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Global deficits in executive functioning are transdiagnostic mediators between severe childhood neglect and psychopathology in adolescence

Published online by Cambridge University Press:  08 August 2019

Mark Wade ,
Charles H. Zeanah ,
Nathan A. Fox  and
Charles A. Nelson
Mark Wade*
Affiliation:
Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada
Charles H. Zeanah
Affiliation:
Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
Nathan A. Fox
Affiliation:
Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
Charles A. Nelson
Affiliation:
Harvard Graduate School of Education, Cambridge, MA, USA Boston Children's Hospital of Harvard Medical School, Boston, MA, USA
*
Author for correspondence: Mark Wade, E-mail: [email protected]
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Abstract

Background

Children reared in institutions experience profound deprivation that is associated with both heightened levels of psychopathology and deficits in executive functioning (EF). It is unclear whether deficits in EF among institutionally-reared children serve as a vulnerability factor that increases risk for later psychopathology. It is also unclear whether this putative association between EF and psychopathology is transdiagnostic (i.e. cuts across domains of psychopathology), or specific to a given syndrome. Thus, we examined whether global deficits in EF mediate the association between severe childhood neglect and general v. specific psychopathology in adolescence.

Methods

The sample consisted of 188 children from the Bucharest Early Intervention Project, a longitudinal study examining the brain and behavioral development of children reared in Romanian institutions and a comparison group of never-institutionalized children. EF was assessed at age 8, 12, and 16 using a well-validated measure of neuropsychological functioning. Psychopathology was measured as general (P) and specific internalizing (INT) and externalizing (EXT) factors at age 12 and 16.

Results

Institutionally-reared children had lower global EF and higher general psychopathology (P) at all ages compared to never-institutionalized children. Longitudinal path analysis revealed that the effect of institutionalization on P at age 16 operated indirectly through poorer EF from ages 8 to 12. No indirect effects involving EF were observed for INT or EXT at age 16.

Conclusions

We conclude that stable, global deficits in EF serve as a cognitive endophenotype that increases transdiagnostic vulnerability to psychopathology in adolescence among those who have experienced profound early neglect.

Keywords

adolescenceexecutive functioninggeneral psychopathologyinstitutionalizationpsychosocial deprivation
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 10 , July 2020 , pp. 1687 - 1694
Copyright
Copyright © Cambridge University Press 2019

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