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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: wadem2@gmail.com
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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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References

Bentley, KH, Boettcher, H, Bullis, JR, Carl, JR, Conklin, LR, Sauer-Zavala, S, Pierre-Louis, C, Farchione, TJ and Barlow, DH (2018) Development of a single-session, transdiagnostic preventive intervention for young adults at risk for emotional disorders. Behavior Modification 42, 781–805.CrossRefGoogle ScholarPubMed
Bettis, AH, Coiro, MJ, England, J, Murphy, LK, Zelkowitz, RL, Dejardins, L, Eskridge, R, Adery, LH, Yarboi, J and Pardo, D (2017) Comparison of two approaches to prevention of mental health problems in college students: enhancing coping and executive function skills. Journal of American College Health 65, 313–322.CrossRefGoogle ScholarPubMed
Bick, J, Zeanah, CH, Fox, NA and Nelson, CA (2018) Memory and executive functioning in 12-year-old children with a history of institutional rearing. Child Development 89, 495–508.CrossRefGoogle ScholarPubMed
Blakemore, S-J and Mills, KL (2014) Is adolescence a sensitive period for sociocultural processing? Annual Review of Psychology 65, 187–207.CrossRefGoogle ScholarPubMed
Bloemen, AJP, Oldehinkel, AJ, Laceulle, OM, Ormel, J, Rommelse, NNJ and Hartman, CA (2018) The association between executive functioning and psychopathology: general or specific? Psychological Medicine 48, 1787–1794.CrossRefGoogle ScholarPubMed
Carver, CS, Johnson, SL and Timpano, KR (2017) Toward a functional view of the p factor in psychopathology. Clinical Psychological Science 5, 880–889.CrossRefGoogle Scholar
Caspi, A and Moffitt, TE (2018) All for one and one for all: mental disorders in one dimension. American Journal of Psychiatry 175, 831–844.CrossRefGoogle ScholarPubMed
Caspi, A, Houts, RM, Belsky, DW, Goldman-Mellor, SJ, Harrington, H, Israel, S, Meier, MH, Ramrakha, S, Shalev, I and Poulton, R (2014) The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science 2, 119–137.CrossRefGoogle Scholar
Castellanos-Ryan, N, Brière, FN, O'Leary-Barrett, M, Banaschewski, T, Bokde, A, Bromberg, U, Büchel, C, Flor, H, Frouin, V and Gallinat, J (2016) The structure of psychopathology in adolescence and its common personality and cognitive correlates. Journal of Abnormal Psychology 125, 1039.CrossRefGoogle ScholarPubMed
Cole, DA and Maxwell, SE (2003) Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology 112, 558.CrossRefGoogle ScholarPubMed
Conway, CC, Raposa, EB, Hammen, C and Brennan, PA (2018) Transdiagnostic pathways from early social stress to psychopathology: a 20-year prospective study. Journal of Child Psychology and Psychiatry 59, 855–862.CrossRefGoogle ScholarPubMed
Demeusy, EM, Handley, ED, Rogosch, FA, Cicchetti, D and Toth, SL (2018) Early neglect and the development of aggression in toddlerhood: the role of working memory. Child Maltreatment 23, 344–354.CrossRefGoogle ScholarPubMed
Eisenberg, N, Spinrad, TL and Eggum, ND (2010) Emotion-related self-regulation and its relation to children's maladjustment. Annual Review of Clinical Psychology 6, 495–525.CrossRefGoogle ScholarPubMed
Enders, CK and Bandalos, DL (2001) The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling 8, 430–457.CrossRefGoogle Scholar
Essex, MJ, Boyce, WT, Goldstein, LH, Armstrong, JM, Kraemer, HC and Kupfer, DJ (2002) The confluence of mental, physical, social, and academic difficulties in middle childhood. II: developing the MacArthur Health and Behavior Questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry 41, 588–603.CrossRefGoogle ScholarPubMed
Fosco, GM, Caruthers, AS and Dishion, TJ (2012) A six-year predictive test of adolescent family relationship quality and effortful control pathways to emerging adult social and emotional health. Journal of Family Psychology 26, 565.CrossRefGoogle ScholarPubMed
Goodkind, M, Eickhoff, SB, Oathes, DJ, Jiang, Y, Chang, A, Jones-Hagata, LB, Ortega, BN, Zaiko, YV, Roach, EL and Korgaonkar, MS (2015) Identification of a common neurobiological substrate for mental illness. JAMA Psychiatry 72, 305–315.CrossRefGoogle ScholarPubMed
Hostinar, CE, Stellern, SA, Schaefer, C, Carlson, SM and Gunnar, MR (2012) Associations between early life adversity and executive function in children adopted internationally from orphanages. Proceedings of the National Academy of Sciences 109, 17208–17212.CrossRefGoogle ScholarPubMed
Huang-Pollock, C, Shapiro, Z, Galloway-Long, H and Weigard, A (2017) Is poor working memory a transdiagnostic risk factor for psychopathology? Journal of Abnormal Child Psychology 45, 1477–1490.CrossRefGoogle ScholarPubMed
Humphreys, KL, Gleason, MM, Drury, SS, Miron, D, Nelson, CA 3rd, Fox, NA and Zeanah, CH (2015) Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial. The Lancet Psychiatry 2, 625–634.CrossRefGoogle ScholarPubMed
Laceulle, OM, Vollebergh, WA and Ormel, J (2015) The structure of psychopathology in adolescence: replication of a general psychopathology factor in the TRAILS study. Clinical Psychological Science 3, 850–860.CrossRefGoogle Scholar
Lahey, BB, Applegate, B, Hakes, JK, Zald, DH, Hariri, AR and Rathouz, PJ (2012) Is there a general factor of prevalent psychopathology during adulthood? Journal of Abnormal Psychology 121, 971.CrossRefGoogle Scholar
Lahey, BB, Rathouz, PJ, Keenan, K, Stepp, SD, Loeber, R and Hipwell, AE (2015) Criterion validity of the general factor of psychopathology in a prospective study of girls. Journal of Child Psychology and Psychiatry 56, 415–422.CrossRefGoogle Scholar
Lamm, C, Troller-Renfree, SV, Zeanah, CH, Nelson, CA and Fox, NA (2018) Impact of early institutionalization on attention mechanisms underlying the inhibition of a planned action. Neuropsychologia 117, 339–346.CrossRefGoogle ScholarPubMed
Lind, T, Raby, KL, Caron, E, Roben, CK and Dozier, M (2017) Enhancing executive functioning among toddlers in foster care with an attachment-based intervention. Development and Psychopathology 29, 575–586.CrossRefGoogle ScholarPubMed
Luciana, M and Nelson, CA (1998) The functional emergence of prefrontally-guided working memory systems in four-to eight-year-old children. Neuropsychologia 36, 273–293.CrossRefGoogle ScholarPubMed
Luciana, M and Nelson, CA (2002) Assessment of neuropsychological function through use of the Cambridge Neuropsychological Testing Automated Battery: performance in 4-to 12-year-old children. Developmental Neuropsychology 22, 595–624.CrossRefGoogle ScholarPubMed
Martel, MM, Pan, PM, Hoffmann, MS, Gadelha, A, do Rosário, MC, Mari, JJ, Manfro, GG, Miguel, EC, Paus, T and Bressan, RA (2017) A general psychopathology factor (P factor) in children: structural model analysis and external validation through familial risk and child global executive function. Journal of Abnormal Psychology 126, 137.CrossRefGoogle ScholarPubMed
McDermott, JM, Troller-Renfree, SV, Vanderwert, R, Nelson, CA, Zeanah, CH and Fox, N (2013) Psychosocial deprivation, executive functions, and the emergence of socio-emotional behavior problems. Frontiers in Human Neuroscience 7, 167.CrossRefGoogle ScholarPubMed
McElroy, E, Belsky, J, Carragher, N, Fearon, P and Patalay, P (2018) Developmental stability of general and specific factors of psychopathology from early childhood to adolescence: dynamic mutualism or p-differentiation? Journal of Child Psychology and Psychiatry 59, 667–675.CrossRefGoogle ScholarPubMed
McTeague, LM, Huemer, J, Carreon, DM, Jiang, Y, Eickhoff, SB and Etkin, A (2017) Identification of common neural circuit disruptions in cognitive control across psychiatric disorders. American Journal of Psychiatry 174, 676–685.CrossRefGoogle ScholarPubMed
Meredith, R (2015) Sensitive and critical periods during neurotypical and aberrant neurodevelopment: a framework for neurodevelopmental disorders. Neuroscience & Biobehavioral Reviews 50, 180–188.CrossRefGoogle ScholarPubMed
Merz, EC, Landry, SH, Johnson, UY, Williams, JM and Jung, K (2016) Effects of a responsiveness–focused intervention in family child care homes on children's executive function. Early Childhood Research Quarterly 34, 128–139.CrossRefGoogle ScholarPubMed
Miller, AB, Sheridan, MA, Hanson, JL, McLaughlin, KA, Bates, JE, Lansford, JE, Pettit, GS and Dodge, KA (2018) Dimensions of deprivation and threat, psychopathology, and potential mediators: a multi-year longitudinal analysis. Journal of Abnormal Psychology 127, 160.CrossRefGoogle ScholarPubMed
Pollak, SD, Nelson, CA, Schlaak, MF, Roeber, BJ, Wewerka, SS, Wiik, KL, Frenn, KA, Loman, MM and Gunnar, MR (2010) Neurodevelopmental effects of early deprivation in postinstitutionalized children. Child Development 81, 224–236.CrossRefGoogle ScholarPubMed
Preacher, KJ and Hayes, AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods 40, 879–891.CrossRefGoogle ScholarPubMed
Rabipour, S and Raz, A (2012) Training the brain: fact and fad in cognitive and behavioral remediation. Brain and Cognition 79, 159–179.CrossRefGoogle ScholarPubMed
Rapport, MD, Orban, SA, Kofler, MJ and Friedman, LM (2013) Do programs designed to train working memory, other executive functions, and attention benefit children with ADHD? A meta-analytic review of cognitive, academic, and behavioral outcomes. Clinical Psychology Review 33, 1237–1252.CrossRefGoogle ScholarPubMed
Rutter, M, Sonuga-Barke, EJ, Beckett, C, Castle, J, Kreppner, J, Kumsta, R, Schlotz, W, Stevens, S, Bell, CA and Gunnar, MR (2010). Deprivation-specific psychological patterns: effects of institutional deprivation. Monographs of the Society for Research in Child Development 75, i–x, 1–253.CrossRefGoogle Scholar
Schaefer, JD, Moffitt, TE, Arseneault, L, Danese, A, Fisher, HL, Houts, R, Sheridan, MA, Wertz, J and Caspi, A (2018) Adolescent victimization and early-adult psychopathology: approaching causal inference using a longitudinal twin study to rule out noncausal explanations. Clinical Psychological Science 6, 352–371.CrossRefGoogle ScholarPubMed
Shapero, BG, Greenberg, J, Pedrelli, P, de Jong, M and Desbordes, G (2018) Mindfulness-based interventions in psychiatry. Focus 16, 32–39.CrossRefGoogle Scholar
Siegle, GJ, Ghinassi, F and Thase, ME (2007) Neurobehavioral therapies in the 21st century: summary of an emerging field and an extended example of cognitive control training for depression. Cognitive Therapy and Research 31, 235–262.CrossRefGoogle Scholar
Snyder, HR, Miyake, A and Hankin, BL (2015) Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches. Frontiers in Psychology 6, 328.CrossRefGoogle ScholarPubMed
Snyder, HR, Young, JF and Hankin, BL (2019) Chronic stress exposure and generation are related to the P-factor and externalizing specific psychopathology in youth. Journal of Clinical Child & Adolescent Psychology 48, 306–315.CrossRefGoogle ScholarPubMed
Sonuga-Barke, EJ, Kennedy, M, Kumsta, R, Knights, N, Golm, D, Rutter, M, Maughan, B, Schlotz, W and Kreppner, J (2017) Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. The Lancet 389, 1539–1548.CrossRefGoogle Scholar
Tackett, JL, Lahey, BB, Van Hulle, C, Waldman, I, Krueger, RF and Rathouz, PJ (2013) Common genetic influences on negative emotionality and a general psychopathology factor in childhood and adolescence. Journal of Abnormal Psychology 122, 1142.CrossRefGoogle Scholar
Tibu, F, Sheridan, MA, McLaughlin, K, Nelson, C, Fox, N and Zeanah, C (2016a) Disruptions of working memory and inhibition mediate the association between exposure to institutionalization and symptoms of attention deficit hyperactivity disorder. Psychological Medicine 46, 529–541.CrossRefGoogle Scholar
Tibu, F, Sheridan, MA, McLaughlin, KA, Nelson, CA, Fox, NA and Zeanah, CH (2016b) Reduced working memory mediates the link between early institutional rearing and symptoms of ADHD at 12 years. Frontiers in Psychology 7, 1850.CrossRefGoogle Scholar
Valcan, DS, Davis, H and Pino-Pasternak, D (2018) Parental behaviours predicting early childhood executive functions: a meta-analysis. Educational Psychology Review 30, 607–648.CrossRefGoogle Scholar
Wade, M, Fox, NA, Zeanah, CH and Nelson, CA (2018) Effect of foster care intervention on trajectories of general and specific psychopathology among children with histories of institutional rearing: a randomized clinical trial. JAMA Psychiatry 75, 1137–1145.CrossRefGoogle ScholarPubMed
Wade, M, Fox, NA, Zeanah, CH and Nelson, CA (2019) Long-term effects of institutional rearing, foster care, and brain activity on memory and executive functioning. Proceedings of the National Academy of Sciences, 201809145.CrossRefGoogle Scholar
White, LK, Moore, TM, Calkins, ME, Wolf, DH, Satterthwaite, TD, Leibenluft, E, Pine, DS, Gur, RC and Gur, RE (2017) An evaluation of the specificity of executive function impairment in developmental psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry 56, 975–982.e3.CrossRefGoogle ScholarPubMed
Wiik, KL, Loman, MM, Van Ryzin, MJ, Armstrong, JM, Essex, MJ, Pollak, SD and Gunnar, MR (2011) Behavioral and emotional symptoms of post-institutionalized children in middle childhood. Journal of Child Psychology and Psychiatry 52, 56–63.CrossRefGoogle ScholarPubMed
Zeanah, CH, Egger, HL, Smyke, AT, Nelson, CA, Fox, NA, Marshall, PJ and Guthrie, D (2009) Institutional rearing and psychiatric disorders in Romanian preschool children. American Journal of Psychiatry 166, 777–785.CrossRefGoogle ScholarPubMed
Zeanah, CH, Fox, NA and Nelson, CA (2012) The Bucharest Early Intervention Project: case study in the ethics of mental health research. The Journal of Nervous and Mental Disease 200, 243–247.CrossRefGoogle ScholarPubMed
Zeanah, CH, Humphreys, KL, Fox, NA and Nelson, CA (2017) Alternatives for abandoned children: insights from the Bucharest Early Intervention Project. Current Opinion in Psychology 15, 182–188.CrossRefGoogle ScholarPubMed
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