Early childhood executive control modulates negative affectivity's role in increasing adolescent body mass index trajectories.

BACKGROUND: Executive control and temperament have been associated with pediatric obesity. However, interactions between these constructs in relation to future weight outcomes have not been investigated. OBJECTIVE: This longitudinal study examined early childhood executive control, early temperament (negative affectivity and surgency), and their interactions as predictors of adolescent BMI trajectories. METHODS: At age 5.25, children (N = 229) completed executive control tasks, and parents completed the Child Behavior Questionnaire to assess temperament. BMI was calculated annually between ages 14-17. RESULTS: Greater early negative affectivity predicted more positive BMI growth. Although early childhood executive control was not associated with BMI growth, greater negative affectivity predicted greater BMI escalation at average and below average executive control abilities. CONCLUSIONS: For children without robust executive control abilities early in development, negative affectivity may be a risk factor for accelerated adolescent BMI growth. Targeted assessment of early risk factors may be useful for childhood obesity prevention efforts.

Associations between middle childhood executive control aspects and adolescent substance use and externalizing and internalizing problems.

This study examines the degree to which two middle childhood executive control aspects, working memory and combined inhibitory control/flexible shifting, predict adolescent substance use and externalizing and internalizing problems. Participants were 301 children (ages 3-6 years; 48.2% male) recruited from a Midwestern city in the United States and followed into adolescence (ages 14-18 years). Working memory had a statistically significant unadjusted association with externalizing problems (r = -.30, p = .003) in a confirmatory factor analysis. Neither factor significantly predicted any of the adolescent outcomes in a structural equation model that adjusted for each EC aspect, sociodemographic covariates, and middle childhood externalizing and internalizing problems. Stronger prediction of EC aspects might not emerge until they become more fully differentiated later in development.

Exploring the Interaction Between Preschool Executive Control and Caregiver Emotion Socialization in Predicting Adolescent Weight Trajectories.

There is a critical need for research examining how neural vulnerabilities associated with obesity, including lower executive control, interact with family factors to impact weight trajectories across adolescence. Utilizing a longitudinal design, the present study investigated caregivers' emotion socialization practices as a moderator of the association between preschool executive control and adolescent body mass index (BMI) trajectories. Participants were 229 youth (Mage = 5.24, SD = 0.03; 47.2% assigned female at birth; 73.8% White, 3.9% Black, 0.4% Asian American, 21.8% multiracial; 12.7% Hispanic) enrolled in a longitudinal study. At preschool-age, participants completed performance-based executive control tasks, and their caregivers reported on their typical emotion-related socialization behaviors (i.e., supportive and nonsupportive responses to children's negative emotions). Participants returned for annual laboratory visits at ages 14 through 17, during which their height and weight were measured to calculate BMI. Although neither preschool executive control nor caregiver emotion-related socialization behaviors were directly associated with BMI growth in adolescence, supportive responses moderated the association between executive control and BMI trajectories. The expected negative association between lower preschool executive control and greater BMI growth was present at below average levels of supportive responses, suggesting that external regulation afforded by supportive responses might reduce risk for adolescent overweight and obesity among children with lower internal self-regulatory resources during preschool. Findings highlight the importance of efforts to bolster executive control early in development and targeted interventions to promote effective caregiver emotion socialization (i.e., more supportive responses) for youth with lower internal self-regulatory abilities to mitigate risk for overweight and obesity and promote health across childhood and adolescence.

A Comparison of Task-Based and Questionnaire Assessments of Executive Control Aspects in Relation to Adolescent Marijuana Initiation.

Prior research has linked deficits in executive control (EC) to marijuana use in adolescents but has relied either primarily on adolescent self-report of EC or tasked-based EC, and focused on limited aspects of EC, usually inhibitory control. We examined unique associations of three established aspects of EC (inhibitory control, working memory, and flexible shifting) assessed with both performance on laboratory tasks and self-report in relation to marijuana initiation. Participants were 260 youth (ages 14-18 years) from a small Midwestern city in the United States enrolled in the adolescent phase (beginning in 2017) of an ongoing study of EC development recruited originally between 2006 and 2012 (46% male, 72% European American). The three aspects of executive control were measured in a laboratory setting with well-established performance-based measures and with a psychometrically-sound self-report survey instrument. Youth also provided self-report of marijuana initiation in a phone survey administered during their laboratory visit. Multiple logistic regression analysis indicated that flexible shifting as measured by a performance-based task was negatively and uniquely associated with marijuana initiation (AOR = 0.68, 95% CI = 0.48 - 0.91), and self-reported deficits in inhibitory control were positively associated with marijuana initiation (AOR = 1.92, 95% CI = 1.15 - 3.21). Although larger-scale longitudinal research is needed, findings of this study suggest that screening efforts to identify youth at risk of marijuana initiation might rely on more cost-effective self-report assessment of inhibitory control, but further valuable information can come from more resource-intensive but sensitive performance-based assessment of flexible shifting.

Early executive control buffers risk for adolescent psychopathology during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on youth mental health, and there is a critical need for research examining individual factors that contribute to increased psychopathology during the pandemic. The current study explored whether executive control (EC) abilities in early childhood interact with COVID-related stress to attenuate risk for adolescent psychopathology during the first 6 months of the pandemic. METHODS: Participants were 337 youth (49% female) living in a small midwestern city in the United States. Participants completed EC tasks when they were approximately 4.5 years old as part of a longitudinal study investigating cognitive development. At annual laboratory visits during adolescence and before the pandemic, participants (Mage = 14.57) reported on mental health symptoms. In July and August of 2020, participants (Mage = 16.57) reported on COVID-related stress and depression, anxiety, and trauma symptoms. RESULTS: COVID-related stress was associated with increased internalizing problems after controlling for prepandemic symptom levels. Further, the impact of COVID-related stress on adolescent internalizing problems was moderated by preschool EC, with higher levels of EC buffering the effects of COVID-related stress on adolescent internalizing problems. CONCLUSIONS: Findings highlight the importance of promoting EC early in development, as well as screening for EC deficits and implementing targeted intervention strategies across the lifespan to help reduce the impact of stress on adolescent internalizing problems.

Does preschool executive control mediate the impact of early environmental unpredictability and deprivation on the general factor of psychopathology a decade later?

BACKGROUND: Although deprivation has been consistently shown to increase risk for psychopathology through impaired executive control, the unique effects of other dimensions of early adversity, such as unpredictability, on executive control development are poorly understood. The current study evaluated whether deprivation and/or unpredictability early in life have unique effects on the general factor of psychopathology through impaired preschool executive control. METHODS: Participants included 312 children (51% female) oversampled for greater sociodemographic risk. Preschool executive control was measured using a battery of nine developmentally appropriate executive control tasks. Dimensions of adversity were measured with observational and caregiver assessments, and psychopathology was measured with caregiver and child reports. RESULTS: In separate models, both deprivation and unpredictability had significant indirect effects on the adolescent general factor of psychopathology through impaired preschool executive control. However, when both dimensions of adversity were included simultaneously, early life deprivation, but not unpredictability, was uniquely associated with the general factor of psychopathology in adolescence through impaired preschool executive control. CONCLUSIONS: Preschool executive control appears to be a transdiagnostic mechanism through which deprivation, but not unpredictability, increases risk for the general factor of psychopathology in adolescence. Results elucidate potential transdiagnostic targets for intervention efforts aimed at reducing the development and maintenance of psychopathology across the life span.

Childhood executive control and adolescent substance use initiation: the mediating roles of physical and relational aggression and prosocial behavior.

Although predictive associations between childhood executive control (EC) and adolescent substance use have been established in prior research, the developmental pathways involved in these long-term links have not been well understood. The goal of the current study was to investigate the degree to which aggressive behaviors, including both physical and relational aggression, and prosocial behaviors in elementary school operate as developmental pathways between preschool EC and adolescent substance use, while accounting for participants' age, sex, family history of substance use, and family socioeconomic status. Participants were 329 youth (49% male; 63.6% European American) who were recruited to participate in a study between 2006 and 2012 while youth were in preschool and elementary school and followed into adolescence. The sample was recruited from a small Midwestern city in the United States. EC was assessed with performance-based tasks when children were 5 years 3 months. Youth behaviors with peers were reported by teachers when participants were in elementary school. Self-reports of the substance use initiation (e-cigarettes, cigarettes, alcohol, and marijuana) were obtained in adolescence via phone surveys. Mediation analyses revealed a statistically significant indirect effect from preschool EC to adolescent substance use through youth's engagement in relational aggression in elementary school (b = > -0.22 [-0.51; -0.08]; ß = > -0.18). Our results suggest that developmental pathways to adolescent substance use may begin in preschool, setting the stage for susceptibility to engagement in relational aggression, which increases, in turn, youth's likelihood for substance use initiation in adolescence.

Preschool Executive Control, Temperament, and Adolescent Dietary Behaviors.

BACKGROUND: Child temperament styles characterized by increased emotionality or pleasure seeking may increase risk for less healthful eating patterns, while strong executive control (EC) may be protective. The interaction of these characteristics with longitudinal outcomes has not yet been examined. PURPOSE: The aim of this study was to examine the association of preschool temperament and EC, as well as their interaction with adolescent eating. METHODS: Preschoolers (N = 313) were recruited into a longitudinal study, with behavioral measurement of EC at age 5.25 years, temperament assessed multiple times across preschool, and eating outcomes assessed in adolescence (mean age = 15.34 years). RESULTS: Separate latent moderated structural equation models demonstrated that weaker EC was associated with eating less healthful foods, including high sugar foods, sugar-sweetened beverages (SSBs), and convenience foods (p < .05). In the moderation models, negative affectivity temperament was correlated with eating less healthful foods, high sugar foods, and SSBs (p < .05). Children lower in surgency/extraversion temperament were more likely to drink SSBs. There was an interaction between temperament and EC, such that children high in negative affectivity with weaker EC were particularly more likely to consume less healthful foods, high sugar foods, and SSBs (p < .05). There was no interaction of surgency with EC and food consumption. CONCLUSIONS: Child characteristics measured early in development were associated with later adolescent eating behaviors. Adequate EC could be necessary to counteract the drive toward eating associated with temperaments high in negative affectivity.

A preschool temperament style called Negative Affectivity, characterized by high levels of reactivity and negative emotion, predicted eating patterns a decade later. These children were more likely to eat less healthful foods and drink sugary drinks as adolescents. Strong executive function skills were important for redirecting toward healthful eating in children with Negative Affectivity.

Empirical support for a dual process model of the p-factor: Interaction effects between preschool executive control and preschool negative emotionality on general psychopathology.

Recent work indicates that a general factor, often referred to as the p-factor, underlies nearly all forms of psychopathology. Although the criterion validity and utility of this general factor have been well supported, questions remain about the substantive meaning of the p-factor. The purpose of the present longitudinal study was to empirically test the hypothesis that the p-factor reflects dysregulation arising from a combination of high dispositional negative emotionality and low executive control. The current study examined preschool executive control, measured using a battery of 9 developmentally appropriate executive control tasks, as a moderator of the association between preschool negative emotionality and both concurrent and subsequent levels of general psychopathology in preschool and elementary school using a community sample (N = 497). Latent moderated structural equation models demonstrated that preschool executive control significantly moderated the associations between preschool negative emotionality and general psychopathology both in preschool and approximately 5 years later in elementary school. These results suggest that the general factor of psychopathology may reflect dysregulation arising from a tendency to experience high negative affect, without sufficient executive control to effectively down-regulate that affect. This work has important implications for identifying transdiagnostic targets for prevention and intervention efforts, as well as furthering understanding of the substantive meaning and construct validity of the general factor of psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The roles of sleep and executive function in adolescent nighttime eating.

Nighttime eating has been associated with obesity, inflammation, and poor nutritional intake, yet correlates of this behavior are understudied in pediatric populations and among adolescents in particular. The current study examines modifiable factors related to nighttime eating, including sleep parameters and regulatory abilities-as well as the interplay between these constructs-in adolescents. A total of 223 adolescents (Mage = 15.32 years, 52.9 % female, 15.7 % classified as overweight, 21.1 % had obesity) wore ActiGraph devices to measure sleep and were instructed to complete three 24-h dietary recall measures over a two-week period. Participants also completed self-report measures of executive function. Greater variability in sleep duration was consistently associated with higher average calorie, sugar, and fat consumption after 8, 9, and 10 PM. The main effect of global executive function on all nighttime eating measures was nonsignificant, and executive function did not moderate relationships between sleep parameters and nighttime eating measures. Since adolescents' eating habits may set the stage for lifelong dietary practices, efforts to ensure consistent sleep duration may reduce risk for nighttime eating in this nutritionally vulnerable population.

Executive control throughout elementary school: Factor structure and associations with early childhood executive control.

This study examined the factor structure of executive control throughout elementary school, as well as associations between executive control abilities in preschool and elementary school. Data were drawn from a longitudinal study of executive control development in a community sample of children (N = 294; 53% female, 47% male) oversampled for low family income (25.4% below poverty line; Mincome = $46,638; SD = $33,256). The sample was representative of the Midwestern city in which the study was conducted in terms of race (71.4% White, 24.5% multiracial, 3.7% Black, and .3% Asian American) and ethnicity (14% Hispanic). Children completed a battery of ten performance-based tasks assessing executive control abilities in grades 1 (Mage = 7.08 years), 2 (Mage = 8.04 years), 3 (Mage = 9.02 years), and 4 (Mage = 9.98 years). Confirmatory factor analysis supported a two-factor structure at each grade with factors representing working memory and inhibitory control/flexible shifting. Measurement invariance testing revealed partial scalar (indicator intercepts) invariance for working memory and partial metric (indicator loadings) and partial scalar invariance for inhibitory control/flexible shifting. Preschool executive control (age 4.5 years), represented by a unitary latent factor, significantly predicted working memory (ßs = .79, .72, .81, .66) and inhibitory control/flexible shifting (ßs = .69, .64, .63, .62) factors in grades 1 through 4. Follow-up analyses indicated that the findings were not attributable to general cognitive ability. Findings support greater separability of executive control components in elementary school versus preschool, and considerable continuity of executive control from preschool through elementary school. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal associations between executive control and body mass index across childhood.

BACKGROUND: Childhood obesity remains a prevalent public health concern. Executive control, a set of higher-order cognitive abilities for directing attention and behaviour, has been identified as a malleable factor potentially related to weight outcomes in youth. However, the directionality of this relationship remains unclear. OBJECTIVES: This study examined reciprocal associations between three executive control components-inhibitory control, working memory and flexible shifting-and BMI (body mass index) percentile during childhood. METHODS: At four points throughout elementary school, a community sample (N = 294) completed executive control tasks and had their height and weight objectively measured. Controlling for sex and socioeconomic risk status, random intercept cross-lagged panel models were tested. RESULTS: Better inhibitory control performance predicted lower subsequent BMI at each timepoint, and better working memory and flexible shifting performance in grade three both predicted lower subsequent BMI in grade 4. However, BMI did not predict subsequent executive control performance at any timepoint. CONCLUSIONS: Executive control abilities, including automatic response modulation, being able to hold and manipulate mental information, and being able to make flexible mental transitions, may be protective against weight problems, particularly in middle childhood when these abilities have had more time to mature and children begin to gain more independence.

Associations Between Preschool Sleep Problems and Observed Dimensions of Elementary Classroom Engagement.

Sleep has clear importance for academic success. However, most research in this area has focused on older children and adolescents and has used narrow measures of academic achievement, overlooking the importance of early sleep problems in shaping children's classroom behaviors that support academic success. Using a community sample (N = 276, 50% female), the current study examined associations between parent-reported preschool sleep problems (M age = 3.84, SD = 0.83) and three dimensions of classroom engagement coded during live classroom observations in the first grade (M age = 6.72, SD = 0.34). The moderating role of family socioeconomic status (SES) was also considered. A multivariate multilevel model found that more preschool sleep problems were associated with less focused engagement (defined as involvement in academic tasks, such as writing or asking questions), but more competing responses (defined as inappropriate or distracting behaviors). Preschool sleep problems were not associated with task management (defined as preparation for academic tasks, such as locating classroom materials). Although family SES did not moderate any of these associations, higher income-to-needs ratios in preschool were associated with more focused engagement and fewer competing responses. Findings highlight the role of early sleep problems in classroom behaviors that facilitate academic success. Targeting sleep problems prior to the school transition may serve as a useful approach to optimizing learning conditions during this key developmental period.

Associations of childhood executive control with adolescent cigarette and E-cigarette use: Tests of moderation by poverty level.

BACKGROUND: Adolescent cigarette smoking has continued to decline, whereas electronic cigarette (e-cigarette) use has increased dramatically among youth. Nicotine use in any form, even at low levels, during adolescence can have adverse consequences, particularly for low-income individuals. To elucidate potential early intervention targets, this study examined childhood executive control (EC), a set of cognitive processes for directing attention and behavior, in relation to adolescent cigarette and e-cigarette onset, testing for differential prediction by poverty level. METHOD: Participants were 313 children (51% female, 64% European American) recruited in a small city in the Midwestern United States beginning in 2006 and then followed into adolescence between ages 14 and 16 years. EC was measured in the laboratory with performance-based tasks when children were age 5 years, 3 months. Self-reports of cigarette onset and e-cigarette onset were obtained in adolescence (Mage = 15.65 years). Overall, 24% of the sample was at or below the poverty line. RESULTS: Cigarette onset was higher in the poverty group (17%) than in the non-poverty (8%) group, but e-cigarette onset did not differ by poverty level (36% poverty versus 38% non-poverty). Multiple group structural equation modeling revealed a statistically significant group difference such that EC ability was a significant negative predictor of e-cigarette onset for poverty but not for non-poverty youth. A similar group difference was evident as a trend for cigarette onset. CONCLUSIONS: Because EC has been shown to be modifiable, early interventions to improve EC for children living in poverty might help prevent adolescent e-cigarette onset.

Improving Referrals to Diabetes Self-Management Education in Medically Underserved Adults.

OBJECTIVE: Electronic health records (EHRs) and clinical decision-support algorithms improve diabetes care. This quality improvement (QI) project aimed to determine whether an electronic diabetes education referral protocol using the Diabetes Self-Management Education and Support for Adults With Type 2 Diabetes: Algorithm of Care (DSMES Algorithm) and protocol training would increase the proportion of adult patients with type 2 diabetes at a federally qualified health center electronically referred for diabetes self-management education and support (DSMES). DESIGN AND METHODS: The EHR was modified to include the DSMES Algorithm and questions regarding prior participation in diabetes education. Protocol trainings were conducted. Data were obtained via retrospective chart review. A one-sample t test was used to evaluate the statistical difference between the electronic referral (e-referral) rates of the pre-intervention and intervention groups. RESULTS: Completion of the DSMES Algorithm was positively associated with e-referrals to diabetes education (P <0.001). The intervention group had a higher rate of e-referral for DSMES than the pre-intervention group (31 vs. 0%, P <0.001). CONCLUSION: E-referral protocols using the DSMES Algorithm and protocol training may aid in the identification and documentation of self-care needs of medically underserved patients with type 2 diabetes and improve e-referrals to DSMES. Of clinical importance, these findings translate into active patient engagement, team-based care, and information-sharing. Additional work is needed to determine whether the e-referral rate is sustained or increases over time. Further investigations should also be explored to evaluate the impact of e-referral protocols and algorithms on participation in DSMES.

Executive Control in Early Childhood as an Antecedent of Adolescent Problem Behaviors: A Longitudinal Study with Performance-based Measures of Early Childhood Cognitive Processes.

Identifying childhood cognitive processes that predict adolescent problem behaviors can help guide understanding and prevention of these behaviors. In a community sample of 313 youth recruited in a small Midwestern city between 2006 and 2012 (49% male, 64% European American), executive control and foundational cognitive abilities were assessed at age 5 in a lab setting with performance-based measures. In adolescence, youth provided self-report of problem behaviors in surveys administered annually between ages 14 and 16. Executive control was negatively associated with externalizing behavior problems and adolescents getting in trouble at school, accounting for foundational cognitive abilities and family background covariates. Executive control had negative, but nonsignificant, associations with internalizing problems and substance use initiation. The findings point to deficits in executive control as a childhood risk factor for later problems and a potential target for preventive interventions.

Associations between specific components of executive control and eating behaviors in adolescence: A study using objective and subjective measures.

A growing literature suggests that executive control (EC; also known as "executive functioning" or "EF") in adolescence may play an important role in the development of key health behaviors, including eating behaviors. However, existing literature has significant limitations in the conceptualization and measurement of EC. The current study aims to address these limitations by employing a multidimensional approach to conceptualizing and measuring adolescent EC, including both objective and subjective measures covering multiple components of EC, and examining links with specific eating behaviors. A community sample of adolescents (N = 208; mean age = 14.5 years) completed a battery of performance-based neuropsychological tasks assessing specific components of EC (i.e., working memory, inhibitory control, flexible shifting), a norm-referenced questionnaire covering problems with specific components of EC in daily life, and a measure assessing key eating behaviors (i.e., uncontrolled eating, emotional eating, cognitive restraint). Objectively-measured adolescent working memory was significantly and uniquely associated with cognitive restraint, with stronger working memory associated with less cognitive restraint. No other associations between performance-based EC tasks and eating behaviors were found. In contrast, using subjective reports of EC, problems with inhibitory control were associated with greater uncontrolled eating, and problems with flexible shifting were associated with greater emotional eating. The results suggest links between specific aspects of EC and specific eating behaviors in adolescence, as well as the potential importance of context for understanding the role of EC in eating behavior. Given evidence that EC is modifiable, the findings have potential implications for novel interventions addressing eating behaviors by targeting EC.

Associations of Early Socio-familial Stress with Maladaptive and Adaptive Functioning in Middle Childhood: Roles of Executive Control and Foundational Cognitive Abilities.

This study examined whether cognitive processes in preschool, conceptualized as a unitary construct of executive control (EC) as well as foundational cognitive abilities (FCA), predict both maladaptive and adaptive functioning in middle childhood and mediate associations between early childhood socio-familial stress and those functional outcomes. Performance-based, multidimensional, and age-appropriate measures of EC and FCA were collected in a laboratory setting from 313 preschool-age children at age 5, along with questionnaire data from children and their parents on three dimensions of early socio-familial stress and parent smoking. Parent, teacher, and child self-report data on 285 of these children were obtained when they were in grade 3 or 4. Middle childhood data were used to create indices of maladaptive and adaptive functioning. A bi-factor structural equation modeling analysis captured distinct dimensions of preschool EC and FCA and was used to test the hypothesized pathways. EC had a statistically significant negative association with later maladaptive functioning. FCA, but not EC, served as a mediator in links between each type of family stressor and both maladaptive and adaptive functioning in middle childhood. Results suggest that EC may play a role in predicting maladaptation, whereas early childhood FCA may operate as an intervening variable in pathways from early family stressors to subsequent maladaptation as well as adaptation. Findings point to the need to address FCA by reducing early family stressors. Early interventions that enhance cognitive abilities may help reduce maladaptive and promote adaptive functioning later in childhood, thereby potentially preventing, in turn, later behavioral problems.

Executive control goes to school: Implications of preschool executive performance for observed elementary classroom learning engagement.

The transition to elementary school is accompanied by increasing demands for children to regulate their attention and behavior within the classroom setting. Executive control (EC) may be critical for meeting these demands; however, few studies have rigorously examined the association between EC and observed classroom behavior. This study examined EC in preschool (age 5 years 3 months) as a predictor of classroom learning engagement behaviors in first grade, using a battery of performance-based EC tasks and live classroom observations in a longitudinal sample of 313 children. Multilevel modeling results indicated that stronger EC predicted more focused engagement and fewer task management and competing responses, controlling for socioeconomic status, child sex, and age at observations. Results suggest that early EC may support subsequent classroom engagement behaviors that are critical for successful transition to elementary school and long-term learning trajectories. (PsycINFO Database Record