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

## TL;DR

This study finds that better self-reported executive function in early adolescents is linked to improved mental health over time, with emotional self-regulation being especially important.

## Contribution

The study provides new longitudinal evidence on how executive function predicts mental health outcomes in early adolescence.

## Key findings

- Better executive function was associated with better mental health outcomes over one year.
- Emotional self-regulation, particularly emotional control and planning, showed the strongest associations with mental health.
- The relationship between executive function and mental health varied by gender and specific skills like working memory.

## Abstract

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.

This study used data from 8,072 adolescents (aged 11-15 years) in 84 United Kingdom schools, collected as part of the MYRIAD (MY Resilience In ADolescence) trial, to examine how executive function relates to adolescent mental health outcomes over one year. Young people who reported better executive function were more likely to report better mental well-being, as well as less social-emotional-behavioral difficulties, depression, and suicidality, over time. The relation to mental health outcomes at one year was strongest for better emotional self-regulation, including emotional control and planning, reported at baseline in both boys and girls.