Psychiatric Symptoms, Cognition, and Symptom Severity in Children

• NCJ Number: 310304
• Journal: Jama Psychiatry Volume: 81 Issue: 12 Dated: 2024 Pages: 1236-1245
• Author(s): Adam Pines ; Leonardo Tozzi; Claire Bertrand; Arielle S. Keller; Xue Zhang; Susan Whitfield-Gabrieli; et al
• Date Published: August 2024
• Length: 10 pages
• Grant Number(s): 2017-MU-CX-0044
• Agencies: NIJ-Sponsored
• Publication Type: Research (Applied/Empirical)

Annotation

This paper explores whether a nonlinear association between cognitive abilities and psychiatric symptom severity can explain conflicting reports from samples evaluating disparate symptom severities.

Abstract

This study explores whether the association between general cognition and mental health symptoms diverges at different symptom severities in children. Linear, polynomial, and generalized additive models revealed significant yet opposite associations between internalizing symptoms and cognitive performance at low vs high symptom severities. The findings suggest that accounting for prominent nonlinearities in the association between cognition and psychiatric symptoms may be able to better capture between-child heterogeneity and resolve ostensibly conflicting results in studies assaying dissimilar symptom severities. A total of 5175 children with complete data at 2 time points assessed 2 years apart from the ongoing Adolescent Brain and Cognitive Development (ABCD) study were evaluated for a general cognition factor and mental health symptoms. Polynomial and generalized additive models afforded derivation of continuous associations between cognition and psychiatric symptoms across different ranges of symptom severity. Aggregate cognitive test scores (general cognition) were primarily evaluated in relation to total and subscale-specific symptoms reported from the Child Behavioral Checklist. Internalizing symptoms were both positively and negatively associated with general cognition at a significant level. These results appear to reconcile mixed findings in prior studies, which implicitly assume that symptom severity tracks linearly with cognitive ability across the entire spectrum of mental health. As the association between cognition and symptoms may be opposite in low vs high symptom severity samples, these results reveal the necessity of clinical enrichment in studies of cognitive impairment. (Published Abstract Provided)