Executive Function Problems Research Articles

注意缺陷多动障碍儿童的执行功能与行为问题的相关研究

注意缺陷多动障碍儿童的执行功能与行为问题的相关研究

Everyday executive function and adaptive skills in children and adolescents with autism spectrum disorder: Cross-sectional developmental trajectories

Background and aims The development of Executive Function in Autism Spectrum Disorder has been investigated using mainly performance-based executive function measures. Less is known about the development of everyday executive function skills. The present study aimed to identify the developmental patterns of everyday executive function of children and adolescents with autism spectrum disorder compared to neurotypical controls. The association between executive function and adaptive skills was also investigated. Methods The present study used a cross-sectional developmental trajectory approach and data were collected from 57 children and adolescents with autism spectrum disorder, matched to 63 controls of the same age (7–15 years). Results Results showed age-related performance declines in most everyday executive function domains (e.g. inhibition, working memory, planning) in autism spectrum disorder, whereas for executive function emotional control and shift, non-significant differences emerged across age in autism spectrum disorder. Everyday executive function predicted adaptive skills over and above age and IQ, in participants overall. Conclusions and implications These results suggest that several everyday executive function problems increase in adolescence in autism spectrum disorder and that these everyday executive function developmental patterns deviate to a great extent from those of typical development. Shedding more light on the developmental course of all types of executive function processes as well as their association with crucial social outcomes in autism spectrum disorder could contribute to a better theoretical understanding of the heterogeneity of the neurocognitive development in autism spectrum disorder.

Executive functions in children with developmental coordination disorder: a 2-year follow-up study.

Executive function impairments have been identified in children with poor motor skills, with and without a diagnosis of developmental coordination disorder (DCD). However, most studies are cross-sectional. This study investigates the development of executive function in children with poor motor skills over 2 years. Children aged 7 to 11 years (n=51) were assessed twice, 2 years apart, on verbal and nonverbal measures of executive functions: executive-loaded working memory (ELWM); fluency; response inhibition; planning; and cognitive flexibility. Typically developing children (n=17) were compared with those with a clinical diagnosis of DCD (n=17) and those with identified motor difficulties (n=17) but no formal diagnosis of DCD. Developmental gains in executive function were similar between groups, although a gap between children with poor motor skills and typically developing children on nonverbal executive functions persisted. Specifically, children with DCD performed significantly more poorly than typically developing children on all nonverbal executive function tasks and verbal fluency tasks at both time points; and children with motor difficulties but no diagnosis of DCD showed persistent executive function problems in nonverbal tasks of ELWM and fluency. Children with DCD and motor difficulties demonstrated executive function difficulties over 2 years, which may affect activities of daily living and academic achievement, in addition to their motor deficit. Executive function difficulties in children with poor motor skills persist throughout middle childhood. Children with motor difficulties, without a developmental coordination disorder (DCD) diagnosis, demonstrate less pervasive executive function difficulties than those with DCD. Executive function problems in the groups with motor difficulties and DCD affect mostly nonverbal domains. All groups showed similar developmental gains in executive function.

Executive functioning, academic skills, and quality of life in pediatric patients with brain tumors post-proton radiation therapy.

Radiation therapy (RT) is integral in the treatment of pediatric brain tumors; however, photon RT (XRT) often results in intellectual decline, executive functioning (EF) deficits, academic underachievement/failure, and lower health-related quality of life (HRQoL). Proton RT (PRT) provides more targeted therapy, minimizing damage to the developing brain, yet few studies have examined its neuropsychological effects. This study investigated the role of EF in academic skills and HRQoL in a sample of children treated with PRT. A mediation model was proposed in which academic skills mediated relations between aspects of EF and school-based HRQoL (sHRQoL). Sixty-five children (x̅age = 12.4; 43.9% male) treated with PRT completed follow-up neuropsychological testing as part of routine care. Measures included assessment of intellectual functioning, EF, attention, and academic skills (reading, math, spelling). Parents reported on children's EF and attention problems. sHRQoL was assessed via child self-report. Children who underwent PRT demonstrated relatively intact intelligence, academics, attention, EF, and sHRQoL, but were at risk for reduced processing speed. Poorer working memory and processing speed were related to lower sHRQoL. Better EF and faster processing speed were associated with better academic skills, which were linked to higher sHRQoL. Better working memory was associated with better math performance, which was linked to higher sHRQoL; this relationship did not hold for reading or spelling. Results highlight the importance of EF skills in academic performance and sHRQoL, and the need for routine screening of EF deficits and proactive supports. Supports may include cognitive rehabilitation and in-class accommodations. Overall, results compare favorably to XRT outcomes reported in the literature.

Group-based intervention on attention and executive functions in the school context

The objective of the study was to examine the effects of a group-based behavioural, cognitive and skills training intervention (Maltti) provided in schools for elementary school pupils with attention and executive function (EF) deficits. The treatment effects were identified by comparing an intervention group (n = 46) with a waitlist control group (n = 26). Specific effects of the intervention on behavioural deficits in attention and EF in a classroom setting as well as on academic skills were examined. Our analysis indicated that significant intervention effects could be found in the behavioural manifestation of attentional and executive skills in the classroom setting among children (n = 30) who were evaluated as having moderate symptoms in the pre-intervention assessment. Positive effects of the intervention were also observed in arithmetic and reading skills. The severity level of pre-intervention attention and EF deficits did not moderate the results observed in the academic skills tests. The results of this study suggest that a combination of behavioural, cognitive and skills training methods applied in a school context can be effective in reducing attention and EF problems and enhancing the academic performance of children with attention and EF deficits.

Cognition and behaviour in children with congenital abdominal wall defects

AimTo characterise neurodevelopment at age two years and cognition and behaviour at age five years in children born with abdominal wall defects (gastroschisis or exomphalos). Study designParticipants were treated as neonates for gastroschisis or exomphalos and invited for routine clinical follow-up at ages two and five years. Thirty-nine two year-olds and 20 five year-olds with gastroschisis and 20 two year-olds and 10 five year-olds with exomphalos returned for age-appropriate assessments of development (two years) and intellectual functioning (IQ), executive function, and behavioural problems. Results were compared with normative data from the tests and published data from local term-born children. ResultsFor both gastroschisis and exomphalos two year-olds, neurodevelopment was in line with the test normative data, but below the level of local normative data for all domains (effect sizes from −0.4 to −1.4 standard deviations). At five years, children with gastroschisis performed similarly to the normative mean for IQ but had high rates of various executive functioning problems on parent report (18–41% compared with 7% expected from norms). There was also a tendency for increased frequency of internalising problems (33% compared with normative expectation of 16%). Five year-olds with exomphalos also performed similarly to the normative mean for IQ and had low rates of executive and behavioural problems. ConclusionsSurvivors of gastroschisis and exomphalos may be at risk of poor neurodevelopment in toddlerhood, depending on the reference group, and children with gastroschisis may be particularly at risk for executive functioning difficulties despite an IQ within normal limits.

INTERVENCIÓN EN FUNCIONES EJECUTIVAS EN EDUCACIÓN INFANTIL

Abstract.INTERVENTION IN EXECUTIVE FUNCTIONS IN EARLY CHILDHOOD EDUCATIONExecutive functions defined as the set of higher-order cognitive processes that allow an intentional and directed behavior towards a goal, are vital for success in life, at school, and at work. Improving executive functions in the early stages is very important because problems in executive functioning, in the preschool stage, predict cognitive achievement in later stages and have a central role in school readiness and in the first academic skills acquisition. Recent studies have found positive relationships between executive functioning capacities and math readiness in preschoolers. Likewise, an extensive bibliography suggests an inverse relationship between executive functions and aggressive behavior in humans. For this reason, the objective of this research is to conduct a review of the programs and activities aimed at improving the executive functions in the preschool stage. Various activities and programs have been shown to improve children executive functions, such as computer games, martial arts, yoga, mindfulness and programs included in the school curriculum. The results of studies conducted on the implementation of some of the above activities or programs are promising and suggest that different strategies can be useful in improving executive functions during the preschool years.Key words: executive functions, early childhood education, evaluation, Intervention, development, inhibitory control, working memory, cognitive flexibility.Resumen.Las funciones ejecutivas definidas como el conjunto de procesos cognitivos de orden superior que permiten un comportamiento intencional y dirigido hacia un objetivo, son vitales para el éxito en la vida, en la escuela, y en el trabajo. Mejorar las funciones ejecutivas en las primeras etapas es muy importante porque los problemas en el funcionamiento ejecutivo, en la etapa preescolar, predicen los logros cognitivos en etapas posteriores y tienen un papel central en la preparación escolar y en la adquisición de las primeras habilidades académicas. Estudios recientes han encontrado relaciones positivas entre las capacidades de funcionamiento ejecutivo y la preparación de matemáticas en niños en edad preescolar. Igualmente, una extensa bibliografía sugiere una relación inversa entre las funciones ejecutivas y la conducta agresiva en los seres humanos. Por esta razón, el objetivo de la presente investigación es realizar una revisión de los programas y actividades destinados a la mejora de las funciones ejecutivas en la etapa preescolar. Diversas actividades y programas han demostrado mejorar las funciones ejecutivas de los niños, tales como los juegos computarizados, las artes marciales, el yoga, la atención plena y los programas incluidos en el currículum escolar. Los resultados de los estudios realizados sobre la aplicación de algunas de las actividades o programas mencionados son prometedores y sugieren que las diferentes estrategias pueden ser útiles para mejorar las funciones ejecutivas durante el período preescolar.Palabras clave: funciones ejecutivas, educación infantil, intervención, desarrollo, control inhibitorio, memoria de trabajo, flexibilidad cognitiva.

Association between psychological distress, subjective cognitive complaints and objective neuropsychological functioning in brain tumor patients

ObjectivesPsychological distress and cognitive impairment are common complications in patients with brain tumors that are associated with poor quality of life and worse prognosis. This pilot study aimed to evaluate the associations between psychological distress, subjective cognitive complaints and baseline neuropsychological performance of brain tumor patients before neurosurgery. Patients and methodsSixty-two patients with various brain tumors referred for routine neuropsychological assessment 2–3days before neurosurgery participated in the study. Short neuropsychological assessment battery was used to evaluate attention and executive functions, memory and verbal fluency. Presence of cognitive complaints was evaluated during neuropsychological interview using standardized symptoms checklist. Level of psychological distress was assessed using the Hospital Anxiety and Depression Scale. ResultsVarious attention and executive function problems were reported by 13–58% patients; memory problems by 8–63%; language problems by 10–58% of patients. 36–57% of patients scored below 5th percentile on objective memory measures; 32–45% on attention measures and 11–27% on verbal fluency. However, correlation between objective neuropsychological findings and subjective cognitive complaints was weak, ranging from 0.0 to 0.3. 45% of patients met criteria for increased psychological distress. Psychological distress was associated with subjective cognitive complaints but failed to predict objective neuropsychological findings. Brain tumor histological diagnosis, side and location were not related to neuropsychological functioning. ConclusionCognitive impairment and psychological distress are highly prevalent in BT patients before neurosurgery. Although depression and distress may adversely impact quality of life and prognosis of BT patients, our current findings do not confirm that distress has strong negative impact on objective preoperative cognitive functioning. However, it is related to worse subjective evaluation of one’s cognitive abilities. Therefore, objective neuropsychological assessment of cognitive functions is highly recommended despite concern.

Mediated pathways from maternal depression and early parenting to children's executive function and externalizing behaviour problems

AbstractStructural equation models were used to examine pathways from maternal depression and early parenting to children's executive function (EF) and externalizing behaviours in the first nationally representative study to obtain direct assessments of children's kindergarten EF skills (i.e., the Early Childhood Longitudinal Study Kindergarten Class of 2010–2011). Preliminary analyses revealed that maternal depression was negatively related to children's EF and positively related to children's externalizing behaviour problems. However, the negative association between maternal depression and children's EF was completely mediated by maternal parenting practices (i.e., warmth and home learning stimulation). Furthermore, there was an indirect effect from maternal parenting practices to children's externalizing behaviour problems through EF, such that children with stronger EF skills had fewer externalizing behaviour problems. Findings provide support for a family process model in which warm, cognitively stimulating parenting supports children's EF, which in turn decreases externalizing behaviours.Highlights This study examined pathways from parent mental health to children's executive function (EF) and behaviour problems. Maternal depression was negatively related to children's EF and positively related to children's behaviour problems. The negative association between maternal depression and children's EF was completely mediated by maternal parenting. There was an indirect effect from maternal parenting to children's behaviour problems through EF.

Child and parental executive functioning in type 1 diabetes: Their unique and interactive role toward treatment adherence and glycemic control.

Managing type 1 diabetes (T1D) requires the ability to make complex and critical decisions regarding treatment, to execute complex tasks accurately, and to make adjustments when problems arise. This requires effective neuropsychological competences of patients and their families, especially in the domain of executive functioning (EF): the ability to self-monitor, plan, solve problems, and set priorities. Previous research focused mainly on child EF, neglecting the impact of parental EF. This study included both mothers and fathers and examined associations between child and parental EF and treatment adherence to T1D in a broad age range of patients. Parents of 270 patients (6-18 years) with T1D (mean age 12.7 years; 52.6% female) were included. Mothers (N = 232) and fathers (N = 168) completed questionnaires on child and parental EF and on treatment adherence. Analyses examined the associations linking child and parental EF to treatment adherence and glycemic control (and potential moderation effects in these associations) using hierarchical linear regression. Child EF problems were negatively associated with treatment adherence. As an indication of moderation, this effect was stronger in older children. Better treatment adherence and glycemic control were reported when both child and parent showed less EF problems. Effects were more pronounced in mothers than in fathers. This study demonstrated a significant interplay between child and parental EF in the association with treatment adherence and glycemic control. Researchers and clinicians should remain attentive toward the role of neuropsychological concepts such as EF. Implementation in clinical practice seems meaningful.

Boys with Oppositional Defiant Disorder/Conduct Disorder Show Impaired Adaptation During Stress: An Executive Functioning Study

Evidence for problems in executive functioning (EF) in children with oppositional defiant disorder/conduct disorder (ODD/CD) is mixed and the impact stress may have on EF is understudied. Working memory, sustained attention, inhibition and cognitive flexibility of boys with ODD/CD (n = 65) and non-clinical controls (n = 32) were examined under typical and stressful test conditions. Boys with ODD/CD showed impaired working memory under typical testing conditions, and impairments in working memory and sustained attention under stressful conditions. In contrast to controls, performance on sustained attention, cognitive flexibility and inhibition was less influenced by stress in boys with ODD/CD. These results suggest that boys with ODD/CD show impairments in adaptation to the environment whereas typically developing boys show adaptive changes in EF.

Assessment of executive functioning in binge-eating disorder independent of weight status.

Executive functioning (EF) problems may serve as vulnerability or maintenance factors for Binge-Eating Disorder (BED). However, it is unclear if EF problems observed in BED are related to overweight status or BED status. The current study extends this literature by examining EF in overweight and normal-weight BED compared to weight-matched controls. Participants were normal-weight women with BED (n = 23), overweight BED (n = 32), overweight healthy controls (n = 48), and normal-weight healthy controls (n = 29). The EF battery utilized tests from the National Institutes of Health (NIH) Toolbox and Delis-Kaplan Executive Function System (D-KEFS). After controlling for years of education and minority status, overweight individuals performed more poorly than normal-weight individuals on a task of cognitive flexibility requiring generativity (p < .01), and speed on psychomotor performance tasks (p = .01). Normal-weight and overweight BED performed worse on working memory tasks compared to controls (p = .04). Unexpectedly, normal-weight BED individuals out-performed all other groups on an inhibitory control task (p < .01). No significant differences were found between the four groups on tasks of planning. Regardless of weight status, BED is associated with working memory problems. Replication of the finding that normal-weight BED is associated with enhanced inhibitory control is needed.

Parent–child relationships and child executive functioning at school entry: the importance of fathers

ABSTRACTThis study aimed to examine the unique and interactive contributions of the quality of mothers’ and fathers’ relationships with their toddlers to the prediction of children’s subsequent executive functioning (EF). The sample included 46 low-risk middle-class families. The quality of mother–child and father–child interactions was assessed independently during separate interactive sequences at 18 months. Child EF problems were reported by teachers in kindergarten. The results indicated that only father–child interactions made a unique contribution to the prediction of children’s EF, and no interaction effect was observed. Kindergarteners who benefited from higher quality interactions with their fathers in toddlerhood were considered by their teachers to present fewer EF problems in everyday school situations. These results appeared to be somewhat more pronounced in father–son than father–daughter dyads. Overall, the results suggest that fathering and father–child relationships may deserve more empirical attention than they have received thus far in the EF literature.

Planning ability impairments in probable Alzheimer's disease patients: Evidence from the Tower of London test.

Alzheimer's disease (AD) is associated with progressive impairment of higher-level cognitive abilities. Previous research suggests that early impairment of executive functions occurs during the course of the disease, but few studies have specifically investigated planning ability in an AD population.ObjectiveThe purpose of the current study was to examine whether AD patients retain the ability to plan ahead, by analyzing specificities of their behavior in successfully achieving a pre-established goal.MethodsTwenty-one AD patients and thirty-three elderly controls underwent a problem-solving assessment using the Tower of London (TOL) test.ResultsAD patients were less accurate and less efficient than controls. AD patients also committed more mistakes. This indicates a decline in working memory and inhibitory deficits, resulting in impulsive and inappropriate behaviors.ConclusionThese results are in agreement with previous studies, showing executive function problems in patients with AD. Specifically, this study demonstrates the presence of planning ability deficits in AD, considering both qualitative and quantitative approaches. The wide range of analysis presented in this study can aid clinicians in identifying the nature of the poor performance of AD patients during a planning task.

Single‐trial EEG‐informed fMRI analysis of emotional decision problems in hot executive function

BackgroundExecutive function refers to conscious control in psychological process which relates to thinking and action. Emotional decision is a part of hot executive function and contains emotion and logic elements. As a kind of important social adaptation ability, more and more attention has been paid in recent years.ObjectiveGambling task can be well performed in the study of emotional decision. As fMRI researches focused on gambling task show not completely consistent brain activation regions, this study adopted EEG‐fMRI fusion technology to reveal brain neural activity related with feedback stimuli.MethodsIn this study, an EEG‐informed fMRI analysis was applied to process simultaneous EEG‐fMRI data. First, relative power‐spectrum analysis and K‐means clustering method were performed separately to extract EEG‐fMRI features. Then, Generalized linear models were structured using fMRI data and using different EEG features as regressors.ResultsThe results showed that in the win versus loss stimuli, the activated regions almost covered the caudate, the ventral striatum (VS), the orbital frontal cortex (OFC), and the cingulate. Wide activation areas associated with reward and punishment were revealed by the EEG‐fMRI integration analysis than the conventional fMRI results, such as the posterior cingulate and the OFC. The VS and the medial prefrontal cortex (mPFC) were found when EEG power features were performed as regressors of GLM compared with results entering the amplitudes of feedback‐related negativity (FRN) as regressors. Furthermore, the brain region activation intensity was the strongest when theta‐band power was used as a regressor compared with the other two fusion results.ConclusionsThe EEG‐based fMRI analysis can more accurately depict the whole‐brain activation map and analyze emotional decision problems.

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

ABSTRACTWhile previous randomised controlled trials and meta-analyses offer only limited evidence for the effectiveness of cognitive rehabilitation, qualitative studies examining patient perspectives report more positive outcomes. This meta-synthesis of qualitative studies examined patient perspectives of cognitive rehabilitation for memory, attention, and executive function problems in people with multiple sclerosis. Using set eligibility criteria, we screened electronic databases, reference lists, and academic networks for relevant papers. Seven papers (195 participants) were selected. Two independent researchers conducted quality appraisals of papers. Data analysis, guided by the thematic synthesis approach, yielded six main themes. These suggested that patients benefitted from the group environment in rehabilitation. Cognitive rehabilitation facilitated the participants’ reflection and awareness of their cognitive deficits, and was associated with increased knowledge and understanding of their illness. Increased strategy use was reported and associated with improvements in cognitive functioning and greater confidence and perseverance. Participants reported emotional and social improvements, and felt more optimistic. Overall, these changes had a positive impact on participants’ quality of life. This synthesis of qualitative studies indicates that people with multiple sclerosis who experience cognitive deficits benefit from cognitive rehabilitation programmes. This finding must, however, be viewed in light of the limitations of this meta-synthesis. The meta-synthesis was registered in the PROSPERO database under CRD42017040148.

Specificity of executive functioning and processing speed problems in common psychopathology.

Interest continues in neuropsychological measures as cross-disorder intermediate phenotypes in understanding psychopathology. A central question concerns their specificity versus generalizability to particular forms of psychopathology, particularly for executive functioning (EF) and response speed. Three conceptual models examining these relationships were tested to clarify this picture at different levels in the diagnostic hierarchy. Participants (total n = 641, age 18-60) yielded complete structured diagnostic interviews and a neuropsychological test battery comprising measures of executive function, processing speed, and IQ. Repeated measures multivariate analysis of variance, linear regression, and structural equation modeling (SEM) were used to test (a) a specificity model, which proposes that individual disorders are associated with component EF processes and speed; (b) a severity model, which proposes that the total number of comorbid disorders explain poor EF and/or slow speed; and (c) a higher-order dimensional model, which proposes that internalizing versus externalizing disorders are differentially related to EF or speed. EF effects were best explained by a specificity model, with distinct aspects of EF related to attention deficit hyperactivity disorder versus antisocial substance use disorders. Speed, on the other hand, emerged as a general indicator of externalizing psychopathology in the dimensional model, as well as overall severity of psychopathology in the severity model. Granular approaches are likely to be most productive for linking EF to psychopathology, whereas response speed has underused potential as an endophenotype for psychopathology liability. Results are discussed in terms of an integrated conceptualization of neuropsychological processes and putative neural systems involved in general and specific aspects of psychopathology. (PsycINFO Database Record

Dépression de la personne âgée ou maladie d’Alzheimer prodromique : quels outils pour le diagnostic différentiel ?

IntroductionDepression and Alzheimer's disease are both very frequent in elderly people. Cognitive deficits are the hallmark of Alzheimer's disease, but they are also common in depressed elderly people who often present cognitive deficits such as memory, attention and executive function problems. On the other hand, people with early Alzheimer's disease demonstrate emotional and behavioral disorders generally encountered in depression such as loss of energy, apathy, mood disorder, and irritability. Thus, in older adults with depression, the presence of cognitive deficits can make it difficult to distinguish cognitive decline that is associated with a depressive illness and the decline encountered in Alzheimer's disease because the clinical picture of the two disorders are similar. However, early distinction between the two disorders is very important from a prognostic and therapeutical point of view. ObjectiveAfter a brief description of the relationship between depression and early Alzheimer's disease in elderly people, this paper aims to present an updated literature review of data on differential diagnoses between these disorders. MethodWe performed a non-systematical, yet as exhaustive as possible, literature search with Pubmed electronic database, screening studies from 2000 to 2016. ResultsThe majority of the studies concerned cognitive aspects, but only a few studies investigated others markers such as cerebral imaging, electroencephalography, cerebrospinal fluid markers. At the neuropsychological examination, a detailed analysis of the mnesic profile revealed a better benefit of semantic cueing in patients with late life depression in comparison to those with prodromal Alzheimer's disease and better performances in recognition memory. Moreover, longitudinal follow-up of patients with depression indicated that deficits in delayed recall memory, but not in executive functions, were associated with the subsequent development of Alzheimer's disease. Several studies showed that tests of executive functions could not differentiate between patients with late life depression and patients with prodromal Alzheimer's disease. A measure of global cognitive decline does not seem to be helpful in differentiating early Alzheimer's disease and depression, unlike an analysis of the neuropsychological profile on several composite scales, such as the Mini Mental State Examination. Furthermore, recent work has investigated the utility of olfactory or gustative markers with promising results and convenient tools for clinical practice. Concerning morphological brain imaging, only detailed volumetric analysis could show differences between the two diseases, but these techniques are not always available for clinical practice. It is the same for other recent techniques, such as quantitative electroencephalography, Near InfraRed Spectroscopy, Single Photon Emission Computed Tomography, or Transcranial Doppler Ultrasonography, which have received little attention so far as differential diagnostic tools. Finally, cerebrospinal fluid analysis could be useful, including beta amyloid levels. ConclusionDespite numerous efforts in recent years, differential diagnosis of dementia from depression in the elderly remains difficult. Results of this review highlight the necessity of conducting more research in this area, with multi-method studies, using not only cognitive analysis but also cerebral imaging techniques.

The mediating roles of cortisol reactivity and executive functioning difficulties in the pathways between childhood histories of emotional insecurity and adolescent school problems.

This study tested a hypothesized cascade in which children's insecure representations of the interparental relationship increase their school problems by altering children's cortisol reactivity to stress and their executive functioning. Participants included 235 families. The first of five measurement occasions occurred when the children were in kindergarten (M age = 6 years), and they were followed through the transition to high school. The results indicated that children's histories of insecure representations of the interparental relationship during the early school years were associated with executive functioning difficulties in adolescence (M age = 14 years). This in turn predicted subsequent increases in school adjustment difficulties 1 year later. In addition, elevated cortisol reactivity to interadult conflict mediated the association between early histories of insecurity and subsequent executive function problems in adolescence.

Cortical morphology as a shared neurobiological substrate of attention-deficit/hyperactivity symptoms and executive functioning: a population-based pediatric neuroimaging study.

Attention-deficit/hyperactivity symptoms have repeatedly been associated with poor cognitive functioning. Genetic studies have demonstrated a shared etiology of attention-deficit/hyperactivity disorder (ADHD) and cognitive ability, suggesting a common underlying neurobiology of ADHD and cognition. Further, neuroimaging studies suggest that altered cortical development is related to ADHD. In a large population-based sample we investigated whether cortical morphology, as a potential neurobiological substrate, underlies the association between attention-deficit/hyperactivity symptoms and cognitive problems. The sample consisted of school-aged children with data on attention-deficit/hyperactivity symptoms, cognitive functioning and structural imaging. First, we investigated the association between attention-deficit/ hyperactivity symptoms and different domains of cognition. Next, we identified cortical correlates of attention-deficit/hyperactivity symptoms and related cognitive domains. Finally, we studied the role of cortical thickness and gyrification in the behaviour-cognition associations. We included 776 children in our analyses. We found that attention-deficit/hyperactivity symptoms were associated specifically with problems in attention and executive functioning (EF; b = -0.041, 95% confidence interval [CI] -0.07 to -0.01, p = 0.004). Cortical thickness and gyrification were associated with both attention-deficit/hyperactivity symptoms and EF in brain regions that have been previously implicated in ADHD. This partly explained the association between attention-deficit/hyperactivity symptoms and EF (bindirect = -0.008, bias-corrected 95% CI -0.018 to -0.001). The nature of our study did not allow us to draw inferences regarding temporal associations; longitudinal studies are needed for clarification. In a large, population-based sample of children, we identified a shared cortical morphology underlying attention-deficit/hyperactivity symptoms and EF.