Las funciones ejecutivas: su significado y aplicación clínica / Executive functions: meaning and clinical application

Las funciones ejecutivas generalmente se conceptualizan como un conjunto de procesos generales de control de orden superior que trabajan juntos para dirigir y gestionar las funciones cognitivas, emocionales y conductuales, especialmente durante la resolución activa de problemas. Su disfunción es frecuente de ser detectada como comorbilidad de otros trastornos del neurodesarrollo, causa o efecto? La detección precoz de la disfunción ejecutiva y su abordaje terapéutico temprano, mejora el pronóstico global madurativo en el periodo infantojuvenil. Esta sucinta revisión de las funciones ejecutivas intenta resaltar su importancia para el pediatra y su mirada de los trastornos del neurodesarrollo (AU)

Executive functions are typically understood as a set of general higher-order control processes that collectively direct and manage cognitive, emotional, and behavioral functions, especially during active problem solving. Their dysfunction is often detected as a comorbidity of other neurodevelopmental disorders; cause or effect? Early detection of executive dysfunction and a prompt therapeutic approach improves the overall developmental prognosis in childhood and adolescence. This brief review of executive functions aims to highlight their importance for the pediatrician and his/her view of neurodevelopmental disorder (AU)

Differences of resting-state brain functional connectivity in patients with early-onset and late-onset obsessive compulsive disorder and their correlation with cognitive flexibility / 中华行为医学与脑科学杂志

Objective:To explore the differences of the resting-state functional connectivity(FC) between goal-directed network and habituation networks in patients with early- and late-onset obsessive compulsive disorder (OCD) and the correlation between the strength of FC in the differential brain regions and cognitive flexibility.Methods:From October 2019 to April 2021, 40 patients with OCD were included in this study, including 22 patients with early-onset OCD and 18 patients with late-onset OCD.The cognitive flexibility of all subjects was assessed using the Wisconsin card sorting test (WCST), the Stroop task and the trail making test (TMT). The brain regions which were associated with goal-directed network(caudate, orbitofrontal cortex, ventromedial prefrontal cortex, and anterior cingulate cortex) and the brain regions which were associated with habituation network(putamen, supplementary motor area and insula) were selected as FC regions of interest (ROI). The DPABI and SPM12 plug-ins in the matlab2011a platform were used for whole brain FC analysis to compare the difference of FC between patients with early-onset OCD and patients with late-onset OCD on the two networks.The data were analyzed by SPSS 25.0 with χ2 test, independent samples t-test, and Pearson correlation analysis. Results:Compared with patients with early-onset OCD, patients with late-onset OCD had significantly enhanced FC of the left supplementary motor area with the left putamen and left insula.The total number of persistent errors of WCST in patients with late-onset OCD was greater than that in patients with early-onset OCD ((20.61±11.30), (14.95±8.94), P<0.05). The FC of the left putamen-left supplementary motor area was significantly and positively correlated with the total number of sustained responses ( r=0.678, P=0.003) and the total number of incorrect responses ( r=0.590, P=0.013) in patients with late-onset OCD.The FC of the left supplementary motor area-left insula was significantly positively correlated with the number of responses required to complete the first classification in patients with late-onset OCD ( r=0.485, P=0.049). Conclusion:Patients with late-onset OCD have stronger habituation network FC than patients with early-onset OCD, and the enhanced FC correlates with patients' cognitive flexibility performance, while late-onset OCD has more impaired cognitive flexibility than early-onset OCD.

Evidências de validade do teste informatizado para avaliação das funções executivas / Evidence of validity of the computerized test for evaluating executive functions / Evidencia de validez de la prueba computarizada para evaluación de funciones ejecutivas

Funções executivas (FE) referem-se ao conjunto de habilidades que, de forma integrada, coordenam o comportamento e a cognição. Assim, o comprometimento no desenvolvimento das FE está ligado a vários desfechos negativos ao longo da vida. Portanto, a avaliação dessas habilidades na infância é essencial para identificar e prevenir prejuízos na vida adulta. Este estudo teve como objetivo investigar evidências de validade do Teste Informatizado para Avaliação das Funções Executivas (Tafe) pelo critério de idade e pelo padrão de correlação entre medidas do TAFE e outras medidas de FE. Para isso, foi utilizada uma amostra de 51 crianças, entre 4 e 10 anos de idade, matriculadas em uma escola privada na cidade de Goiânia (GO), da pré-escola ao 4º ano do ensino fundamental. Como instrumentos, foram utilizados, além do Tafe, as tarefas de Bloco de Corsi, Teste de Trilhas A e B, Teste de Trilhas Pré-Escolares, Teste de Stroop Pré-Escolares e Subteste Dígitos da Escala Wechsler de Inteligência. Foram conduzidas análises estatísticas Kruskal Wallis para verificar a evidência de validade por relação com idade e análises de correlação não paramétrica de Spearman para avaliar as evidências de validade convergente. O instrumento investigado mostrou-se efetivo para discriminar entre as diferentes faixas etárias, assim, sensível ao desenvolvimento das FE. Os resultados obtidos no Tafe correlacionaram-se aos obtidos em outros testes que também avaliaram FE, mostrando claros padrões de convergência. Logo, as análises dos resultados fornecem evidências de validade ao Tafe, derivadas a partir de diferentes estratégias de investigação.(AU)

Executive functions (EF) refer to the set of skills that, in an integrated way, coordinate behavior and cognition. Thus, the commitment in developing EF is linked to several negative outcomes throughout life. Therefore, the assessment of these abilities in childhood is essential to identify and prevent possible harm in adult life. This study aimed to investigate evidences of validity of the Computerized Test for Evaluation of Executive Functions (TAFE) by the age criterion and by the pattern of correlation between TAFE measures and other EF measures. To this end, a sample of 51 children, between 4 and 10 years old, enrolled in a private school in the municipality of Goiânia (GO), from preschool to the 4th year of elementary school, was used. As instruments, in addition to TAFE, the tasks of Corsi Block, Trails Test A and B, Preschool Trails Test, Preschool Stroop Test and the Digits Subtest of the Wechsler Intelligence Scale were used. Kruskal Wallis statistical analyzes were conducted to verify the evidence of validity by age criteria and Spearman's nonparametric correlation analysis to assess evidence of convergent validation. The instrument investigated was effective to discriminate between different age groups, thus being sensitive to the development of EF. The results obtained in TAFE were correlated with those obtained in other tests that also assess FE, showing patterns of convergence. Therefore, the analysis of the results provides validation evidence to TAFE, derived from different investigation methods.(AU)

Las funciones ejecutivas (FE) se refieren al conjunto de habilidades que coordinan la conducta y la cognición. Así, el deterioro en el desarrollo de FE está relacionado con varios resultados negativos durante la vida. Por tanto, la valoración de estas habilidades en la infancia es fundamental para identificar y prevenir posibles daños en la vida adulta. Este estudio tuvo como objetivo investigar la evidencia de validez de la Prueba Computarizada para Evaluación de Funciones Ejecutivas (Tafe) por el criterio de edad y convergencia entre las medidas Tafe y otras medidas de FE. Para ello, se utilizó una muestra de 51 niños, de entre 4 y 10 años de edad, matriculados en un colegio privado de Goiânia (Goiás, Brasil) desde la preescolar hasta 4.º de primaria. Como instrumentos, además del Tafe, se utilizaron las tareas de Bloque de Corsi, el Test de los senderos A y B, el Test de los Senderos Preescolares, el Test de Stroop Preescolar y la Subprueba de Dígitos de la Escala Wechsler de Inteligencia. Se realizaron análisis estadísticos de Kruskal Wallis para verificar la validez por criterios de edad y análisis de correlación no-paramétrica de Spearman para evaluar la evidencia de validez convergente. Tafe demostró ser efectivo para discriminar entre diferentes grupos de edad, así es sensible al desarrollo de FE. Los resultados en Tafe se correlacionaron con los obtenidos en otras pruebas de FE, lo que muestra claros patrones de convergencia. Por tanto, el análisis aporta evidencias de validez para Tafe, derivadas de diferentes estrategias de investigación.(AU)

Evidencias de validez de la tarea de los dedos en una modalidad de administración asincrónica / Validity evidence of the finger task in an asynchronous administration modality

La batería de Autorregulación Cognitiva -TAC-es una herramienta informatizada para la evaluación de los principales procesos ejecutivos en una modalidad de administración presencial. Aunque sus características técnicas hacen viable su administración en una modalidad remota y asincrónica aún no cuenta con evidencias de validez y confiabilidad de sus puntuaciones en una modalidad de administración no presencial. Por ello, este estudio propone obtener evidencias de las propiedades psicométricas de la Tarea de los Dedos -TAC-en su modalidad de administración remota y asincrónica para la evaluación de la Inhibición comportamental y la flexibilidad cognitiva en personas adultas. Para cumplir con este objetivo, se analizó la presencia de dos efectos experimentales que aportan validez de constructo y se comparó su desempeño en las dos modalidades de administración. Finalmente, se analizó la confiabilidad de las puntuaciones a través del método de división por mitades. Los resultados obtenidos aportan evidencia empírica de las propiedades psicométricas del instrumento(AU)

The cognitive self-regulation battery -TAC-is a computerized tool designed to evaluate the work memory, three inhibitory processes and cognitive flexibility. There is still no evidence of validity and reliability of their scores in remote administration mode. The goal of this work is to obtain evidence of reliability and validity for the tac fingers task in remote and asynchronous administration mode for cognitive flexibility and behavioral inhibition evaluation in the adult population. It was analyzed iftwo experimental effects were detected. Its presence indicates the activation or participation of cognitive flexibility and behavioral inhibition in the resolution of activities proposed by the task. Also, the performance of the participants in both modalities was compared. The internal consistency was analyzed through the method of division by halves. The results obtained provide empirical evidence of psychometric properties of TAC fingers task for evaluation of cognitive flexibility and behavioral inhibition in the adult population(AU)

Study Of Relationship Between Cognitive Flexibility And Well-Being Of School Students

The study was conducted to explore the relationship between cognitive flexibility and well-being of school students. The study was conducted on 100 school students. Cognitive Flexibility Inventory (Dennis and Vander Wal, 2009) and Well-Being Scale (Singh and Gupta 2001) adapted by the investigator was used for data collection. Results indicated that the female school students have higher level of cognitive flexibility than male school students. The rural school students are more cognitive flexibility as compared to urban school students. There was significant relationship between cognitive flexibility and well-being of school students.

Relationship between schizotypal personality traits and creativity in college students： mediating role of cognitive flexibility / 四川精神卫生

ObjectiveTo explore the relationship between schizotypal personality traits and creativity in college students and the mediating role of cognitive flexibility. MethodsSchizotypal Personality Questionnaire （SPQ）， Cognitive Flexibility Inventory （CFI） and Williams Creative Aptitude Test （WCAT） were used to assess 471 college students. Thereafter， Spearman correlation analysis was used to explore the relationship among the variables and the Bootstrap methodology was used to estimate the mediating role of cognitive flexibility. ResultsThe total SPQ， positive and disorganized schizotypal traits scores， and CFI score were all positively correlated with WCAT score （r=0.241~0.313， P<0.01）. The total SPQ， positive and disorganized schizotypal traits scores were also positively correlated with CFI score （r=0.111~0.128， P<0.05）. Cognitive flexibility mediated the relationship between positive schizotypal traits and creativity ［indirect effect=0.052 （95% CI： 0.016~0.112， P<0.01）， accounting for 11.93% of the total effect］. Cognitive flexibility mediated the relationship between disorganized schizotypal traits and creativity ［indirect effect=0.075 （95% CI： 0.020~0.161， P<0.01）， accounting for 11.50% of the total effect］. ConclusionSchizotypal personality has a direct impact on the creativity of medical students and also cause an indirect impact on their creativity through the mediating role of cognitive flexibility.

Funciones Ejecutivas en Estudiantes con Trastorno Específico del Lenguaje al Comienzo de la Escolarización Básica / Executive Functions in Students with Specific Language Impairment at the Beginning of Elementary Education

Resumen Las funciones ejecutivas (FE) constituyen un conjunto de habilidades implicadas en el control y regulación del funcionamiento cognitivo. La relación entre fe y desarrollo del lenguaje es especialmente relevante en la conceptualización de los trastornos lingüísticos. El objetivo del estudio consistió en explorar el uso diferencial de fe en dos grupos: Desarrollo Lingüístico Típico (DLT) y Trastorno Específico del Lenguaje (TEL). Participaron 44 estudiantes (56,82 % niños), 22 DLT y 22 TEL, con edades entre 6,00-6,92 años (M=6.17, DT=.19). El factor diagnóstico previo mostró efectos significativos en atención ejecutiva (p<.001, η2 parcial =.77), memoria de trabajo (p<.001, if parcial =.67), flexibilidad cognitiva (p<.01, η2 parcial =.15), y planificación (p<.001, η2 parcial =.63). En todos los casos, salvo en flexibilidad cognitiva, el tamaño del efecto fue fuerte. Los resultados avalarían la tesis de no especificidad en TEL y la posible presencia de disfunciones cognitivas generales que subyacen al trastorno.

Abstract The executive functions (EF) constitute a set of skills involved in the control and regulation of cognitive functioning. The relation between EF and the development of language is especially relevant regarding the conceptualization of linguistic disorders. This study aims to explore the differential use of EF between two groups: Typical Language Development (TLD) and Specific Language Impairment (SLI). The participants were 44 students (56,82% boys), 22 TLD and 22 SLI, with ages between 6,00-6,92 years (M=6.17, SD=.19). The previous diagnostic factor showed significant effects in executive attention (p<.001, η2 partial =.77), working memory (p<.001, η2 partial =.67), cognitive flexibility (p<.01, η2 partial =.15), and planning (p< .001, η2 partial =.63). In every case, except for cognitive flexibility, the effect was strong. The results would support the thesis of non-specificity in the SLI and the possible presence of general cognitive dysfunctions that underlie the disorder.

Funciones ejecutivas en niños escolarizados con alta y baja creatividad / Executive functions in School-aged Children with high and low Creativity

Resumen Objetivo: El presente estudio tuvo como objetivo analizar el perfil de funcionamiento ejecutivo característico en niños creativos. Método: Participaron 200 niños y niñas escolarizados de la provincia de Entre Ríos, República Argentina, seleccionados por medio de un muestreo intencional. La creatividad se evaluó por medio de la prueba de figuras del Test de Pensamiento Creativo de Torrance (TTCT), Forma A y la prueba verbal CREA C, inteligencia creativa. Como medida de las Funciones Ejecutivas (FE), se emplearon diferentes pruebas para valorar cada dominio: (1) subtest de memoria de trabajo del WISC IV; (2) Stroop, test de colores y palabras, para inhibición; (3) WCST computarizado, para flexibilidad cognitiva reactiva y Fluidez verbal y Five Point Test para fluidez cognitiva espontánea, y (4) Laberintos de Porteus para valorar la planificación. Para estudiar perfiles de funcionamiento ejecutivo se realizaron MANCOVAS ingresando la inteligencia como covariable. Resultados: Los resultados del presente estudio sugieren la existencia de un perfil de FE en niños creativos en función de su desempeño en la prueba de figuras del TTCT (F de Hotelling (7, 90) = 3.404; p = .003, η2 parcial = .21) y del CREA C (F de Hotelling (7, 98) = 8.831; p < .001, η2 parcial = .39). Conclusión: Los hallazgos del presente estudio muestran que los niños con mayor creatividad, tanto en tareas de dibujo como en tareas verbales, presentan un perfil de FE caracterizado por una mayor capacidad de memoria de trabajo, inhibición y flexibilidad cognitiva espontánea. Sin embargo, parecería que la naturaleza de la tarea es un factor que podría modular la contribución de los procesos cognitivos de alto orden al potencial creativo.

Abstract Objective: The objective of this study is to analyze the executive functioning profile, characteristic in creative children. Method: The participants were 200 school children from the province of Entre Ríos, Argentina, selected through intentional sampling. Creativity was assessed using the figure test of Torrance Tests of Creative Thinking (TTCT), Form A and the CREA C verbal test, creative intelligence. To measure executive functions (EF), different tests were used to assess each domain: (1) WISC IV Working Memory Subtest; (2) Stroop Color and Word Test for inhibition; (3) computerized WCST for reactive cognitive flexibility and verbal fluency, the Five Point Test for spontaneous cognitive fluency, and finally; (4) Porteus Maze test to assess planning. Multivariate analysis of covariance (MANCOVAS) was performed to study executive functioning profiles, entering intelligence as a covariate. Results: The study results suggest the existence of an EF profile in creative children based on their performance in the TTCT figure test (Hotelling's F (7, 90) = 3.404, p = .003, η2 partial = 0.21) and from CREA C (Hotelling's F (7, 98) = 8.831; p < 0.001, η2 partial = 0.39). Conclusions: The findings of this study show that children with greater creativity, both in drawing and verbal tasks, show an EF profile characterized by a greater capacity for working memory, inhibition, and spontaneous cognitive flexibility. However, due to the task's nature, the high-order cognitive processes could contribute in a greater or lesser extent to creative potential.

Flexibilidad cognitiva y tres procesos inhibitorios durante los primeros años de la escolaridad primaria / Cognitive flexibility and three inhibitory processes during the first years of school period

La inhibición y la flexibilidad cognitiva son funciones ejecutivas principales, mientras la primera aportaría al funcionamiento de la segunda. Actualmente, se identifican distintos procesos inhibitorios -inhibición perceptual, cognitiva y de la respuesta- que presentarían relaciones diferenciales con diversas habilidades. Sin embargo, no se registran estudios sobre tales relaciones con la flexibilidad cognitiva durante los primeros años escolares, donde estas funciones están en desarrollo y contribuyen con el desempeño escolar. Este trabajo se propuso estudiar la relación y contribución de cada proceso inhibitorio a la flexibilidad cognitiva en niños escolares de 6 a 8 años. Los participantes (N=171) efectuaron tareas inhibitorias y de flexibilidad cognitiva. Los resultados muestran una relación baja entre la inhibición perceptual y la flexibilidad cognitiva y ausencia de relaciones con los otros procesos inhibitorios. Ello aporta evidencia al modelo no-unitario de la inhibición y permite discutir sobre la relación de los procesos durante el desarrollo(AU)

Inhibition and cognitive flexibility are basic executive functions, and inhibition would contribute to performance of cognitive flexibility. Actually, different inhibitory processes are identified ­perceptual, cognitive and response inhibition. They engagement differentially in diverse skills; however, studies about differential relationships between inhibitory processes and cognitive flexibility during first years of school period are not registered. At this stage, all of these functions are in development and are essential for children's academic performance. The goal of this work is to study the relation and contribution of each inhibitory process with the cognitive flexibility, in scholar children from 6 to 8 years-old. The participants (N=171) carried out inhibitory and cognitive flexibility tasks. The results show low relation between perceptual inhibition and cognitive flexibility, and absence of relations with other inhibitory processes. The study contributes evidence in support of the non-unitary approach of inhibition, and allows discuss about relationships between these functions during the development(AU)

The relationship of sports practice with motor performance, selective attention, cognitive flexibility and processing speed in children aged 7 to 10 years / A relação da prática esportiva com o desempenho motor, atenção seletiva, flexibilidade cognitiva e velocidade de processamento em crianças de 7 a 10 anos

INTRODUCTION: Sports initiation is usually started during childhood and adolescence, and the beneficial effects of this practice for physical and motor capacities are already known. Recent research has shown the potential of sports to stimulate and modify cognitive development. OBJECTIVE: To verify the relationship of sports practice during childhood on cardiorespiratory, motor, attention, cognitive flexibility and cognitive processing speed. METHODS: 130 students aged 7 to 10 years participated in the study, of which 68 were athletes and 62 non-athletes, divided into sports group and control group. The researchers carried out three visits for the application of the research instruments, which were carried out in a randomized manner within the school premises, divided into three blocks: 1) attention test for cancellation and test of tracks A and B (applied collectively); 2) jumping tests; 3) anamnesis, body composition and the Körperkoordination für Kinder (KTK) test. RESULTS: Children practicing sports obtained lower values in the weight (28 ± 10.08 kg vs 33.9 ± 15.3 kg), waist circumference (57.8 ± 7.7 cm vs 61.7 ± 9.6 cm) and circumference of the hip (69.1 ± 9.5 cm vs 72.8 ± 10.5 cm). In addition, we observed higher values in single-hops scores (96.9 ± 17.3 vs 85.6 ± 14.3) and lateral jumps scores (99.1 ± 18.8 vs 91.2 ± 18.0) compared to children who do not play sports. (p < 0.05). The high performance in single-heel jumps, side jumps, motor quotient, B-trails and B-A trails presented as predictors of sports practice (CI > 0.50_. CONCLUSION: The results indicated a positive relationship between children practicing sports in childhood and interesting benefits in the ability of cognitive flexibility, without expressing differences in motor coordination compared to non-practicing children.

INTRODUÇÃO: A iniciação esportiva é geralmente iniciada durante a infância e adolescência. Já é conhecido os efeitos benéficos desta prática para as capacidades físicas e motoras. Pesquisas recentes vêm demonstrando o potencial da prática esportiva em estimular e modificar o desenvolvimento cognitivo OBJETIVO: Analisar a relação da prática esportiva durante a infância na coordenação motora, atenção, flexibilidade cognitiva e velocidade de processamento cognitivo MÉTODO: Participaram do estudo 130 estudantes com idades entre 7 a 10 anos, sendo 68 praticantes de modalidades esportivas e 62 não praticantes de modalidades esportivas, divididos em grupo de esportistas (GE) e grupo controle (GC). Os pesquisadores realizaram três visitas para aplicação dos instrumentos de pesquisa, os quais foram realizados de forma aleatorizada dentro das dependências da escola, divididos em três blocos: 1) teste de atenção por cancelamento e teste de trilhas A e B (aplicados de forma coletiva); 2) testes de saltos; 3) anamnese, composição corporal e o teste Körperkoordination für Kinder (KTK) RESULTADOS: Crianças que praticam esporte obtiveram menores valores nas variáveis massa corporal (28 ± 10,08 kg vs 33,9 ± 15,3 kg), circunferência da cintura (57,8 ± 7,7 cm vs 61,7 ± 9,6 cm) e circunferência do quadril (69,1 ± 9,5 cm vs 72,8 ± 10,5 cm). Ademais, observam-se maiores valores nos dos saltos monopedais (96,9 ± 17,3 vs 85,6 ± 14,3) e saltos laterais (99,1 ± 18,8 vs 91,2 ± 18,0) em comparação às crianças que não praticam esporte (p < 0,05). O alto desempenho nos saltos monopedais, saltos laterais, quociente motor, trilhas B e Trilhas B-A apresentaram-se como preditores da prática esportiva (IC > 0,50) CONCLUSÃO: Os resultados indicaram relação positiva entre crianças praticantes de modalidades esportivas na infância e benefícios interessantes na capacidade da flexibilidade cognitiva, sem expressar diferenças na coordenação motora em comparação às crianças não praticantes

Mindfulness and suicide risk in undergraduates:chain mediating effect of cognitive flexibility and de-pressive cognition / 中华行为医学与脑科学杂志

Objective To explore the chain mediating effect of cognitive flexibility and depressive cognition between mindfulness and suicide risk in undergraduates. Methods Suicidal Behaviors Question-naire-revised (SBQ-R),mindful attention awareness scale ( MAAS),cognitive flexibility inventory (CFI) and depressive cognition scale (DCS) were used to investigate 2 627 freshmen from a medical university in Guangdong Province. Results The scores of suicide risk,mindfulness,cognitive flexibility and depressive cognition were (M(QR)):4. 00(2. 00),67. 00(15. 00),78. 00(13. 00),5. 00(7. 00),respectively. The re-sults of correlation analysis showed that suicide risk was positively correlated with depressive cognition ( r=0. 280,P<0. 01), and negatively correlated with the level of mindfulness and cognitive flexibility ( r=-0. 253,r=-0. 196,P<0. 01). Mindfulness was positively correlated with cognitive flexibility (r=0. 539,P<0. 01),negatively correlated with depressive cognition (r=-0. 518,P<0. 01). Cognitive flexibility was nega-tively correlated with depressive cognition (r=-0. 584,P<0. 01). Mediation modeling analysis showed that mindfulness had a significant direct effect on suicide risk. The direct effect value was -0. 101,accounting for 34. 9% of the total effect. The total indirect effect of mindfulness on suicide risk was -0. 188,accounting for 65. 1% of the total effect. The mediating effect of cognitive flexibility as mediator between mindfulness and suicide risk was -0. 063,accounting for 21. 8% of the total effect. The mediating effect of depressive cogni- tion as mediator between mindfulness and suicide risk was -0. 054,accounting for 18. 7% of the total effect. The chain mediating effect of cognitive flexibility and depressive cognition was -0. 071, accounting for 24. 6% of the total effect. Conclusion Mindfulness can influence suicide risk,not only through the direct path,but also through the indirect path of cognitive flexibility and depressive cognition,as well as the chain mediating path between these two variables.

Mindfulness and suicide risk in undergraduates: chain mediating effect of cognitive flexibility and depressive cognition / 中华行为医学与脑科学杂志

Objective@#To explore the chain mediating effect of cognitive flexibility and depressive cognition between mindfulness and suicide risk in undergraduates.@*Methods@#Suicidal Behaviors Questionnaire-revised (SBQ-R), mindful attention awareness scale (MAAS), cognitive flexibility inventory (CFI) and depressive cognition scale (DCS) were used to investigate 2 627 freshmen from a medical university in Guangdong Province.@*Results@#The scores of suicide risk, mindfulness, cognitive flexibility and depressive cognition were (M(QR)): 4.00(2.00), 67.00(15.00), 78.00(13.00), 5.00(7.00), respectively.The results of correlation analysis showed that suicide risk was positively correlated with depressive cognition (r=0.280, P<0.01), and negatively correlated with the level of mindfulness and cognitive flexibility (r=-0.253, r=-0.196, P<0.01). Mindfulness was positively correlated with cognitive flexibility (r=0.539, P<0.01), negatively correlated with depressive cognition (r=-0.518, P<0.01). Cognitive flexibility was negatively correlated with depressive cognition (r=-0.584, P<0.01). Mediation modeling analysis showed that mindfulness had a significant direct effect on suicide risk.The direct effect value was -0.101, accounting for 34.9% of the total effect.The total indirect effect of mindfulness on suicide risk was -0.188, accounting for 65.1% of the total effect.The mediating effect of cognitive flexibility as mediator between mindfulness and suicide risk was -0.063, accounting for 21.8% of the total effect.The mediating effect of depressive cognition as mediator between mindfulness and suicide risk was -0.054, accounting for 18.7% of the total effect.The chain mediating effect of cognitive flexibility and depressive cognition was -0.071, accounting for 24.6% of the total effect.@*Conclusion@#Mindfulness can influence suicide risk, not only through the direct path, but also through the indirect path of cognitive flexibility and depressive cognition, as well as the chain mediating path between these two variables.

Assessment of Cognition in Schizophrenia Using Trail Making Test: A Meta-Analysis

OBJECTIVE: The present meta-analysis aimed to analyze the cognitive performance of schizophrenia patients measured by Trail Making Tests (TMT) and the contribution of socio-demographic factors to cognitive impairments. METHODS: PubMed and PsycARTICLES databases were searched for the studies published between January 1985 and November 2017. Data were drawn from 19 studies encompassing 1095 patients and 324 controls. The effect size and heterogeneity were assessed with Comprehensive Meta-Analysis version 2 using random-effect model. RESULTS: Overall, the results showed that the schizophrenia patients performed significantly (p < 0.001) worse than healthy controls in both TMT-A and B. However, concurrent substance abuse, clinical status (inpatient or outpatient), duration of education and duration of illness were not associated with cognitive impairment among the schizophrenia patients. CONCLUSION: The present meta-analysis confirmed the cognitive processing speed and flexibility of schizophrenia patients were impaired. However, their duration of education, duration of illness and clinical status (inpatient or outpatient) were not the risk factors.

Predictors of depression and anxiety among caregivers of hospitalised advanced cancer patients

<p><b>INTRODUCTION</b>Cancer is a chronic disease that requires long-term treatment and care. Caregivers of cancer patients are at greater risk of developing depression than the general population. The effect of caregivers' cognitive flexibility on depression and anxiety has not been well studied. We aimed to investigate the social characteristics, burden levels and cognitive flexibility of caregivers of advanced cancer patients, and determine the relationship between these factors and depression and anxiety. We hypothesised that factors such as cognitive flexibility and caregiver burden level significantly predict anxiety and depression.</p><p><b>METHODS</b>The study included 69 primary informal caregivers of patients with Stage 4 cancer. Methods utilised included diagnostic semi-structured interviews, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Zarit Caregiver Burden Inventory and cognitive flexibility inventory.</p><p><b>RESULTS</b>BDI scores were found to be significantly higher in caregivers who cared for men compared to those who cared for women (20.44 ± 2.06 vs. 13.29 ± 1.81; t = 2.60; p = 0.01). BDI mean scores were statistically lower in caregivers who received help with caregiving compared to those who did not (t = 2.62; p = 0.01). Cognitive flexibility level, burden level and lack of social support were found to be predictors of caregiver depression.</p><p><b>CONCLUSION</b>The study showed that individuals with low cognitive flexibility levels are more likely to have depressive and anxiety symptoms. Based on our findings, we opine that evaluations of caregivers' cognitive strategies and social support are needed to determine the risk of depression in caregivers of cancer patients.</p>

Influencia del nacimiento prematuro en el desarrollo de funciones ejecutivas de niños en edad escolar / Influence of premature birth in the development of executive functions in children at a school age / Influência do nascimento prematuro no desenvolvimento das funções executivas das crianças em idade escolar

El desarrollo de las funciones ejecutivas culmina con la mielinización cerebral, tal desarrollo va a depender de la estructuración cerebral al momento del nacimiento, en este aspecto se tomó en cuenta la edad gestacional del infante en el momento del parto; a fin de identificar su influencia en el desarrollo de estas funciones se realizó un estudio con un enfoque cuantitativo de diseño descriptivo-correlacional, con una selección de muestra por modelo no probabilístico y voluntario de 160 niños entre 6 y 10 años de edad, divididos en dos grupos, uno clínico, que cumplía los criterios de prematurez expuestos por la OMS, y el otro corresponde a los respectivos pares de la muestra clínica. En los resultados se encontró que los prematuros presentan debilidad en los niveles básicos y complejos del proceso atencional y menos flexibilidad mental, sin presentar mayor compromiso en las estrategias de automonitoreo de la conducta. Al igual que un menor desempeño en relación al desarrollo ejecutivo o de capacidades relacionadas con la organización y planeación.

The development of executive functions ends up with brain mielinization, such development depends on the structure of the brain at the time of birth, this aspect takes into account the length of the pregnancy at the time of birth, in order to identify its influence in the development of these functions, we carried out a study using a quantitative approach with a descriptive-correlation design, with a sample selected using a voluntary non-probabilistic model with a 160 students between the ages of 6 and 10, divided in two groups: a clinical group under the criteria for premature birth established by the WHO and the other group was made up of peers. The results showed that premature children presented weaknesses in basic and complex attention processes and less mental flexibility without compromising self-monitoring behavior strategies. Likewise, there was a lower performance regarding the executive development in capacities related to organization and planification.

O desenvolvimento das funções executivas culmina com a mielinización cerebral, tal desenvolvimento vai depender da estruturação cerebral ao momento do nascimento, neste aspecto, foi tomada em consideração a idade gestacional do infante no momento do parto; a fim de identificar a sua influência no desenvolvimento dessas funções foi realizado um estudo com uma abordagem quantitativa de design descritivo-de correlação, com uma seleção de amostra por modelo não probabilístico e voluntário de 160 crianças entre os 6 e10 anos de idade, divididos em dois grupos, um clínico, que cumpre os critérios de prematuridade expostos pela OMS, e o outro no clinico que corresponde aos respectivos pares da amostra clínica. Nos resultados, descobriuse que as crianças prematuras apresentam fraqueza nos níveis básicos e complexos do processo atenção e menos flexibilidade mental, sem apresentar maior empenho nas estratégias de automonitoramento da conduta. Tal como um menor desempenho em relação ao desenvolvimento executivo de capacidades relacionadas com a organização e planeamento.

Effect of childhood maltreatment on cognitive flexibility of executive function: A review / 中国心理卫生杂志

Cognitive flexibility is a kind of ability to convert mental representation,including reactive flexibility and spontaneous flexibility,and as the vital components of executive function.The experience of the childhood maltreatment may damage both reactive flexibility and spontaneous flexibility and result in cognitive flexibility dysfunction.Prefrontal cortex is the main brain regions of cognitive flexibility,childhood maltreatment experience through injuring the growth of frontal lobe leading to the cognitive flexibility dysfunction.Future research could combine the method of behavioral test and brain damage measurement,to carry on minute research on the two components of cognitive flexibility and brain mechanisms at the same time.

Effects of Fast Reading Training on College Students with Hearing Impairment in Different Cognitive Flexibility / 中国康复理论与实践

Objective To inspect the applicability of fast reading training on college students with hearing impairment and variability with cognitive flexibility. Methods Sixty-two hearing impaired students were divided into intervention group (n=30) and control group (n=32). The intervention group received fast reading training eight times, and the control group accepted conventional reading practice. They were subgrouped into high level and low level of cognitive flexibility according to their achievements of Cognitive Flexibility Scale for Col-lege Students. They were asked to read four essays before and after intervention, respectively. Results For the reading speed and valid read-ing speed, the effects of intervention were significant (F>66.62, P80.35, P9.68, P<0.01). For the comprehension, the effect of the time of training was significant (F=4.96, P=0.003), but it was not for the intervention (F=1.269, P=0.265) and cognitive flexibility (F=1.475, P=0.230). Conclusion Fast reading training may improve the read-ing speed of college students with hearing impairment, and may be more effective for those with high level of cognitive flexibility.

Influencia de la memoria de trabajo y la flexibilidad cognitiva en la ejecución de la tarea balloon analogue risk task / Influence of Working Memory and Cognitive Flexibility in Performance of the Balloon Analogue Risk task

Diversos estudios plantean la importancia que tienen las funciones ejecutivas como la flexibilidad cognitiva, la inhibición y la memoria de trabajo en la toma de decisiones. En este estudio se pretende valorar si la memoria de trabajo y la flexibilidad cognitiva, procesos cognitivos presentes en la toma de decisiones, pueden explicar las alteraciones en el rendimiento de los pacientes con daño cerebral adquirido (DCA) en la Balloon Analogue Risk Task (BART). A 73 pacientes con DCA se les administró la BART, el Trail Making Test (TMTB) y el Wisconsin Card Sorting Test (WCST), para valorar la flexibilidad cognitiva; y el subtest Letras y Números (LN) del WAIS-III para evaluar la memoria de trabajo. Los mismos test fueron administrados a un grupo control de 30 sujetos sin DCA. En el grupo clínico, las variables neuropsicológicas estudiadas incluidas para explicar la variación del BART$ fueron TMTB, p < .001, y WCST, p <.001. Observamos que únicamente la flexibilidad cognitiva valorada con WCST y TMTB pudo explicar las alteraciones en el rendimiento de los pacientes con DCA en la BART. Por tanto, es lógico pensar que si el rendimiento de la BART depende de la flexibilidad cognitiva de estos pacientes, entonces es de esperar que dicha capacidad sea un buen factor predictivo en la toma de decisiones.

A number of studies have raised the importance of certain executive functions such as attention, cognitive flexibility, response inhibition, and working memory in decision-making. The purpose of this study is to prove whether or not working memory and cognitive flexibility, capacities present in decision-making, can explain the changes in the performance of patients with acquired brain damage in Balloon Analogue Risk Task (BART). 73 patients with adult Acquired Brain Injury (ABI) were assessed with the BART, Trail Making Test B (TMTB), Wisconsin Card Sorting Test (WCST) to asses cognitive flexibility; and subtest Letter-Number (LN) of WAIS -III to asses working memory. The same test was administered to a control group of 30 subjects without ABI. In the clinical group, the only variables studied that were included to explain the variation in BART$ were TMTB, p < .001, and WCST, p < .001. We observe that changes in the performance of our patients with ABD in BART could only be explained by cognitive flexibility. Therefore we can conclude that performance in BART depends on the cognitive flexibility of these patients; therefore, it is to be expected that this capacity will be a good predictor of decision-making.

Função atencional e flexibilidade cognitiva em escolares com fissura labiopalatina / Attentional function and cognitive flexibility on students with cleft fissure / Función atencional y flexibilidad cognitiva en escolares confisura labio palatina

Fatores interferentes nos processos atencionais da criança em geral e, com fissura labiopalatina em fase escolar, podem acarretar prejuízos na aprendizagem. Objetivo: Identificar as competências de atenção e flexibilidade cognitiva em escolares com fissura labiopalatina e baixo desempenho acadêmico. Participaram 45 alunos de escolas públicas, ambos os sexos, faixa etária de 8 a 10 anos, compondo três grupos: GI, formado por participantes com fissura labiopalatina e com baixo desempenho acadêmico em leitura, escrita e aritmética; GII, formado por escolares sem alterações no desenvolvimento e com baixo desempenho em leitura, escrita e aritmética; e GIII, selecionado para compor o grupo controle, formado por escolares sem alterações no desenvolvimento e com bom desempenho em leitura, escrita e aritmética. Instrumentos utilizados: Teste Raven Matrizes Progressivas; Teste de Desempenho Escolar; e Wisconsin CardSorting. Verificou-se que os recursos intelectuais mostraram-se na média e acima dela em todos os grupos. Nas habilidades acadêmicas, constatou-se que na atividade escrita o GI teve o desempenho mais comprometido, porém, com melhor performance na leitura comparado ao GII. Em atividades de aritmética, a diferença ocorreu somente quando ambos os grupos foram comparados ao GIII. Os desempenhos atencionais e de flexibilidade cognitiva ocorreram na média em 73% dos participantes do GI, e 100% do GII e GIII. Conclui-se que os prejuízos nas atividades acadêmicas não constituíram relação direta com os desempenhos otimizados nas funções cognitivas executivas avaliadas nos grupos com queixa de baixo rendimento escolar, com e sem fissura labiopalatina, embora nesse último tenha tido a performance mais prejudicada.

Interfering factors at general child including those with cleft lip and palate at school stage attention can do harm in learning. Objective: Identify the cognitive competences of attention and flexibility on students with cleft fissure and low academic performance. Participants were 45 students, both genders, 8 to 10 years old, which are attending between the 3rd and 5th grade of the public school and compose three groups: GI, with cleft lip and palate and low academic performance; GII, without development changes, but with low academic performance; and, GIII, as control group, without any changes at their development. The resources used were: Raven Test, Progressive Matrices; Scholar Development Test, and, the Wisconsin CardSorting, Some results are: Intellectual resources appeared in the middle and above it in all groups. In academic skills, the GI group had the lowest performance at writing activity, but the same group presented better reading performance compared to GII. In arithmetic activities, the difference occurred only when both groups were compared to GIII. Attentional and cognitive flexibility performance, with the average rating, occurred in 73% of GI, and 100% on the other groups. It was concluded that the impaired academic activities did not constitute direct relationship with optimized performance in executive cognitive functions at the groups complaining about low academic performance, with and without cleft lip and palate, although the last one has had the most impaired performance.

Factores que interfieren en los procesos de atención del niño con patología de fisura labio palatina o sin ella durante la escolarización, y provocan problemas en el aprendizaje. Objetivo: Observar las competencias de atención y flexibilidad cognitiva en escolares con fisura labio palatina, o sin ella, pero de bajo desempeño académico. Participaron 45 alumnos de escuelas públicas, de ambos sexos, entre 8 y 10 años de edad, integrando tres grupos: GI confisura labio palatina y bajo desempeño académico; GII sin cambios en el desarrollo y con bajo desempeño académico; y GIII como grupo de control, sin cambios en el desarrollo. Instrumentos utilizados: Test de Matrices Progresivas de Raven; Test de Desempeño Escolar; y Wisconsin CardSorting. Los resultados son: El coeficiente intelectual verificado fue el normal esperado e incluso superior en todos los grupos. En las habilidades académicas, se ha constatado que en la actividad escrita el GI tuvo un desempeño inferior, pero con mejor performance en la lectura, comparado con el GII. En actividades de Aritmética la diferencia se observó, solamente, cuando ambos grupos se compararon al GIII. Los desempeños de atención y de flexibilidad cognitiva verificados fueron: con una clasificación media en un 73% de casos en el GI, y con un 100% los restantes. Es posible concluir que el bajo rendimiento en las actividades académicas no evidenció una relación directa con el desempeño superior en funciones cognitivas-ejecutivas, evaluadas en los grupos de bajo rendimiento escolar, independientemente, de padecer de fisura labio palatina, aunque este último haya presentado una performance más agravada.

Funciones ejecutivas y sintomatología asociada con los trastornos de la conducta alimentaria / Executive functions and symptoms associated with eating disorders

Estudios recientes coinciden en que las pacientes con trastornos de la conducta alimentaria (TCA) presentan ineficiencias en las funciones ejecutivas secundarias al padecimiento. Así, el objetivo de este trabajo fue explorar la posibilidad de que tales ineficiencias formen parte del endofenotipo de los TCA y que no sean únicamente consecuencias de los mismos. Para ello, se evaluaron 69 mujeres: 23 con TCA, 23 con sintomatología asociada a los TCA y 23 sin sintomatología de riesgo a desarrollarlas. Todas las participantes respondieron el cuestionario de actitudes hacia la alimentación, la entrevista diagnóstica de trastornos alimentarios-IV, la Torre de Londres y la prueba de clasificación de tarjetas de Wisconsin. Los resultados mostraron ineficiencias en las funciones ejecutivas, específicamente en la planeación y en la flexibilidad de pensamiento, en el grupo con sintomatología asociada a los TCA similares a las que presentaron las participantes con TCA; hallazgos que abren la posibilidad de que las dificultades sean previas al establecimiento y que incluso pudiesen constituirse como un factor de riesgo.

Recent studies agree in that patients with Eating Disorders (ED) suffer from inefficiencies in Executive Functions as a consequence of the disease. In order to determine whether or not such inefficiencies make part of the endophenotype of ED-not that they result as a mere consequence of ED-69 women were evaluated: 23 diagnosed with ED, 23 with symptoms associated to ED and 23 women without any ED or risks for developing them. All participants were administered the Eating Attitude Test (EAT -40), the Interview for Diagnosis of Eating Disorders-IV (IDED -IV), the Tower of London Test and the Wisconsin Card Sorting Test. The results showed inefficiencies in executive functions-specifically in planning and cognitive flexibility for both the analogous symptoms group and the diagnosed ED group. The findings suggest that these alterations could be present prior to the establishment of the ED, and that they can actually constitute a risk factor.