Disclosures: Morales-Muñoz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
April 13, 2021
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Childhood cognitive deficits play role in later mental health problems

Disclosures: Morales-Muñoz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Certain cognitive deficits in childhood were distinctively linked to different psychopathological symptoms among young people, according to results of a cohort study published in JAMA Network Open.

“As far as we are aware, existing studies have not examined the prospective and specific associations of childhood cognition with different forms of psychopathological symptoms in young people,” Isabel Morales-Muñoz, PhD, of the department of public health solutions at the Finnish Institute for Health and Welfare, and colleagues wrote. “It is essential to do so to understand how mental disorders develop, whether there are specific pathways associated with the development of specific mental disorders and to what extent this development could be changed.”

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Specifically, the investigators aimed to evaluate the specificity of associations between attention, working memory and inhibition in childhood and borderline personality disorder (BPD), psychosis, depression and hypomania in adolescence and young adulthood. They analyzed data of pregnant women in Avon, U.K., who were included in the Avon Longitudinal Study of Parents and whose expected date of delivery was between April 1, 1991, and Dec. 31, 1992. The initial sample comprised 13,988 individuals alive at age 1 year. For the current study, data were available of 6,333 individuals for any psychopathological measures between ages 11 and 12 years, 4,903 between ages 17 and 18 years and 2,963 between ages 22 to 23 years. Exposures included sustained attention, selective attention and attentional control evaluated via the Test of Everyday Attention for Children at age 8 years, as well as working memory and inhibition evaluated at age 10 years via the Counting Span Task and the stop-signal paradigm, respectively. BPD symptoms evaluated between ages 11 and 12 years, psychotic experiences and depression evaluated between ages 17 and 18 years and hypomania evaluated between ages 22 and 23 years served as main outcomes and measures.

The researchers included 5,315 individuals in the statistical analysis, of whom 2,551 were males and 2,764 were females. Results showed an association between higher sustained attention at age 8 years and decreased risk for BPD symptoms between ages 11 and 12 years (adjusted OR = 0.964; 95% CI, 0.933-0.996), enhanced inhibition performance at age 10 years with decreased risk for psychotic experiences between ages 17 and 18 years (aOR = 0.938; 95% CI, 0.89-0.989), higher sustained attention at age 8 years with decreased risk for depressive symptoms between ages 17 and 18 years (aOR = 0.969; 95% CI, 0.938-0.9997) and enhanced working memory performance at age 10 years with decreased risk for hypomania symptoms between ages 22 and 23 years (aOR = 0.694; 95% CI, 0.529-0.911). Morales-Muñoz and colleagues controlled for potential psychopathology overlay and found all associations remained, aside from working memory and hypomania. Further, they reported an association between higher sustained attention at age 8 years and decreased risk for BPD symptoms between ages 11 and 12 years, as well as decreased risk for depression between ages 17 and 18 years. They also reported an association between enhanced inhibition performance at age 10 years and decreased risk for psychotic experiences between ages 17 and 18 years.

“Our results suggest that cognition could hypothetically be a target for prevention strategies, though determining the feasibility and nature of such strategies requires further investigation,” the researchers wrote. “This study’s results substantially add to previous findings of associations between childhood cognitive deficits and later mental health problems. This study suggests that there are longitudinal associations between childhood cognition and a range of subsequent psychopathological conditions, as well as specific independent pathways in these prospective associations.”