Identifying Cognitive Problems in Children and Adolescents with Depression Using Computerized Neuropsychological Testing

Abstract

Depression in children and adolescents can negatively impact cognitive functioning, social development, and academic performance. The purpose of this study was to determine whether a computerized battery of neuropsychological tests could detect neurocognitive difficulties in children and adolescents with depression. Participants included 30 children and adolescents between the ages of 9 and 17 years (M = 14.6, SD = 2.1) with a clinical diagnosis of depression. Healthy control participants were individually matched on age, education, sex, race, primary language, handedness, and self-reported computer familiarity. All participants completed the Central Nervous System Vital Signs computerized battery. This battery of seven tests yields 23 test scores and 5 domain scores (Memory, Psychomotor Speed, Reaction Time, Complex Attention, and Cognitive Flexibility). Children and adolescents with depression performed worse on the Memory (Cohen's d = .43) and Complex Attention domains (d = .58) than matched controls. On the individual test scores, children and adolescents with depression performed worse on delayed verbal memory (d = .63), delayed visual memory (d = .34), measures of reaction time (d = .34-.53), and accuracy/inhibition on complex attention tasks (d = .49-.65). When considering the five domain scores simultaneously, children and adolescents with depression were more likely to have two or more scores at or below the 5th percentile (p = .05). Children and adolescents with depression have problems with reduced processing speed, memory for verbal information, and executive functioning on this computerized battery of tests, which represents a feasible method for neuropsychological screening.

Executive function and attention in children and adolescents with depressive disorders: a systematic review

“…Three studies included a measure of verbal learning and memory in their investigations some of these tasks require immediate recall and may be considered short-term verbal memory. None reported group differences on immediate recall [13,18,31] but two of these noted worse performance on the delayed recall component [13,31].…”

“…Other measures of set shifting also failed to reveal significant group differences in error rate although group differences in reaction times were detected [32,79]. Brooks et al [13] did find a significant differences and medium effect size for errors on the shifting attention test of the CNS vital signs battery.…”

“…Only one study found that the clinical group, which consisted of 19 children and adolescents with either MDD or DD, performed significantly worse than the healthy control group using the difference in response time between the mismatching word-and-colour condition and the colour-naming condition [15]. Although Brooks et al [13] did not find a significant group difference they noted a small-to-medium effect size for errors on the Stroop task. On the modified Stroop test, Neshat-Doost et al [64] noted greater response latencies and more colour-naming errors in the depressed group independent of valence category.…”

“…Six studies included in the review used different versions of the continuous performance test (CPT) to assess the ability to sustain attention in paediatric depression [11,13,15,34,54,58]. Two reported medium effect sizes for CPT omissions, commissions and greater inconsistencies in reaction times for the clinical group [13,15].…”

“…Many of the tasks used to measure response inhibition require other cognitive resources such as working memory (keeping rules in mind) and activating an alternative response. Five studies were identified that have used the Stroop to assess inhibitory control in paediatric depressive disorders [13,15,19,23,64]. While three of these five studies used the standard colour-word Stroop, NeshatDoost et al [19] and Dalgleish et al [64] employed a modified version with positive, neutral, depression-related, threat-related, and trauma-related words.…”