There has been much discussion over the past few years about the potential benefits of supplementing traditional approaches to the assessment of mental health problems, which are based largely on reports of symptoms and observed behaviors, with more objective measures. Task-based neurocognitive measures are one of the more obvious approaches that can be considered. Potential tasks include those indexing executive functioning, through its key components: working memory, inhibitory control, set-shifting and planning, and those assessing more basic cognitive functions such as non-executive aspects of memory, processing speed, and response variability. Importantly, it is now becoming clear that the relationships between psychopathology and neurocognitive functioning are more complex than once thought. Neurocognitive deficits in executive and more basic cognitive functioning are seen across a broad range of psychiatric disorders, and although there may be subtle differences in cognitive profile across different disorders, most data support a more transdiagnostic approach.1 There is also considerable within-disorder heterogeneity, meaning that 2 individuals with the same disorder may have very different cognitive profiles.2 Also, although traditional, biologically based, causal models of mental disorders suggest a linear relationship between genetic and environmental causal factors leading to differences in brain structure and functioning that result in cognitive deficits with these manifested as psychiatric symptoms,3 recent data have questioned these linear relationships and suggested a greater degree of independence between neurocognitive deficits and psychopathology.4 The study of Manfro et al.5 published in this issue throws light on both aspects of this important issue, the potential for objective assessment and the relationship between neurocognition, psychopathology, and functional impairment.
|Journal||Journal of the American Academy of Child & Adolescent Psychiatry|
|Early online date||14 Jan 2021|
|Publication status||E-pub ahead of print - 14 Jan 2021|