Measurement of executive functioning with the National Institute of Health Toolbox and the association to anxiety/depressive symptomatology in childhood/adolescence

Kavanaugh, Brian C.; Cancilliere, Mary Kathryn; Fryc, Alexa; Tirrell, Eric; Oliveira, Jane S; Oberman, Lindsay M.; Wexler, Bruce E.; Carpenter, Linda L.; Spirito, Anthony

doi:10.1080/09297049.2019.1708295

Cited by 18 publications

(15 citation statements)

References 56 publications

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“…While executive function deficits can make diabetes self‐management more difficult, in turn, these difficulties in self‐management could lead to worsening glycemic outcomes, 94–97 which may lead to a dysfunctional cycle of further brain injury and even greater neurocognitive function deficits 83 . Additionally, worse executive functions are linked to lower QoL and mental health problems 98–100 …”

Section: Neurocognitive Functioningmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

et al. 2022

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Psychological care of youth with type 1 diabetes (T1D) as well as type 2 diabetes (T2D) is covered. • Additional sections on the psychological assessment, communication, the health care team and psychological impact of technology are added 2 | EXECUTIVE SUMMARY AND RECOMMENDATIONS 2.1 | Collaborative care • Psychosocial care should be integrated with collaborative, personcentered medical care and provided to all youth with diabetes and their families. A • Professionals with expertise in the mental health of children and adolescents are essential members of interdisciplinary diabetes health care team. B • Mental health professionals should be available to interact with youth and their families, and also to support the diabetes team in the recognition and management of mental health and behavior problems. C • It is preferable that mental health specialists who interact with children with diabetes have training in diabetes and its management. E 2.2 | Integrating psychosocial assessments in routine diabetes care • Age-appropriate and validated assessment tools should be routinely implemented in clinical practice to monitor and discuss

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Section: Neurocognitive Functioningmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

et al. 2022

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“…Executive functions are the cognitive mechanisms required for such regulation (Diamond, 2013 ). Cross‐sectional studies indicate that poor executive functions are related to psychopathology in children and adolescents (Kavanaugh et al., 2019 ; Mullin, Perks, Haraden, Snyder, & Hankin, 2020 ). However, it remains to be adequately understood whether impaired executive functions cause child psychopathology or whether they are a consequence of child psychopathology.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal relations between impaired executive function and symptoms of psychiatric disorders in childhood

Halse

Steinsbekk

Hammar

et al. 2022

Child Psychology Psychiatry

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Background: Malfunctioning of executive functions correlates with psychopathology in children. However, the directionality, the extent to which the relation varies for various disorders, and whether prospective relations afford causal interpretations are not known. Methods: A community sample of Norwegian children (n = 874) was studied biennially from the age of 6 to 14 years. Executive functions were assessed using the Behavior Rating Inventory of Executive Function Teacher-report and symptoms of psychopathology were assessed using the Preschool Age Psychiatric Assessment (age 6; parents) and Child and Adolescent Psychiatric Assessment (ages 8-14; children and parents). Prospective reciprocal relations were examined using a random intercept cross-lagged panel model that adjusts for all unobserved time-invariant confounders. Results: Even when time-invariant confounders were accounted for, reduced executive functions predicted increased symptoms of depressive disorders, anxiety disorders, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) 2 years later, even when previous changes in these symptoms were adjusted for. The level of prediction (B = .83, 95% CI [.37, 1.3]) was not different for different disorders or ages. Conversely, reduced executive functions were predicted by increased symptoms of all disorders (B = .01, 95% CI [.01, .02]). Conclusions: Reduced executive functioning may be involved in the etiology of depression, anxiety, ADHD, and ODD/CD to an equal extent. Moreover, increased depression, anxiety, ADHD, and ODD/CD may negatively impact executive functioning.

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“…The DNT program also administers tests of response inhibition, focused attention, and working memory. 14,13 We used measures of response inhibition and sustained attention from the Go/NoGo test of response inhibition, hallmark features of ADHD, in unstructured cluster analysis to identify potential subgroups of children. We then used the micro-cognition biomarkers generated by the DNT and scores on the focused attention and working memory tests to validate and further characterize neurosystem dysfunction in the clusters.…”

Section: Introductionmentioning

confidence: 99%

Using Micro-Cognition Biomarkers of Neurosystem Dysfunction to Define ADHD Subtypes: A Scalable Digital Path to Diagnosis Based on Brain Function

Wexler

Kish²

2023

Preprint

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Background: Diagnostic categories in psychiatry are based on symptoms and include individuals with different underlying pathology. This within-diagnosis heterogeneity confounds new treatment development and treatment selection for individual patients. A research priority to discover biomarkers that define groups of patients with similar neuropathology. Digital neurocognitive training and assessment can provide micro-cognition biomarkers of unprecedented precision. The brain is hierarchically organized from single cells and cell dyads to neurosystems that integrate action of millions of neurons across the brain necessary for cognition and emotion. Micro-cognition biomarkers identify dysfunction at the level of neurosystems that produce clinical illness. We used micro-cognition biomarkers to identify subgroups of children diagnosed with ADHD but with different neuropathology. Methods: K-means clustering was applied to 69 children 6-9 years old with ADHD using performance variables from a Go/NoGo test and the results analyzed against 58 typically developing (TD) children. Neurosystem dysfunction in each group was further characterized by micro-cognition biomarkers extracted from hundreds of responses by each child during digital neurotherapy. Findings: Four highly reproducible clusters were identified that differed on emblematic features of ADHD. Cluster 4 showed two core ADHD features, poor response inhibition and inconsistent attention. Cluster 3 showed only poor response inhibition and the other two showed neither. Cluster 2 showed faster and more consistent responses, higher detection of simple targets and better working memory than TD children but showed the most marked performance decrements when required to track multiple targets or ignore distractors. Cluster 1 showed much greater ability recognizing members of abstract categories rather than natural categories that children learn through physical interaction with the environment while Cluster 4 was the opposite. Interpretation: Digital neurocognitive training provides data-rich fine-grained, low-cost, noninvasive, and scalable micro-cognition biomarkers that characterize subgroups of patients with the same symptom-based psychiatric diagnosis but differing neuropathology.

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Measurement of executive functioning with the National Institute of Health Toolbox and the association to anxiety/depressive symptomatology in childhood/adolescence

Cited by 18 publications

References 56 publications

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

Longitudinal relations between impaired executive function and symptoms of psychiatric disorders in childhood

Using Micro-Cognition Biomarkers of Neurosystem Dysfunction to Define ADHD Subtypes: A Scalable Digital Path to Diagnosis Based on Brain Function

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