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J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):975-982.e3. doi: 10.1016/j.jaac.2017.08.016. Epub 2017 Sep 14.

An Evaluation of the Specificity of Executive Function Impairment in Developmental Psychopathology.

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Children's Hospital of Philadelphia (CHOP), and the Lifespan Brain Institute, Philadelphia, PA. Electronic address:
University of Pennsylvania, Perelman School of Medicine, Philadelphia, and the Lifespan Brain Institute, Children's Hospital of Philadelphia.
National Institute of Mental Health, Emotion and Development Branch, Rockville, MD.



Deficits in executive function (EF) are common in neuropsychiatric disorders, but the specificity of these deficits remains unclear. The aim of the present study was to elucidate the pattern of EF impairment across psychopathologies in children and adolescents. Associations among components of EF with dimensions of psychopathology, including an overall psychopathology factor, were assessed.


Participants (8-21 years) were from the Philadelphia Neurodevelopmental Cohort (N = 9,498). Data from a structured clinical screening interview were reduced to 5 dimensional domains using factor analyses: overall psychopathology, anxious-misery, fear, externalizing, and psychosis. EF components of attentional vigilance, response inhibition, conceptual flexibility, and working memory were assessed. Associations of clinical dimensions with general EF ability and with specific EF components were examined.


EF ability showed common and domain-specific associations with clinical symptoms. General EF was directly associated with the general psychopathology, anxious-misery, and psychosis domains but not with the fear or externalizing domains. For the EF subcomponents, differences emerged in the magnitude and direction of the association between components and clinical domains. Poorer EF was typically associated with increased symptoms across clinical domains; however, in some instances, better EF ability was associated with greater symptom burden, particularly in the fear domain.


EF has widespread associations with psychopathology in youth. Findings showed some overlap in the type of EF impairment across clinical phenotypes, as indicated by similar patterns of associations between some clinical symptoms and EF. However, findings also showed domain-specific associations with EF that differed across EF components and clinical domains.


adolescence; child development; developmental psychopathology; executive function

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