This study involved a psychometric evaluation of the Short Executive Function Scale (SEFS), a new 15-item self-report questionnaire measuring five constructs: Planning, Inhibition, Working Memory, ...Shifting, and Emotional Control. Participants included 717 U.S. undergraduate students (
= 18.9 years old,
= 1.9; 78.8% cisgender female, 81.7% White) who completed the SEFS. A subset of 156 participants (
= 18.8 years old,
= 0.9; 79.5% cisgender female, 83.3% White) completed the SEFS again at 2- to 3-month retest along with the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) and the Patient Health Questionnaire (PHQ-8). The five-factor model fit well (CFI = 0.941, RMSEA = 0.079) and each scale had acceptable internal consistency (
range: .68-.81) and test-retest reliability (ICC range: .75-.89). Apart from Shifting, all SEFS scales had significantly larger convergent validity coefficients with their respective BRIEF-A scales (
range: -.25 to -.70) than discriminant validity coefficients with the PHQ-8 (
range: -.06 to -.28). These findings provide preliminary psychometric support for the SEFS.
Confirmatory factor analysis (CFA) has been frequently applied to executive function measurement since first used to identify a three-factor model of inhibition, updating, and shifting; however, ...subsequent CFAs have supported inconsistent models across the life span, ranging from unidimensional to nested-factor models (i.e., bifactor without inhibition). This systematic review summarized CFAs on performance-based tests of executive functions and reanalyzed summary data to identify best-fitting models. Eligible CFAs involved 46 samples (N = 9,756). The most frequently accepted models varied by age (i.e., preschool = one/two-factor; school-age = three-factor; adolescent/adult = three/nested-factor; older adult = two/three-factor), and most often included updating/working memory, inhibition, and shifting factors. A bootstrap reanalysis simulated 5,000 samples from 21 correlation matrices (11 child/adolescent; 10 adult) from studies including the three most common factors, fitting seven competing models. Model results were summarized as the mean percent accepted (i.e., average rate at which models converged and met fit thresholds: CFI ≥ .90/RMSEA ≤ .08) and mean percent selected (i.e., average rate at which a model showed superior fit to other models: ΔCFI ≥ .005/.010/ΔRMSEA ≤ −.010/−.015). No model consistently converged and met fit criteria in all samples. Among adult samples, the nested-factor was accepted (41-42%) and selected (8-30%) most often. Among child/adolescent samples, the unidimensional model was accepted (32-36%) and selected (21-53%) most often, with some support for two-factor models without a differentiated shifting factor. Results show some evidence for greater unidimensionality of executive function among child/adolescent samples and both unity and diversity among adult samples. However, low rates of model acceptance/selection suggest possible bias toward the publication of well-fitting but potentially nonreplicable models with underpowered samples.
Public Significance Statement
Previous research has explored whether executive functions are best described as a single self-regulatory ability (i.e., unity) or a diverse set of abilities related to control over thoughts and behaviors (i.e., diversity). This systematic review identified three abilities most frequently evaluated in psychological research (i.e., inhibition, shifting, and updating/working memory), and a reanalysis of previous studies identified greater unity of executive functions during childhood and greater diversity arising from adolescence into adulthood.
This study examined the reliability and validity of scores from questionnaires assessing compensatory cognitive strategy use by young adults. Participants (N = 783; 79.6% women; 77.4% White; Age: M = ...18.7 ± 0.9 years) completed the Compensatory Cognitive Strategies Scale (CCSS), Multifactorial Memory Questionnaire–Strategies (MMQ-S), Neuro-Quality of Life (Neuro-QoL) v2.0 Short Form–Cognitive Function, and Difficulties in Emotion Regulation Scale (DERS). Reliability estimates were acceptable for the CCSS (α = .85) and MMQ-S (α = .86) in the full sample and comparable in subsamples stratified by gender and self-reported mental health conditions. The CCSS and MMQ-S scores showed evidence for convergent validity (r range: .60 to .70) and discriminant validity in the full sample and subsamples (r with DERS range: .13 to .33). Greater compensatory strategy use had small-to-medium associations with greater subjective cognitive concerns on the Neuro-QOL for the full sample and subsamples (r range: −.19 to −.49). The CCSS and MMQ-S scores showed acceptable properties for use with young adults.
Mild Traumatic Brain Injury (mTBI), also known as concussion, has become a growing public health concern, prevalent in both athletic and military settings. Many researchers have examined post-mTBI ...neuropsychological outcomes, leading to multiple meta-analyses amalgamating individual study results. Objective: Considering the plethora of meta-analytic findings, the next logical step stands as a systematic review of meta-analyses, effectively reporting key moderators that predict post-mTBI neuropsychological outcomes. Method: A systematic review of reviews yielded 11 meta-analyses meeting inclusion criteria (i.e., English-language systematic reviews/meta-analyses covering post-mTBI observational cognitive research on late adolescents/adults), with their findings qualitatively synthesized based on moderator variables (i.e., cognitive domain, time since injury, past head injury, participant characteristics, comparison group, assessment technique, and persistent symptoms). Results: The overall effect sizes ranged for both general (range: .07-.61) and sports-related mTBI (range: .40-.81) and differed both between and within cognitive domains, with executive functions appearing most sensitive to multiple mTBI. Cognitive domains varied in recovery rates, but overall recovery occurred by 90 days postinjury for most individuals and by 7 days postinjury for athletes. Greater age/education and male gender produced smaller effects sizes, and high school athletes suffered the largest deficits post-mTBI. Control-group comparisons yielded larger effects than within-person designs, and assessment techniques had limited moderating effects. Conclusions: Overall, meta-analytic review quality remained low with few studies assessing publication or study quality bias. Meta-analyses consistently identified adverse acute mTBI-related effects and fairly rapid symptom resolution. Future meta-analyses should better operationally define cognitive constructs to produce more consistent effect estimates across domains.
A recently published review of 45 studies concluded that approximately half of individuals who sustain a single mild traumatic brain injury (MTBI) experience long-term cognitive impairment (McInnes ...et al. Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS ONE 2017;12:e0174847). Stratified by age, they reported that 50% of children and 58% of adults showed some form of cognitive impairment. We contend that the McInnes et al. review used a definition of "cognitive impairment" that was idiosyncratic, not applicable to individual patients or subjects, inconsistent with how cognitive impairment is defined in clinical practice and research, and resulted in a large number of false positive cases of cognitive impairment. For example, if a study reported a statistically significant difference on a single cognitive test, the authors concluded that every subject with a MTBI in that study was cognitively impaired-an approach that cannot be justified statistically or psychometrically. The authors concluded that impairment was present in various cognitive domains, such as attention, memory, and executive functioning, but they did not analyze or report the results from any of these specific cognitive domains. Moreover, their analyses and conclusions regarding many published studies contradicted the interpretations provided by the original authors of those studies. We re-reviewed all 45 studies and extracted the main conclusions from each. We conclude that a single MTBI is not associated with a high incidence of chronic cognitive impairment.
Objective: This study examined factor models for the Post-Concussion Symptom Scale (PCSS) at baseline and after suspected sport-related concussion, and measurement invariance from pre-injury to ...post-injury assessments and across age, gender, and health history groups (e.g., attention-deficit/hyperactivity disorder, psychiatric history). Methods: Adolescent student athletes (ages 13-18) completed a baseline PCSS (n = 39,015; 54.3% boys) and a subsample within 21 days of a suspected concussion (n = 1,554; 56.7% boys) completed a post-injury PCSS. Five models were evaluated for fit and invariance. Results: Confirmatory factor analyses showed good baseline and post-injury model fit for a previously supported four-factor model (i.e., cognitive-sensory, sleep-arousal, vestibular-somatic, and affective), an alternative four-factor model (i.e., cognitive, sleep-arousal, physical, and affective), and an incomplete bifactor model with vestibular-somatic and affective specific factors, along with partial invariance from pre-injury to post-injury assessments. Partial-to-full invariance was established for each model at baseline across demographic and health history groups. Conclusions: Results showed empirical and conceptual support for both PCSS subscales (i.e., cognitive, sleep-arousal, physical, and affective) and a total score for use in pre-injury to post-injury assessments and across demographic and health history groups at baseline. Future normative data, stratified by demographics and health history, could provide more precise symptom assessments for concussion management.
Limited research has examined the symptom sequelae of head injuries in women survivors of intimate partner violence (IPV), despite this community being at increased risk for neurotrauma due to ...partner abuse. The current study compared post-concussion symptom severity between women with and without IPV-related head injuries. Women were recruited from court jurisdictions in Kentucky, USA, after receiving a protective order for partner abuse. The sample included 268 women with no prior head injuries (age:
standard deviation (
) = 31.89.8, 77.2% White) and 251 women with lifetime IPV-related head injuries (age:
= 31.89.8, 88.0% White). Women with IPV-related head injuries were slightly older (
= 2.46,
= 0.014) with lower education (
= 5.81,
= 0.016), were more frequently unemployed (
= 9.23,
= 0.002), and had a higher likelihood of residing in a rural setting (
= 30.16,
< 0.001). Women with IPV-related head injuries were also more often White (
= 10.47,
= 0.001), but this group difference was almost entirely related to rural versus urban residence. Women with IPV-related head injuries reported a higher severity of lifetime physical IPV (
= 7.27,
< 0.001,
= 0.64, 95% confidence interval CI: .46, .82) and sexual IPV (
= 4.65,
< 0.001,
= 0.41 0.24, 0.59). A three-factor model of post-concussion symptoms, inclusive of cognitive, physical, and emotional symptoms, fit well (
= 368.99,
< 0.0001, comparative fit index CFI = 0.974, Tucker-Lewis index TLI = 0.968, root mean square error of approximation RMSEA = 0.079 0.071, 0.087), and showed evidence for strong measurement invariance across women with and without IPV-related head injuries. The subscale and total scores each had acceptable reliability: cognitive (ω = 0.88 0.86, 0.90), physical (ω = 0.74 0.70, 0.77), and emotional (ω = 0.88 0.86, 0.89), and total score (ω = 0.93 0.92, 0.95). Women with IPV-related head injuries reported all individual post-concussion symptoms at a significantly higher frequency, with medium group differences in cognitive (
= 7.57,
< 0.001,
= 0.67 0.50, 0.85) and physical symptoms (
= 7.73,
< 0.001,
= 0.68 0.51, 0.86) and large group differences in emotional (
= 8.51,
< 0.001,
= 0.75 0.57, 0.93) and total symptoms (
= 9.07,
< 0.001,
= 0.80 0.62, 0.98). All sociodemographic characteristics were independently associated with post-concussion symptoms, as were physical IPV (total score:
= 0.28 0.19, 0.35,
< 0.001) and sexual IPV severity (total score:
= 0.22 0.13, 0.30,
< 0.001). In hierarchical regression analyses, controlling for sociodemographic characteristics (i.e., age, race/ethnicity, education, unemployment, and rural/urban residence) and physical and sexual IPV severity, IPV-related head injury was independently significant and accounted for significant additional variance when predicting cognitive (
= 0.05,
< 0.001), physical (
= 0.03,
< 0.001), emotional (
= 0.07,
< 0.001), and total symptoms (
= 0.06,
< 0.001). Negative-binomial regression resulted in similar findings. This study demonstrates that multiple sociodemographic and IPV history variables are related to post-concussion symptom severity, but IPV-related head injury was independently associated with greater symptom severity. Women with IPV-related head injuries may be at increased risk for unaddressed health problems spanning cognitive, physical, and emotional domains. Future research is needed to psychometrically evaluate assessment instruments for this population and to assess efficacy of interventions to address their unique health care needs.
This study examined whether college students with and without depression or anxiety differed in subjective cognitive concerns, academic self-efficacy, and cognitive strategy use.
Participants ...included 582 college students (M = 19.0 ± 1.0 years-old, 79.4% women, 81.9% White).
Participants completed online self-report questionnaires on subjective cognitive functioning, academic self-efficacy, cognitive strategy use, and depression and anxiety symptoms, which were used to categorize participants as having anxiety or depression based on established clinical cutoffs.
Participants with anxiety or depression reported greater subjective cognitive concerns and lower academic self-efficacy compared to participants without anxiety or depression, but these groups differed only modestly in cognitive strategy use.
Despite greater cognitive concerns, participants with anxiety or depression reported only modestly greater cognitive strategy use. Future research should evaluate interventions to increase strategy use among college students with anxiety or depression, tailoring these interventions for modern students by incorporating telehealth approaches and smartphone use.
Individuals possess different beliefs regarding the malleability of intelligence, also known as intelligence mindsets. Despite evidence demonstrating a link between a growth mindset of ...intelligence—the belief that intelligence can develop through effort—and academic achievement, this link has not been closely examined from a mental health perspective. Given the increasing prevalence of mental health conditions, such as anxiety and depression, among undergraduate students, an important question is whether the well-established link between mental health symptom severity and academic outcomes depends on the intelligence mindset beliefs that individuals possess. A growth mindset of intelligence might buffer the negative impact of anxiety and depression on academic outcomes, whereas a fixed mindset—the belief that intelligence cannot be changed—might exacerbate this negative relationship. The present study examined data collected from 660 undergraduate psychology students in the United States to test whether intelligence mindset beliefs moderated the relationship between mental health symptom severity and various indicators of academic outcomes: academic self-efficacy, GPA, and perceived academic standing. Results revealed that intelligence mindset beliefs did not moderate the observed negative association between mental health symptom severity and academic outcomes. Findings indicate that promoting a growth mindset of intelligence might not be a particularly effective strategy for buffering university students from the negative impact of anxiety and depression on academic outcomes. However, this conclusion is limited by the cross-sectional design of the study, and future prospective research is necessary to further clarify the relationship between intelligence mindset, mental health, and academic outcomes.
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