The Longitudinal Relationship Between Self-Reported Executive Function and Mental Health in Early Adolescence

Psychological theories emphasize the role of executive function in the mental health of adolescents. Yet, the longitudinal relationship remains poorly understood. This cohort study explored the longitudinal relationship between self-reported executive function and adolescents' mental health and potential gender differences.

Data were collected at 3 time points from 8,072 adolescents (11-15 years old) in 84 secondary schools in the United Kingdom, as part of the MYRIAD (MY Resilience In ADolescence) trial (ISRCTN86619085). The longitudinal relationship between adolescents' self-reported executive function (Behavior Rating Inventory of Executive Function, Second Edition [BRIEF-2]) and 4 mental health outcomes-well-being (Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS]), social-emotional-behavioral difficulties (Strength and Difficulties Questionnaire [SDQ]), risk for depression (Center for Epidemiologic Studies Depression Scale [CES-D]), and suicidality (item-based)-was explored using 3 mixed-effects regression models. Model 1 included a composite measure of executive function; model 2 included behavioral, cognitive, and emotional self-regulation; and model 3 included 7 executive function skills.

Better executive function (ie, lower BRIEF-2 scores) was associated with better mental health over 1 year (regression coefficient [95% CI]: well-being -0.23 [-0.24, -0.22], social-emotional-behavioral difficulties 0.24 [0.23, 0.24], risk for depression 0.33 [0.32, 0.34], and suicidality 0.02 [0.01, 0.02]). This association weakened over time for all outcomes except suicidality (model 1). Associations were strongest for emotional self-regulation (model 2) and specifically emotional control and planning (model 3). The relative role of other executive function skills (eg, working memory and self-monitoring) differed by outcome and gender.

Better executive function was associated with better mental health over time. Potential intervention targets include emotional self-regulation, particularly emotional control and planning.