The relationship between executive function and fine motor control in young and older adults

The present study examined the relationship between executive function (EF) and fine motor control in young and older healthy adults. Participants completed 3 measures of executive function; a spatial working memory (SWM) task, the Stockings of Cambridge task (planning), and the Intra-Dimensional Extra-Dimensional Set-Shift task (set-shifting). Fine motor control was assessed using 3 subtests of the Purdue Pegboard (unimanual, bimanual, sequencing). For the younger adults, there were no significant correlations between measures of EF and fine motor control. For the older adults, all EFs significantly correlated with all measures of fine motor control. Three separate regressions examined whether planning, SWM and set-shifting independently predicted unimanual, bimanual, and sequencing scores for the older adults. Planning was the primary predictor of performance on all three Purdue subtests. A multiple-groups mediation model examined whether planning predicted fine motor control scores independent of participants’ age, suggesting that preservation of planning ability may support fine motor control in older adults. Planning remained a significant predictor of unimanual performance in the older age group, but not bimanual or sequencing performance. The findings are discussed in terms of compensation theory, whereby planning is a key compensatory resource for fine motor control in older adults.     

The mediating effect of adaptive and maladaptive emotion regulation strategies on executive functioning impairment and depressive symptoms among adolescents

Past research results suggest that executive functioning (EF) impairment represents an important vulnerability factor in depression. Little research, however, has examined mechanisms underlying this association. The current study investigates the associations between EF impairment, emotion regulation (ER) strategies, and depressive symptoms in a sample of 579 adolescents (320 females, mean age = 12.06 years). Parents reported on adolescents’ EF and general psychopathology, and adolescents self-reported ER strategies and depressive symptoms. The results indicate that greater EF impairment is associated with more depressive symptoms. Youth with greater EF impairment reported more maladaptive ER and less adaptive ER, and maladaptive and adaptive ER strategies jointly mediated the association between EF impairment and depressive symptoms. The results highlight an important role of both maladaptive and adaptive ER in explaining the relationship between EF and depressive symptoms and suggest that clinical interventions targeting ER skills may provide one strategy for the prevention and treatment of depression. Further longitudinal research is needed to replicate these results and evaluate the causality of the relations.     

Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales

This study aimed to analyze performance on measures of neuropsychological and behavioral executive functions (EF) in adolescents with attention deficit hyperactivity disorder (ADHD), and to evaluate the utility of performance-based tests for predicting scores on behavioral EF ratings. One hundred eighteen adolescents (75 ADHD and 43 controls) aged 12–16 years performed neuropsychological tests and completed a behavior rating scale of EF. The ADHD group presented significantly lower scores than controls on Full Scale IQ (FSIQ) and all indexes of the WISC-IV, except the verbal comprehension index (VCI). The ADHD group had significantly lower scores on performance-based tests of working memory, planning and inhibition, and on EF rating scales. Scores on the cognitive EF working memory, planning and flexibility modestly predicted performance on behavioral EF. The results suggest that the combined use of performance-based tests and rating scales provides valuable complementary information that can improve the assessment of executive domains in ADHD.     

Executive functioning in individuals with a history of ASDs who have achieved optimal outcomes

Executive functioning (EF) is examined among children and adolescents once diagnosed with an autism spectrum disorder (ASD), but who no longer meet diagnostic criteria. These individuals have average social and language skills, receive minimal school support and are considered to have achieved “optimal outcomes” (OOs). Since residual impairments in these individuals might be expected in deficits central to autism, and in developmentally advanced skills, EF was examined in 34 individuals who achieved OOs, 43 individuals with high-functioning autism (HFA), and 34 typically developing (TD) peers. Groups were matched on age (M = 13.49), gender, and nonverbal IQ (NVIQ) but differed on verbal IQ (VIQ; HFA < TD, OO). On direct assessment, all three groups demonstrated average EF; however, the OO and HFA groups exhibited more impulsivity and less efficient planning and problem-solving than the TD group, and more HFA participants exhibited below average inhibition than did OO and TD participants. Parent-report measures revealed average EF among the OO and TD groups; however, the OO group exhibited more difficulty than the TD group on set-shifting and working memory. HFA participants demonstrated more difficulty on all parent-reported EF domains, with a clinical impairment in attention-shifting. Results suggest that EF in OO appears to be within the average range, even for functions that were impaired among individuals with HFA. Despite their average performance, however, the OO and TD groups differed on measures of impulsivity, set-shifting, problem-solving, working memory, and planning, suggesting that the OO group does not have the above-average EF scores of the TD group despite their high-average IQs.     

A longitudinal study of processes predicting the specificity of autobiographical memory in the adolescent offspring of depressed parents

Deficits in specific autobiographical memory retrieval are closely associated with depression. The ability to retrieve specific autobiographical memories develops throughout childhood and adolescence and is associated with adolescent depression within and across time. Studying young samples before they first experience depression provides an approach for testing processes that underlie reduced autobiographical memory specificity. This study is the first to examine the longitudinal association of rumination and executive function with autobiographical memory specificity in a sample of adolescents at elevated risk for future depression. A total of 259 adolescents (aged between 10 and 18 years) completed the Autobiographical Memory Test at baseline and 1-year follow-up. Measures of rumination, executive function, and depressive symptoms were obtained at baseline. The interaction between rumination and executive function predicted autobiographical memory specificity over time. Whereas rumination in the context of low executive function predicted reduced specificity, this was not the case in the context of high executive function. The interaction between rumination and executive function was independent of the effects of age, gender, IQ, baseline levels of memory specificity, and depressive symptoms.     

Predicting internalizing symptoms over a two year period by BIS,FFFS and attentional control

Identifying risk factors for the development of internalizing disorders is of major importance. In this context, behavioral inhibition (BIS), the fight-flight-freeze-system (FFFS), and attentional control (AC) have been proposed as being possible risk factors for both anxiety disorders and depression. Even though related cross-sectionally, it is still unclear whether these factors are precursors for internalizing disorders. In this longitudinal study, 1811 participants (aged 12–15) completed questionnaires on BIS/FFFS, AC, and internalizing symptoms at pretest and at two year follow-up. Supporting the alleged importance of BIS/FFFS and AC in the development of internalizing symptoms, BIS/FFFS and AC showed predictive value for anxiety and depression symptoms at two year follow-up. For anxiety symptoms this predictive value was not independent of the level of symptoms at pretest. For depression symptoms, AC showed predictive value over and above pretest level of depression symptoms. In the context of early detection of at risk adolescents, results suggest that screening of current anxiety and depression symptoms is most relevant in addition to a focus on AC for the screening of depression. However, it cannot be ruled out that at a further extended follow-up also BIS/FFFS might show independent predictive value for symptoms of anxiety and/or depression.     

Interrelations Between Executive Function and Symptoms of Hyperactivity/Impulsivity and Inattention in Preschoolers: A Two Year Longitudinal Study

The present study, including children at risk for developing Attention Deficit Hyperactivity Disorder (ADHD), examined the idea that complex executive functions (EFs) build upon more simple ones. This notion was applied in the study of longitudinal interrelations between core EF components — simple and complex inhibition, selective attention, and working memory (WM) — at age 5 and 6 as well as their predictive relations to ADHD symptoms at age 7. The results showed that simple inhibition and selective attention at age 5 independently predicted complex inhibition and WM at age 6. In addition, EFs primarily predicted symptoms of inattention rather than hyperactivity/impulsivity even at this young age. Finally, age 6 complex inhibition was shown to act as a mediator in the relations between simple inhibition and selective attention at age 5 and symptoms of inattention at age 7. These findings provide novel longitudinal support for the theory that fundamental EF components show a progression with age toward more complex executive control (see Garon et al. Psychological Bulletin 134(1):31–60 2008). Further, complex inhibition, implicating both inhibition and WM, seems to be a particularly strong correlate of ADHD symptoms in young children and should as such be the focus of future studies examining the relation between cognitive function and ADHD symptoms from a developmental perspective.     

In Eating‐Disordered Inpatient Adolescents,Self‐Criticism Predicts Nonsuicidal Self‐Injury

We examined the role of depressive traits—self‐criticism and dependency—in nonsuicidal self‐injury (NSSI) and suicidal ideation among inpatient adolescents with eating disorders. In two studies (N = 103 and 55), inpatients were assessed for depressive traits, suicidal ideations, and NSSI. In Study 2, motivation for carrying out NSSI was also assessed. In both studies, depression predicted suicidal ideation and self‐criticism predicted NSSI. In Study 2, depression and suicidal ideation also predicted NSSI. The automatic positive motivation for NSSI was predicted by dependency and depressive symptoms, and by a two‐way interaction between self‐criticism and dependency. Consistent with the “self‐punishment model,” self‐criticism appears to constitute a dimension of vulnerability for NSSI.     

Maternal depressive symptoms and child temperament: Longitudinal associations with executive functioning

The present study investigated the contributions of maternal depressive symptoms and child temperament to youths' executive functioning (EF) across an 18-year longitudinal study. The primary hypothesis proposed that the association between youths' exposure to early maternal depressive symptoms (ages 3 & 5) and their EF (age 18) would be moderated by temperament in middle childhood (ages 8 & 10). Temperament was a significant moderator of the association between early maternal depressive symptoms and youth EF. Positive child temperament (high effortful control, EC, and low negative affectivity, NA) was associated with higher EF when maternal depressive symptoms during early childhood were low. In contrast, elevated maternal depressive symptoms overrode any associations between child temperament and later EF. Parallel analyses examining the interaction between child temperament and maternal depressive symptoms during middle childhood (controlling for earlier maternal depressive symptoms) revealed a different pattern of results. Clinical implications for prevention/intervention work on EF are discussed.     

Relations between key executive functions and aggression in childhood

The present study examined relationships between three key executive functions (working memory, inhibition, and mental set-shifting) and multiple types of aggression in a general population sample of 9-year-old children. One hundred and forty-eight children completed a battery of executive function tasks and were rated on aggression by their primary teachers. All executive function (EF) composites were related to a composite measure of aggression. Working memory (WM) was most consistently related to the different types of aggression (overt, relational, reactive, and proactive), whereas inhibition and mental set-shifting only were related to relational and reactive aggression, respectively. Specificity in relations (studied as independent contributions) was generally low with the exception of the relation between WM and relational aggression. Taken together, our results highlight the roles of WM and relational aggression in EF-aggression relations in middle childhood.     

The role of executive functions in social impairment in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by socio-communicative impairments. Executive dysfunction may explain some key characteristics of ASD, both social and nonsocial hallmarks. Limited research exists exploring the relations between executive function and social impairment in ASD and few studies have used a comparison control group. Thus, the objective of the present study was to investigate the relations between executive functioning using the Behavioral Rating Inventory of Executive Functioning (BRIEF), social impairment as measured by the Social Responsiveness Scale (SRS), and overall autistic symptomology as measured by the Autism Diagnostic Observation Schedule (ADOS) in children and adolescents with and without ASD. Seventy children and adolescents diagnosed with ASD and 71 typically developing controls were included in this study. Findings showed that behavioral regulation executive processes (i.e., inhibition, shifting, and emotional control) predicted social function in all children. However, metacognitive executive processes (i.e., initiation, working memory, planning, organization, and monitoring) predicted social function only in children with ASD and not in typically developing children. Our findings suggest a distinct metacognitive executive function-social symptom link in ASD that is not present in the typical population. Understanding components of executive functioning that contribute to the autistic symptomology, particularly in the socio-communicative domain, is crucial for developing effective interventions that target key executive processes as well as underlying behavioral symptoms.     

Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

Executive function and theory of mind: Predictive relations from ages 2 to 4

Despite robust associations between children's theory of mind (ToM) and executive function (EF) skills, longitudinal studies examining this association remain scarce. In a socially diverse sample of 122 children (seen at ages 2, 3, and 4), this study examined (a) developmental stability of associations between ToM, EF, verbal ability, and social disadvantage; (b) continuity and change in ToM and EF; and (c) predictive relations between ToM and EF. Verbal ability and social disadvantage independently predicted changes in EF (but not ToM). Task scores improved with age and showed stable individual differences. The authors examined predictive relations between ToM and EF using partial correlations (controlling for age and verbal ability) and hierarchical regressions (that also controlled for social disadvantage and initial ToM and EF). The findings provide only partial support for the view that ToM is a prerequisite for EF but stronger support for the proposal that EF facilitates children's performance on ToM tasks.     

Interpersonal Violence,Depression, and Executive Function

This study considers links between the number of types of violence to which women have been exposed, depression, and executive functions (EFs). Substantial research has established EF deficits among depressed individuals as well as individuals exposed to trauma. Studies have also indicated a relationship between trauma exposure and depressive symptoms across a range of traumatic events, such as combat exposure, motor vehicle accidents, natural disasters, and assaults. This study examines this relationship in an ethnically diverse community sample of 93 women exposed to interpersonal violence who completed a battery of EF tasks that assessed processing speed, working memory, response inhibition, and set shifting. Women reported an average of 5.8 types of interpersonal violence events. The number of types of interpersonal violence events was significantly related to depressive symptoms, although not EF performance. Specific EFs, such as working memory and response inhibition, were positively related to depressive symptoms.     

Self-Reported Depressive Symptoms Have Minimal Effect on Executive Functioning Performance in Children and Adolescents

The relation between mood and executive functioning in children and adolescents has not been previously reported. This study examined the association between self-reported depressive symptoms in both clinical outpatient and psychiatric inpatient samples to the following measures of executive functioning: the Controlled Oral Word Association Test, Animal Naming, Trail Making Test, and Wisconsin Card Sorting Test. Records from children and adolescents aged 7–17 years old with an IQ > 70 were examined. Data were gathered at either an outpatient neuropsychology clinic (n = 89) or an inpatient psychiatric hospital setting (n = 81). Mood was measured with the Children’s Depression Inventory. Generally, statistical associations between self-reported depressive symptoms and executive functioning were small and non-significant. The variance predicted by mood on measures of executive functioning was minimal (generally less than 2 %) for the total sample, the outpatient group, inpatient group, and a subgroup who endorsed elevated mood symptoms. These results suggest that impaired performance on measures of executive functioning in children and adolescents is minimally related to self-reported depressive symptoms.     

Transactional Relationships among Cognitive Vulnerabilities, Stressors, and Depressive Symptoms in Adolescence

The transactional cognitive vulnerability to stress model Hankin & Abramson (Psychological Bulletin, 127:773–796, 2001) extends the traditional diathesis-stress model by proposing that the relationships among cognitions, depressive symptoms, and stressors are dynamic and bidirectional. In this study three different pathways among these variables were assessed simultaneously: (1) cognitive vulnerabilities and stressors as predictors of depressive symptoms (vulnerability model), (2) depressive symptoms and cognitive vulnerabilities as predictors of stressors (stress generation model), and (3) depressive symptoms and stressors as predictors of cognitive vulnerabilities (consequence model). A fully cross-lagged design panel was employed with 1,187 adolescents (545 girls and 642 boys, Mean Age?=?13.42 years) who were assessed at two time points separated by 6 months. They completed measures of cognitive vulnerabilities (maladaptive schema domains and negative inferential style), stressors, and depressive symptoms. Inferential style and schemas of the disconnection and rejection domain predicted prospective increases in depressive symptoms. Initial levels of depressive symptoms and most cognitive vulnerabilities predicted greater stress generation. Initial levels of stressors and depressive symptoms predicted an increase in negative inferential style and maladaptive schema domains over time. These bidirectional relationships were mostly similar for boys and girls, although there were a few gender differences. The findings support a transactional model with reciprocal relationships among stress, depressive symptoms, and cognitive vulnerabilities. Transactional implications for depression interventions among adolescents are discussed.     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

What Specific Facets of Executive Function are Associated with Academic Functioning in Youth with Attention-Deficit/Hyperactivity Disorder?

The purpose of the study was to evaluate the relation between ratings of Executive Function (EF) and academic functioning in a sample of 94 middle-school-aged youth with Attention-Deficit/Hyperactivity Disorder (ADHD; Mage = 11.9; 78 % male; 21 % minority). This study builds on prior work by evaluating associations between multiple specific aspects of EF (e.g., working memory, inhibition, and planning and organization) as rated by both parents and teachers on the Behavior Rating Inventory of Executive Function (BRIEF), with multiple academic outcomes, including school grades and homework problems. Further, this study examined the relationship between EF and academic outcomes above and beyond ADHD symptoms and controlled for a number of potentially important covariates, including intelligence and achievement scores. The EF Planning and Organization subscale as rated by both parents and teachers predicted school grades above and beyond symptoms of ADHD and relevant covariates. Parent ratings of youth’s ability to transition effectively between tasks/situations (Shift subscale) also predicted school grades. Parent-rated symptoms of inattention, hyperactivity/impulsivity, and planning and organization abilities were significant in the final model predicting homework problems. In contrast, only symptoms of inattention and the Organization of Materials subscale from the BRIEF were significant in the teacher model predicting homework problems. Organization and planning abilities are highly important aspects academic functioning for middle-school-aged youth with ADHD. Implications of these findings for the measurement of EF, and organization and planning abilities in particular, are discussed along with potential implications for intervention.     

Self-Regulation and Other Executive Functions Relationship to Pediatric OCD Severity and Treatment Outcome

The intersection of obsessive-compulsive disorder (OCD) and executive functioning (EF) in children and adolescents is an emerging topic in the current literature. Spurred by the consistent association between increased EF deficits and higher adult obsessive-compulsive severity, a few initial studies have replicated this relationship in pediatric OCD samples and also have found preliminary evidence that EF deficits are associated with worse response to first-line psychotherapeutic or psychopharmacological treatments for pediatric OCD. This study aimed to extend the literature by providing the first comprehensive investigation of how multiple EF domains, measured repeatedly over the course of treatment, impact pediatric obsessive-compulsive severity and response to multimodal treatment. Multi-level modeling results found that deficits in shifting, inhibition, emotional control, planning/organizing, monitoring and initiating all predicted higher average obsessive compulsive severity across treatment. Interestingly, out of the eight domains of EF investigated, only emotional control moderated treatment outcome such that those with worse emotional control experienced less of a reduction in obsessive-compulsive severity during treatment. The findings generally align with previous theories for the link between EF and OCD and indicate that emotional control has important implications in the treatment of pediatric OCD. In fact, emotional control may provide one explanation for why factors such as disgust sensitivity, oppositional behavior, and third-wave behavioral treatment techniques have all been linked to pediatric OCD treatment outcome. Future research should investigate augmentation strategies that target emotional control in children and adolescents.     

Links between theory of mind and executive function in young children with autism: clues to developmental primacy

There has been much theoretical discussion of a functional link between theory of mind (ToM) and executive function (EF) in autism. This study sought to establish the relationship between ToM and EF in young children with autism (M = 5 years, 6 months) and to examine issues of developmental primacy. Thirty children with autism and 40 typically developing children, matched on age and ability, were assessed on a battery of tasks measuring ToM (1st- and 2nd-order false belief) and components of EF (planning, set shifting, inhibition). A significant correlation emerged between ToM and EF variables in the autism group, independent of age and ability, while ToM and higher order planning ability remained significantly related in the comparison group. Examination of the pattern of ToM-EF impairments in the autism group revealed dissociations in 1 direction only: impaired ToM with intact EF. These findings support the view that EF may be 1 important factor in the advancement of ToM understanding in autism. The theoretical implications of these findings are discussed.