Executive (dys)functions and ODD and CD: A systematic review and meta-analysis.

Abstract

Objective: Precursors of antisocial behavior in children may be associated with neuropsychological deficits, namely in executive functions (EF). The main objective of this systematic review and meta-analysis was to synthesize evidence of the relation between EF performance and early manifestations of antisocial behavior in children and adolescents. Method: The procedures of this systematic review and meta-analysis were based on the PRISMA recommendations. The review was based on a systematic search in the EBSCOhost and Pubmed databases. Fifty studies were included in this review, 37 of which contributed with data for meta-analysis. All studies examined the possible relation between the EF measures and behavior problems in childhood and adolescence. Meta-analytical procedures were performed, and the overall effect size was calculated from randomeffect models, using the Comprehensive Meta-Analysis software. Results: A substantial part of the studies report EF deficits in children and adolescents who present behavior problems, revealing that these deficits are already present in youth, long before being associated with antisocial behavior in adults, especially when in comorbidity with attention-deficit hyperactivity disorder (ADHD). Specifically, typical controls (TC) performed significantly better than disruptive behavior disorders (DBD) groups on measures of overall EF, g = −.35, 95% CI [−0.48, −0.22], p < .001. Similar results were found for working memory, g = −.26, 95% CI [−0.45, −0.07], p < .001, cognitive inhibition, g = −.30, 95% CI [−0.57, −0.04], p = .03, behavioral inhibition, g = −.45, 95% CI [−0.71, −0.19], p = .001, and cognitive flexibility (tests scores), g = −.31, 95% CI [−0.60, −0.02], p = .04. Comparing DBD + ADHD participants with TC, no significant differences were found, either for overall EF or for each dimension. Finally, DBD participants performed better than DBD + ADHD participants on measures of overall EF, g = .20, 95% CI [0.08, 0.33], p = .002. Conclusion: These findings are in line with neuropsychological theories arguing that executive dysfunctions may interfere with the children's and/or adolescents' ability to control their own conduct, in order to inhibit inappropriate behaviors in favor of the prosocial ones. This review and meta-analysis also identify the main characteristics and potential limitations of the existing studies. Key Points Question: (a) To what extent are deficits in EF more evident in children and adolescents showing DBD? (b) do children and adolescents with DBD show evidence of EF deficits regardless of ADHD? Findings:The reviewed studies indicate that participants with behavioral problems present worse performance in EF tasks in comparison to typical groups. Importance: These results provide further evidence regarding EF deficits in children and adolescents diagnosed with behavior problems and suggest that these deficits may be aggravated by comorbid ADHD. Next Steps: In light of these results, EF training programs can be better tailored to the characteristics of ...

The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders

“…p), both of which can disrupt the development of RF and heighten the risk of later aggression (Fergusson, Horwood, & Lynskey, 1994). For instance, executive functioning impairments, common to various childhood and adolescent mental health conditions such as oppositional defiant disorder (ODD), attention deficit hyperactivity disorder (ADHD), and CD (Figueiredo, Ramião, Barroso, & Barbosa, 2022), have been linked to RF deficits in both healthy and clinical populations (Ogilvie, Stewart, Chan, & Shum, 2011;Rutherford et al, 2018). Constructs that are related to RF, such as empathy and theory of mind (ToM) during childhood and adolescence, have been also found to predict later symptoms of ASPD, psychopathy, violence, and offending behavior (Frick & White, 2008;Galán, Choe, Forbes, & Shaw, 2017;Karoğlu, Ferguson, & Ó Ciardha, 2022;Rhee et al, 2021).…”