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. 2023 Dec 4;2(1):66-77.
doi: 10.1016/j.jaacop.2023.11.001. eCollection 2024 Mar.

Executive Functioning, Internalizing and Externalizing Symptoms: Understanding Developmental Dynamics Through Panel Network Approaches

René Freichel  1 , Janine Pfirrmann  1 , Peter J de Jong  2 , Janna Cousijn  3 , Ingmar H A Franken  3 , Albertine J Oldehinkel  4 , Ilya M Veer  1 , Reinout W Wiers  1
Affiliations

Executive Functioning, Internalizing and Externalizing Symptoms: Understanding Developmental Dynamics Through Panel Network Approaches

René Freichel et al. JAACAP Open. .

Abstract

Objective: Early adolescence is a transition period during which many mental health disorders emerge. The interplay between different internalizing and externalizing mental health problems in adolescence is poorly understood at the within-person level. Executive functioning (EF) in early adolescence has been shown to constitute a transdiagnostic risk factor, but the specificity of the associations between different domains of EF and mental health problems remains unclear.

Method: Network dynamics (ie, temporal effects) of different internalizing and externalizing symptoms were investigated leveraging data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal panel study of adolescents (>1,641 participants) assessed at ages 11, 13, and 15. Two novel methodological panel network approaches were used: cross-lagged panel network models and graphical vector autoregressive models. Hierarchical regression models were used to investigate prospective associations between different measures of EF and broadband transdiagnostic dimensions.

Results: Depressive problems predicted a range of other internalizing symptoms (ie, panic, somatic problems, separation anxiety, general anxiety, social phobia) over time, particularly during early adolescence. Important feedback loops with reciprocal associations between different anxiety symptoms were identified. Different facets of EF assessed at age 11, particularly sustained attention, showed weak but significant prospective associations with internalizing and externalizing symptoms at age 13.

Conclusion: The present findings emphasize the importance of targeting depressive problems in early adolescence to prevent a spiral of different internalizing symptoms from arising later on.

Keywords: executive functioning; externalizing; internalizing; network.

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Figures

Figure 1
Figure 1
Cross-Sectional Internalizing-Externalizing Networks Note: (A-C) Waves 1-3. Attention problems abbreviations: AttHyper = attention-deficit/hyperactivity disorder; Externalizing abbreviations: Oppos = oppositional defiant problems; conduct = conduct problems; Internalizing abbreviations: Depr = depressive problems; Somat = somatic problems; GenAnx = Generalized Anxiety Disorder; SocPho = social phobia; SepAnx = separation anxiety disorder; Panic = panic disorder; OCD = obessive-compulsive disorder.
Figure 2
Figure 2
Temporal Internalizing-Externalizing Networks From Cross-Lagged Panel Model Note:(A) Wave 1 to 2. (B, C) Wave 2 to 3. AttHyper = attention deficit hyperactivity; Oppos = oppositional defiant problems; Conduct = conduct problems; Depr = depressive problems; Somat = somatic problems; GenAnx = generalized anxiety disorder; SocPhob = social phobia; SepAnx = separation anxiety disorder; Panic = panic disorder; OCD = obsessive-compulsive disorder.
Figure 3
Figure 3
Pruned Temporal Network From Panel Graphical Vector Autoregressive Model Note:AttHyper = attention deficit hyperactivity; Oppos = oppositional defiant problems; Conduct = conduct problems; Depr = depressive problems; Somat = somatic problems; GenAnx = generalized anxiety disorder; SocPhob = social phobia; SepAnx = separation anxiety disorder; Panic = panic disorder; OCD = obsessive-compulsive disorder.
Figure 4
Figure 4
Regression Estimates for Different Executive Functioning Measures Note:The regression estimates refer to the regression models (in step 2) that include sex and previous internalizing and externalizing symptoms as predictors. The standard errors for the regression estimates are shown in vertical bars. CogFlex = cognitive flexibility; Fluct = fluctuations in tempo (sustained attention); ResInhib = response inhibition; RT = reaction times. ∗p < .05.
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