Norwegian University of Science and Technology, Trondheim, Norway.
University of Bergen, Bergen, Norway.
J Child Psychol Psychiatry. 2022 Dec;63(12):1574-1582. doi: 10.1111/jcpp.13622. Epub 2022 Apr 27.
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.
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.
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]).
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.
执行功能障碍与儿童精神病理学有关。然而，这种关系的方向性、在各种障碍中变化的程度，以及前瞻性关系是否提供因果解释尚不清楚。
本研究对挪威的一个社区样本（n=874）进行了为期两年的研究，从 6 岁到 14 岁进行评估。使用行为评定量表的教师报告来评估执行功能，使用学前精神评估（6 岁；父母）和儿童和青少年精神评估（8-14 岁；儿童和父母）来评估精神病理学症状。使用随机截距交叉滞后面板模型来检验前瞻性的相互关系，该模型可以调整所有未观察到的、时间不变的混杂因素。
即使考虑到时间不变的混杂因素，执行功能的降低也预示着 2 年后抑郁障碍、焦虑障碍、注意缺陷多动障碍（ADHD）、对立违抗性障碍（ODD）和品行障碍（CD）的症状增加，即使这些症状的先前变化也被调整了。预测水平（B=0.83，95%CI[0.37，1.3]）在不同的障碍或年龄之间没有差异。相反，所有障碍的症状增加都预示着执行功能的降低（B=0.01，95%CI[0.01，0.02]）。
执行功能障碍可能与抑郁、焦虑、ADHD 和 ODD/CD 的发病机制有关，其程度相当。此外，抑郁、焦虑、ADHD 和 ODD/CD 的增加可能会对执行功能产生负面影响。
