- Poor executive function operates as a transdiagnostic risk factor, correlating with a general psychopathology P-Factor in teacher-referred young children.
- Distinct EF components show divergent associations: sustained attention links positively to emotional problems and negatively to hyperactivity; inhibition associates with conduct and hyperactivity in females.
- Routine screening for executive function difficulties may improve early identification and tailor interventions for emerging childhood psychopathology.
Psychol Med. 2026 Jul 7;56:e222. doi: 10.1017/S003329172610508X.
ABSTRACT
BACKGROUND: Executive function (EF) deficits are consistently linked to psychopathology symptoms, though the mechanisms linking poor EF to symptom expression remain unclear.
METHODS: The study used the Research Domain Criteria (RDoC) approach to examine relationships between teacher-reported latent psychopathology symptoms, including a general psychopathology factor (P-Factor), and EF in young children with emerging mental health problems. Participants were 804 children (70.8% male; aged 49-89 months) referred by their teachers for cognitive, emotional, or behavioral problems at school. To assess psychopathology, teachers completed the Strengths and Difficulties Questionnaire (SDQ). EF measures included inhibition, cognitive flexibility, working memory, sustained attention, and episodic memory, assessed using the NIH Toolbox, Automated Working Memory Assessment, and the Amsterdam Neuropsychological Test battery.
RESULTS: Structural equation modeling (incorporating confirmatory factor analysis) showed reasonable model fit and supported a P-Factor structure. Correlational analyses explored EF-psychopathology associations, followed by a sensitivity analysis controlling for sex. We observed patterns of cognitive processes that showed inverse associations between EF performance and specific clinical problems. Sustained attention was positively associated with emotional problems but negatively associated with hyperactivity problems. Sex-stratified analyses revealed distinct patterns, with inhibition problems strongly linked to conduct and hyperactivity problems, but in females only.
CONCLUSIONS: The findings support poor EF as a transdiagnostic risk factor associated with incremental vulnerability for childhood psychopathology. Divergent findings for sustained attentional processes suggest they can be adaptive in some contexts but maladaptive in others. Screening for EF difficulties in children could enhance early identification and inform interventions.
PMID:42411115 | DOI:10.1017/S003329172610508X
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