Abstract
Although both executive functions and internalizing symptoms go through important changes during adolescence, the role of executive functions in internalizing symptoms is unclear. Based on developmental cascade models of psychopathology, this study aimed to fill this gap by studying the bidirectional predictive relationship between executive functions (cognitive flexibility and selective attention) and symptoms of depression and social anxiety. A sample of 698 adolescents (40.8% girls) between 12 and 17 years of age (M = 14.59, SD = 1.36) participated in three waves over 1 year. They completed measures of executive functions and internalizing symptoms. Depressive symptoms predicted deficits in executive functions. Conversely, social anxiety symptoms predicted an improvement in cognitive flexibility. These results suggest that executive function deficits are not a risk factor for the development of depressive symptoms but a consequence of them, and there are specific patterns of associations for depressive and social anxiety symptoms.
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Ahern, E., Bockting, C. L., & Semkovska, M. (2019). A hot-cold cognitive model of depression: Integrating the neuropsychological approach into the cognitive theory framework. Clinical Psychology in Europe, 1(3), 1–35. https://doi.org/10.32872/cpe.v1i3.34396
Alba, J., Calvete, E., Wante, L., Van Beveren, M. L., & Braet, C. (2018). Early maladaptive schemas as moderators of the association between bullying victimization and depressive symptoms in adolescents. Cognitive Therapy and Research, 42(1), 24–35. https://doi.org/10.1007/s10608-017-9874-5
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.529303
Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey–adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 37–44. https://doi.org/10.1016/j.jaac.2014.10.010
Beck, A. T., & Bredemeier, K. (2016). A unified model of depression: Integrating clinical, cognitive, biological, and evolutionary perspectives. Clinical Psychological Science, 4(4), 596–619. https://doi.org/10.1177/2167702616628523
Brickenkamp, R. (1962). Aufmerksamkeits-Belastungs-Test [d2 Test]. Hogrefe
Brieant, A., King-Casas, B., & Kim-Spoon, J. (2020). Transactional relations between developmental trajectories of executive functioning and internalizing and externalizing symptomatology in adolescence. Development and Psychopathology, 1–12. https://doi.org/10.1017/s0954579420001054
Caballo, V. E., Salazar, I. C., Irurtia, M. J., Arias, B., Hofmann, S. G., & Ciso-A Research Team. (2014). Differences in social anxiety between men and women across 18 countries. Personality and Individual Differences, 64, 35–40. https://doi.org/10.1016/j.paid.2014.02.013
Calvete, E., & Cardeñoso, O. (1999). Beliefs and depressive symptoms: Preliminary findings in the development of a brief irrational beliefs scale. Anales de Psicología, 15(2), 179–190. https://revistas.um.es/analesps/article/view/30061
Calvete, E., Fernández-González, L., González-Cabrera, J. M., & Gámez-Guadix, M. (2018). Continued bullying victimization in adolescents: Maladaptive schemas as a mediational mechanism. Journal of Youth and Adolescence, 47(3), 650–660. https://doi.org/10.1007/s10964-017-0677-5
Calvete, E., Orue, I., & Hankin, B. L. (2013). Transactional relationships among cognitive vulnerabilities, stressors, and depressive symptoms in adolescence. Journal of Abnormal Child Psychology, 41(3), 399–410. https://doi.org/10.1007/s10802-012-9691-y
Connolly, S. L., Wagner, C. A., Shapero, B. G., Pendergast, L. L., Abramson, L. Y., & Alloy, L. B. (2014). Rumination prospectively predicts executive functioning impairments in adolescents. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 46–56. https://doi.org/10.1016/j.jbtep.2013.07.009
De Jong, P. J., Sportel, B. E., de Hullu, E., & Nauta, M. H. (2012). Co-occurrence of social anxiety and depression symptoms in adolescence: Differential links with implicit and explicit self-esteem? Psychological Medicine, 42(3), 475–484. https://doi.org/10.1017/s0033291711001358
Demetriou, E. A., Song, C. Y., Park, S. H., Pepper, K. L., Naismith, S. L., Hermens, D. F., Hickie, I. B., Thomas, E. E., Norton, A., White, D., & Guastella, A. J. (2018). Autism, early psychosis, and social anxiety disorder: A transdiagnostic examination of executive function cognitive circuitry and contribution to disability. Translational Psychiatry, 8(1), 1–10. https://doi.org/10.1038/s41398-018-0193-8
Diamond, A. (2016). Why assessing and improving executive functions early in life is critical. In P. McCardle, L. Freund, & J. A. Griffin (Eds.), Executive Function in Preschool-age Children: Integrating Measurement, Neurodevelopment, and Translational Research (pp. 11–43). American Psychological Association. https://doi.org/10.1037/14797-002
Diamond, A., & Ling, D. S. (2016). Conclusions about interventions, programs, and approaches for improving executive functions that appear justified and those that, despite much hype, do not. Developmental Cognitive Neuroscience, 18, 34–48. https://doi.org/10.1016/j.dcn.2015.11.005
Diamond, A., & Ling, D.S. (2019). Review of the evidence on, and fundamental questions about, efforts to improve executive functions, including working memory. In J. M. Novick, M. F. Bunting, M. R. Dougherty, & R. W. Engle. (Eds.), Cognitive and Working Memory Training: Perspectives from Psychology, Neuroscience, and Human Development (pp. 143–431). Oxford University Press. https://doi.org/10.1093/oso/9780199974467.003.0008
Epkins, C. C., & Heckler, D. R. (2011). Integrating etiological models of social anxiety and depression in youth: Evidence for a cumulative interpersonal risk model. Clinical Child and Family Psychology Review, 14(4), 329–376. https://doi.org/10.1007/s10567-011-0101-8
Esbjørn, B. H., Hoeyer, M., Dyrborg, J., Leth, I., & Kendall, P. C. (2010). Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents. Journal of Anxiety Disorders, 24(8), 866–872. https://doi.org/10.1016/j.janxdis.2010.06.009
Evans, L. D., Kouros, C. D., Samanez-Larkin, S., & Garber, J. (2016). Concurrent and short-term prospective relations among neurocognitive functioning, coping, and depressive symptoms in youth. Journal of Clinical Child and Adolescent Psychology, 45(1), 6–20. https://doi.org/10.1080/15374416.2014.982282
Eysenck, M. W., & Derakshan, N. (2011). New perspectives in attentional control theory. Personality and Individual Differences, 50(7), 955–960. https://doi.org/10.1016/j.paid.2010.08.019
Fernández-Castillo, A., & Gutiérrez Rojas, M. E. (2009). Selective attention, anxiety, depressive symptomatology and academic performance in adolescents. Electronic Journal of Research in Educational Psychology, 7(17), 49–76. http://repositorio.ual.es/bitstream/handle/10835/544/Art_17_295_eng.pdf?sequence=1
Flett, G. L., Coulter, L. M., & Hewitt, P. L. (2012). The Perfectionistic Self-Presentation Scale–Junior Form: Psychometric properties and association with social anxiety in early adolescents. Canadian Journal of School Psychology, 27(2), 136–149. https://doi.org/10.1177/0829573511431406
Friedman, N. P., du Pont, A., Corley, R. P., & Hewitt, J. K. (2018). Longitudinal relations between depressive symptoms and executive functions from adolescence to early adulthood: A twin study. Clinical Psychological Science, 6(4), 543–560. https://doi.org/10.1177/2167702618766360
Fujii, Y., Kitagawa, N., Shimizu, Y., Mitsui, N., Toyomaki, A., Hashimoto, N., Kako, Y., Tanaka, T., Asakura, S., Koyama, T., & Kusumi, I. (2013). Severity of generalized social anxiety disorder correlates with low executive functioning. Neuroscience Letters, 543, 42–46. https://doi.org/10.1016/j.neulet.2013.02.059
Glashouwer, K. A., Vroling, M. S., de Jong, P. J., Lange, W. G., & de Keijser, J. (2013). Low implicit self-esteem and dysfunctional automatic associations in social anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44(2), 262–270. https://doi.org/10.1016/j.jbtep.2012.11.005
Grissom, N. M., & Reyes, T. M. (2019). Let’s call the whole thing off: Evaluating gender and sex differences in executive function. Neuropsychopharmacology, 44(1), 86–96. https://doi.org/10.1038/s41386-018-0179-5
Han, G., Helm, J., Iucha, C., Zahn-Waxler, C., Hastings, P. D., & Klimes-Dougan, B. (2016). Are executive functioning deficits concurrently and predictively associated with depressive and anxiety symptoms in adolescents? Journal of Clinical Child and Adolescent Psychology, 45(1), 44–58. https://doi.org/10.1080/15374416.2015.1041592
Hankin, B. L., Snyder, H. R., & Gulley, L. D. (2016). Cognitive risks in developmental psychopathology. In D. Cicchetti. (Ed.), Developmental Psychopathology (2nd ed., pp. 312–385). Wiley. https://doi.org/10.1002/9781119125556.devpsy308
Jiménez, J. E., Hernández, S., García, E., Díaz, A., Rodríguez, C., & Martín, R. (2012). Test de atención d2: Datos normativos y desarrollo evolutivo de la atención en educación primaria [Attention test d2: Normative data and evolutionary development of attention in primary education]. European Journal of Education and Psychology, 5(1), 93–106. https://doi.org/10.30552/ejep.v5i1.79
Judah, M. R., Grant, D. M., Mills, A. C., & Lechner, W. V. (2013). The neural correlates of impaired attentional control in social anxiety: An ERP study of inhibition and shifting. Emotion, 13(6), 1096–1106. https://doi.org/10.1037/a0033531
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878. https://doi.org/10.1016/j.cpr.2010.03.001
Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among US adolescents: Trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8), 987–996. https://doi.org/10.1007/s00127-019-01697-8
La Greca, A. M., & López, N. (1998). Social anxiety among adolescents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26(2), 83–94. https://doi.org/10.1023/a:1022684520514
Lawson, G. M., Hook, C. J., & Farah, M. J. (2018). A meta‐analysis of the relationship between socioeconomic status and executive function performance among children. Developmental Science, 21(2), e12529 https://doi.org/10.1111/desc.12529
Levens, S. M., Muhtadie, L., & Gotlib, I. H. (2009). Rumination and impaired resource allocation in depression. Journal of Abnormal Psychology, 118(4), 757–766. https://doi.org/10.1037/a0017206
Liang, C. W. (2018). Attentional control deficits in social anxiety: Investigating inhibition and shifting functions using a mixed antisaccade paradigm. Journal of Behavior Therapy and Experimental Psychiatry, 60, 46–52. https://doi.org/10.1016/j.jbtep.2018.03.004
Little, T. D. (2013). Longitudinal Structural Equation Modeling. Guilford Press.
Lo, B. C. Y., Chan, S. K., Ng, T. K., & Choi, A. W. M. (2019). Parental demandingness and executive functioning in predicting anxiety among children in a longitudinal community study. Journal of Youth and Adolescence, 49(1), 299–310. https://doi.org/10.1007/s10964-019-01103-1
Luna, B., Padmanabhan, A., & O’Hearn, K. (2010). What has fMRI told us about the development of cognitive control through adolescence? Brain and Cognition, 72(1), 101–113. https://doi.org/10.1016/j.bandc.2009.08.005
Mac Giollabhui, N., Olino, T. M., Nielsen, J., Abramson, L. Y., & Alloy, L. B. (2019). Is worse attention a risk factor for or a consequence of depression, or are worse attention and depression better accounted for by stress? A prospective test of three hypotheses. Clinical Psychological Science, 7(1), 93–109. https://doi.org/10.1177/2167702618794920
Mărcuş, O., Stanciu, O., MacLeod, C., Liebregts, H., & Visu-Petra, L. (2015). A FISTful of emotion: Individual differences in trait anxiety and cognitive-affective flexibility during preadolescence. Journal of Abnormal Child Psychology, 44(7), 1231–1242. https://doi.org/10.1007/s10802-015-0110-z
Masten, A. S., & Cicchetti, D. (2010). Developmental cascades. Development and Psychopathology, 22(3), 491–495. https://doi.org/10.1017/s0954579410000222
Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017
Moriya, J. (2016). Attentional networks and visuospatial working memory capacity in social anxiety. Cognition and Emotion, 32(1), 158–166. https://doi.org/10.1080/02699931.2016.1263601
Mullin, B. C., Perks, E. L., Haraden, D. A., Snyder, H. R., & Hankin, B. L. (2020). Subjective executive function weaknesses are linked to elevated internalizing symptoms among community adolescents. Assessment, 27(3), 560–571. https://doi.org/10.1177/1073191118820133
Ohannessian, C. M., Milan, S., & Vannucci, A. (2017). Gender differences in anxiety trajectories from middle to late adolescence. Journal of Youth and Adolescence, 46(4), 826–839. https://doi.org/10.1007/s10964-016-0619-7
Olivares, J., Ruiz, J., Hidalgo, M. D., García-López, L. J., Rosa, A. I., & Piqueras, J. A. (2005). Social Anxiety Scale for Adolescents (SAS-A): Psychometric properties in a Spanish-speaking population. International Journal of Clinical and Health Psychology, 5(1), 85–97. https://psycnet.apa.org/record/2005-00955-005
Poon, K. (2018). Hot and cool executive functions in adolescence: Development and contributions to important developmental outcomes. Frontiers in Psychology, 8, 2311. https://doi.org/10.3389/fpsyg.2017.02311
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Reinholdt-Dunne, M. L., Mogg, K., & Bradley, B. P. (2013). Attention control: Relationships between self-report and behavioural measures, and symptoms of anxiety and depression. Cognition and Emotion, 27(3), 430–440. https://doi.org/10.1080/02699931.2012.715081
Schriber, R. A., & Guyer, A. E. (2016). Adolescent neurobiological susceptibility to social context. Developmental Cognitive Neuroscience, 19, 1–18. https://doi.org/10.1016/j.dcn.2015.12.009
Seisdedos, N. (2004). Cambios, test de flexibilidad cognitiva [Changes, Cognitive Flexibility Test] (4th ed.). TEA Ediciones.
Seisdedos, N. (2012). d2, test de atención [d2, Attention Test] (4th ed. rev.). TEA Ediciones.
Shields, G. S., Moons, W. G., Tewell, C. A., & Yonelinas, A. P. (2016). The effect of negative affect on cognition: Anxiety, not anger, impairs executive function. Emotion, 16(6), 792–797. https://doi.org/10.1037/emo0000151
Snyder, H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review. Psychological Bulletin, 139(1), 81–132. https://doi.org/10.1037/a0028727
Snyder, H. R., Friedman, N. P., & Hankin, B. L. (2019). Transdiagnostic mechanisms of psychopathology in youth: Executive functions, dependent stress, and rumination. Cognitive Therapy and Research, 43(5), 834–851. https://doi.org/10.1007/s10608-019-10016-z
Sommerfeldt, S. L., Cullen, K. R., Han, G., Fryza, B. J., Houri, A. K., & Klimes-Dougan, B. (2016). Executive attention impairment in adolescents with major depressive disorder. Journal of Clinical Child and Adolescent Psychology, 45(1), 69–83. https://doi.org/10.1080/15374416.2015.1072823
Spanish Society of Epidemiology and Family and Community Medicine. (2000). Una propuesta de medida de la clase social [A proposed measure of social class]. Atención Primaria, 25(5), 350–363. https://doi.org/10.1016/s0212-6567(00)78518-0
Stange, J. P., Connolly, S. L., Burke, T. A., Hamilton, J. L., Hamlat, E. J., Abramson, L. Y., & Alloy, L. B. (2016). Inflexible cognition predicts first onset of major depressive episodes in adolescence. Depression and Anxiety, 33(11), 1005–1012. https://doi.org/10.1002/da.22513
Tomita, N., Imai, S., Kanayama, Y., & Kumano, H. (2019). Relationships between cortically mediated attentional dysfunction and social anxiety, self-focused attention, and external attention bias. Perceptual and Motor Skills, 126(6), 1101–1116. https://doi.org/10.1177/0031512519867798
Ursache, A., Noble, K. G., & Pediatric Imaging, Neurocognition and Genetics Study. (2016). Socioeconomic status, white matter, and executive function in children. Brain and Behavior, 6(10), e00531. https://doi.org/10.1002/brb3.531
Vilgis, V., Silk, T. J., & Vance, A. (2015). Executive function and attention in children and adolescents with depressive disorders: A systematic review. European Child and Adolescent Psychiatry, 24(4), 365–384. https://doi.org/10.1007/s00787-015-0675-7
Wagner, S., Müller, C., Helmreich, I., Huss, M., & Tadić, A. (2015). A meta-analysis of cognitive functions in children and adolescents with major depressive disorder. European Child and Adolescent Psychiatry, 24(1), 5–19. https://doi.org/10.1007/s00787-014-0559-2
Wang, H., Mo, C., & Fang, F. (2020). Dissociated deficits in attentional networks in social anxiety and depression. Science China Life Sciences, 63(7), 1071–1078. https://doi.org/10.1007/s11427-019-1624-5
White, L. K., Moore, T. M., Calkins, M. E., Wolf, D. H., Satterthwaite, T. D., Leibenluft, E., Pine, D. S., Gur, R. C., & Gur, R. E. (2017). An evaluation of the specificity of executive function impairment in developmental psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 56(11), 975–982. https://doi.org/10.1016/j.jaac.2017.08.016
Yüksel, M. Y., Sevim, E., & Çelimli, Ç. (2018). Examination of the relationship between test anxiety and selective attention among adolescents. Elementary Education Online, 17(2), 864–873. https://doi.org/10.17051/ilkonline.2018.419331
Zelazo, P. D., & Carlson, S. M. (2012). Hot and cool executive function in childhood and adolescence: Development and plasticity. Child Development Perspectives, 6(4), 354–360. https://doi.org/10.1111/j.1750-8606.2012.0024.x
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The authors thank the schools and adolescents who participated in the study. Moreover, thank the Deusto Stress Research team, from University of Deusto, for their collaboration in data collection.
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A.M. collaborated with the design of the study, analyzed the data, wrote the paper, prepared the tables, and revised the references; E.C. designed the study, collaborated with the writing of the study, analyzed the data, and wrote part of the results. All authors approved the final version of the manuscript for submission.
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This research was supported by a grant from the Training of Research Personal of the University of Deusto (Bilbao, Spain) and from the Government of the Basque Country, Spain (Ref. IT982-16).
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Morea, A., Calvete, E. Cognitive Flexibility and Selective Attention’s Associations with Internalizing Symptoms in Adolescents: Are they Reciprocal?. J Youth Adolescence 50, 921–934 (2021). https://doi.org/10.1007/s10964-021-01402-6
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DOI: https://doi.org/10.1007/s10964-021-01402-6