Prior research in working memory (WM) has been hampered by measurement variability and a lack of integration of neural and clinical markers. This study sought to examine whether a multi-level composite of WM with neural, cognitive, and behavioral levels could predict childhood affective symptomatology in seventeen children and adolescents receiving outpatient mental health services. WM-related theta/gamma oscillations at the F3 electrode were measured via electroencephalography (EEG) recording during a spatial WM task. Other measures included a neuropsychological measure of WM, parent questionnaire assessing WM, and self-reported affective symptoms. Gamma power and theta-gamma coupling, but not theta power, predicted high WM demands performance (i.e., 16-19% of variance). Two composite scores were created consisting of gamma power or theta-gamma coupling, clinical WM measure performance, and parent-reported WM symptoms. These multi-level composite score predicted self-reported depressive (22-32% of variance) symptoms, while only the gamma-version of the composite predicted anxious symptoms (39% of variance compared to 12% of variance). A WM composite score consisting of neural, cognitive, and behavioral levels predicted the severity of childhood affective symptomatology. WM, like other EFs, is highly complex and may be most appropriately measured in clinical and research settings with a combination of neural, cognitive, and behavioral measures.

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