making Test) and affective and cognitive theory of mind (Movie for the Assessment of Social Cognition). They also completed self-report questionnaires measuring impulsivity, alexithymia, and empathy. Single-case analyses assessed the proportion of FH+ participants with difficulties in executive function and/or theory of mind. FH+ individuals exhibited difficulties in response inhibition and made more errors during theory of mind processing, indicating an absence of mental state representation, compared with FH- individuals. In the FH+ sample, 53.33% had executive function and/or theory of mind difficulties. Those with lower theory of mind scores reported higher alexithymia and lower empathy on self-report measures. FH+ individuals display heterogeneous executive function and theory of mind abilities. Given that they mostly occur independently of one another, executive function and theory of mind difficulties may be distinct vulnerability markers in AUD.