Psychological Medicine最新文献

{"title":"Characterizing intraindividual variability in bipolar disorder: links to cognition, white matter microstructure, and clinical variables.","authors":"Georgia F Caruana, Sean P Carruthers, James A Karantonis, Lisa S Furlong, Eric J Tan, Erica Neill, Susan L Rossell, Tamsyn E Van Rheenen","doi":"10.1017/S0033291725100731","DOIUrl":"10.1017/S0033291725100731","url":null,"abstract":"<p><strong>Background: </strong>Most cognitive studies of bipolar disorder (BD) have examined case-control differences on cognitive tests using measures of central tendency, which do not consider intraindividual variability (IIV); a distinct cognitive construct that reliably indexes meaningful cognitive differences between individuals. In this study, we sought to characterize IIV in BD by examining whether it differs from healthy controls (HCs) and is associated with other cognitive measures, clinical variables, and white matter microstructure.</p><p><strong>Methods: </strong>Two hundred and seventeen adults, including 100 BD outpatients and 117 HCs, completed processing speed, sustained attention, working memory, and executive function tasks. A subsample of 55 BD participants underwent diffusion tensor imaging. IIV was operationalized as the individual standard deviation in reaction time on the Continuous Performance Test-Identical Pairs version.</p><p><strong>Results: </strong>BD participants had significantly increased IIV compared to age-matched controls. Increased IIV was associated with poorer mean performance scores on processing speed, sustained attention, working memory, and executive function tasks, as well as two whole-brain white matter indices: fractional anisotropy and radial diffusivity.</p><p><strong>Conclusions: </strong>IIV is increased in BD and appears to correlate with other cognitive variables, as well as white matter measures that index reduced structural integrity and demyelination. Thus, IIV may represent a neurobiologically informative cognitive measure for BD research that is worthy of further investigation.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e204"},"PeriodicalIF":5.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placebo and nocebo phenomena in schizophrenia spectrum disorders: a narrative review on current knowledge and potential future directions.","authors":"James A Waltz, Sherry D Pujji, Luana Colloca","doi":"10.1017/S0033291725100901","DOIUrl":"10.1017/S0033291725100901","url":null,"abstract":"<p><p>The experience of psychosis in schizophrenia spectrum disorders involves significant distress and functional impairment, contributing to immense social and economic costs. Current gold standard treatment guidelines emphasize the use of antipsychotic medications, though responses to these treatments vary widely, with the potential for detrimental side effects. However, increasing placebo responses in randomized controlled trials since the 1960s complicate the development of new medications. Elevated placebo responses are common in psychiatric populations, including those with psychosis, and are influenced by individual beliefs and prior experiences. Despite extensive research on placebo mechanisms in conditions such as depression and pain, little is known about mechanisms of these effects in psychosis. This narrative review examines the predictors and belief formation processes underlying placebo and nocebo phenomena in psychosis. We discuss features of randomized controlled trials for antipsychotic medications, individual symptom heterogeneity, and contextual factors. Findings related to placebo effects for motivation and cognition-enhancing drugs are also discussed. We then consider the possibility that theories of predictive coding and aberrant salience provide explanation for aspects of both placebo effects and schizophrenia spectrum symptoms. The role of outcome expectations broadly and in the context of reward processing is considered. We conclude with some recommendations for future placebo research in psychosis, emphasizing the diversity of placebo effects, assessment concerns, cultural considerations, and methodological aspects. Future multidisciplinary research is required to further elucidate placebo effects in schizophrenia spectrum disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e199"},"PeriodicalIF":5.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression links to unstable resting-state brain dynamics: insights from hidden markov models and functional network variability.","authors":"Li Geng, Qiuyang Feng, Xueyang Wang, Jiangzhou Sun, Shuang Tang, Hui Jia, Yu Li, Jiang Qiu","doi":"10.1017/S0033291725101001","DOIUrl":"10.1017/S0033291725101001","url":null,"abstract":"<p><strong>Background: </strong>Depression is closely associated with abnormalities in brain function. Traditional static functional connectivity analyses offer limited insight into the temporal variability of brain activity. Recent advances in dynamic analyses enable a deeper understanding of how depression relates to temporal fluctuations in brain activity.</p><p><strong>Methods: </strong>This study utilized a large resting-state functional magnetic resonance imaging dataset (<i>N</i> = 696) to examine the association between brain dynamics and depression. Two complementary approaches were employed. Hidden Markov modeling (HMM) was used to identify discrete brain states and quantify their temporal switching patterns; temporal variability was computed within and between large-scale functional networks to capture time-varying fluctuations in functional connectivity.</p><p><strong>Results: </strong>Depression scores were positively associated with switching rate and negatively associated with maximum fractional occupancy. Furthermore, depression scores were significantly associated with greater temporal variability both within and between networks, with particularly strong effects observed in the default mode network, ventral attention network, and frontoparietal network. Together, these findings suggest that individuals with higher depression scores exhibit more unstable brain dynamics.</p><p><strong>Conclusion: </strong>Our findings reveal that individuals with higher depression levels exhibit greater instability in brain state transitions and increased temporal variability in functional connectivity across large-scale networks. This instability in brain dynamics may contribute to difficulties in emotion regulation and cognitive control. By capturing whole-brain temporal patterns, this study offers a novel perspective on the neural basis of depression.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e200"},"PeriodicalIF":5.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental cascades linking executive functions with internalizing and externalizing problems in early childhood through early adolescence.","authors":"Jianhua Zhou, Yuxing Ma, Tubei Li, Meiyu Bai, Zheng Ma, Shifeng Li, Xue Gong","doi":"10.1017/S0033291725100810","DOIUrl":"10.1017/S0033291725100810","url":null,"abstract":"<p><strong>Background: </strong>Difficulties in executive functions (EFs) and internalizing and externalizing problems are prospectively related. However, it remains unclear whether the bidirectional relations between specific EF components and internalizing and externalizing problems at the within-person level vary across developmental stages in childhood and early adolescence.</p><p><strong>Methods: </strong>This study utilized data from seven waves of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 (ECLS-K: 2011), following a nationally representative sample of 15,055 children (mean age at baseline = 5.63 years, SD = 0.37; age range = 4.02-7.83) from kindergarten through fifth grade. Internalizing and externalizing problems and inhibitory control were assessed using teacher-reported measures, while working memory and cognitive flexibility were evaluated using standardized cognitive tasks. Data were analyzed using a random intercept cross-lagged panel model, adjusting for the complex sampling design.</p><p><strong>Results: </strong>Working memory negatively predicted internalizing problems from kindergarten to first grade, with no significant link to externalizing problems. Cognitive flexibility showed limited effects, with only spring kindergarten externalizing problems predicting lower cognitive flexibility in first grade. Inhibitory control negatively predicted internalizing problems in early childhood, while internalizing problems positively predicted inhibitory control during the kindergarten-to-first-grade transition. Externalizing problems consistently reduced inhibitory control over time. Notably, inhibitory control negatively predicted externalizing problems until third grade but positively predicted them from third to fourth grade.</p><p><strong>Conclusions: </strong>The findings suggest that while certain EFs can protect against internalizing and externalizing problems in early childhood, these symptoms may also influence EF development, with these interactions evolving as children transition into adolescence.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e194"},"PeriodicalIF":5.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of discrimination across the transition to parenthood and postpartum depression severity among Black women.","authors":"Alison Hipwell, Kelsey Magee, Kate Keenan, Irene Tung, Ashley Hill, Ashley Stiller, Allysa Quick, Michele Levine, Sierra Strickland, Melanie Custodio","doi":"10.1017/S003329172510113X","DOIUrl":"10.1017/S003329172510113X","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression is prevalent among Black women and associated with intersecting systemic factors and interpersonal discrimination. However, gaps remain in understanding pregnancy-related changes in discrimination experiences that influence postpartum mental health and could inform preventive interventions. We hypothesized that young Black women would experience increasing levels of discrimination across the transition to parenthood, heightening depression risk relative to non-pregnant peers.</p><p><strong>Methods: </strong>Participants comprised 335 Black primiparous women (ages 17-30 at delivery) and 335 age- and discriminationmatched non-pregnant controls from the Pittsburgh Girls Study. Self-reported discrimination experiences were collected at four timepoints: two years pre-pregnancy, one year pre-pregnancy, pregnancy, and one year postpartum for the childbearing sample, with corresponding data from the non-pregnant sample across the same interval (matched pairwise).</p><p><strong>Results: </strong>Linear increases in discrimination were observed for the nonpregnant participants (<i>B_S</i> = .480, SE = .090, <i>p</i> <.001), while childbearing participants showed no overall changes, though younger age predicted greater increases over time. For childbearing participants, both baseline discrimination (<i>B_I</i> = .626, <i>SE</i> = .077, <i>p</i> < .001) and increasing discrimination (<i>B_S</i> = 2.55, <i>SE</i> = .939, <i>p</i> < .01) predicted postpartum depressive symptoms, controlling for pre-pregnancy depression. Among non-pregnant participants, only baseline discrimination predicted later depression (<i>B_I</i> = .912, <i>SE</i> = .081, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Experiencing increasing levels of interpersonal discrimination across the transition to parenthood may heighten postpartum depression risk among young Black women, indicating a need for interventions supporting well-being and promoting resilience before, during and after pregnancy.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e193"},"PeriodicalIF":5.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous mentalizing in patients with schizophrenia spectrum disorders: a meta-analysis.","authors":"András Hajnal, Tímea Csulak, Dóra Hebling, Kornélia Farkas Borbásné, Márton Herold, Gergő Berke, Zoltán Sipos, Borbála Pethő, Eszter Varga, Tamás Tényi, Péter Mátrai, Péter Hegyi, Noémi Albert, Róbert Herold","doi":"10.1017/S0033291725100755","DOIUrl":"10.1017/S0033291725100755","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous mentalizing refers to the capacity to attribute mental states to oneself and others without explicit prompts or conscious deliberation. This process enables individuals to comprehend and anticipate social behaviors in a more intuitive manner. Individuals diagnosed with schizophrenia frequently demonstrate deficits in this domain, which contribute to impaired social functioning. The present meta-analysis aims to assess the extent of spontaneous mentalizing impairments in schizophrenia.</p><p><strong>Methods: </strong>A comprehensive search was conducted in four prominent databases: MEDLINE, EMBASE, CENTRAL, and Web of Science. Following the review of the retrieved records and subsequent citation searching, a total of 15 studies were selected for inclusion in the quantitative synthesis. The data of 526 patients diagnosed with schizophrenia and 536 controls were subjected to analysis. Effect sizes for intentionality and appropriateness were computed utilizing weighted or standardized mean differences, and heterogeneity was evaluated.</p><p><strong>Results: </strong>Patients with schizophrenia exhibited substantial impairments in intentionality and appropriateness during mentalizing tasks, with large effect sizes. No significant differences were observed in random movement tasks, although patients also demonstrated deficits in interpreting goal-directed movements. Furthermore, high heterogeneity in some outcomes and variability in study methodologies were also noted.</p><p><strong>Conclusions: </strong>This analysis corroborates substantial spontaneous mentalizing deficits in schizophrenia, underscoring their potential role in impaired social functioning. In conjunction with previous analyses, the present findings emphasize the pervasive nature of mentalizing deficits in schizophrenia, encompassing explicit, implicit, and spontaneous dimensions. These results hold significant implications for therapeutic strategies designed to augment social cognition in individuals with schizophrenia.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e195"},"PeriodicalIF":5.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive change 5+ years since the onset of a psychotic disorder: A systematic review and meta-analysis.","authors":"Joseph Ghanem, Andrew J Watson, Samantha Aversa, Christy Au-Yeung, Olivier Percie du Sert, Marie Starzer, Melissa A Weibell, Helene Gjervig Hansen, Katie M Lavigne, Martin Lepage","doi":"10.1017/S0033291725100627","DOIUrl":"10.1017/S0033291725100627","url":null,"abstract":"<p><p>Cognitive impairments are a core feature of psychotic disorders, but their long-term trajectory remains contentious. Previous meta-analyses focused on the first 5 years following psychosis onset. Here, we evaluated the change in cognitive impairments in psychotic disorders with a meta-analysis of studies with follow-ups of 5+ years. Following preregistration, databases were searched for relevant articles until July 2024. Two authors screened the reports for studies reporting on the change in cognitive impairments in global cognition, verbal learning and memory, visual learning and memory, working memory, attention, speed of processing, reasoning and problem-solving, and verbal fluency in individuals with psychotic disorders, with a minimum follow-up of 5 years. Three authors extracted data, and the PRISMA guidelines were followed. Random-effects meta-analyses and moderator analyses were conducted. Twenty-four studies comprising 2,633 patients and 1,019 controls were included in the study. Over an average of 8.46 years, cognitive impairments remained stable in all eight measures: global cognition (<i>g</i> = 0.09; 95% CI = 0.03-0.20), verbal memory (<i>g</i> = 0.05; 95% CI = -0.11, 0.21), visual memory (<i>g</i> = -0.16; 95% CI = -0.35, 0.03), working memory (<i>g</i> = 0.03; 95% CI = -0.09, 0.14), attention (<i>g</i> = 0.22; 95% CI = -0.36, 0.80), speed of processing (<i>g</i> = 0.10; 95% CI = -0.14, 0.35), reasoning and problem-solving (<i>g</i> = 0.16; 95% CI = -0.03, 0.35), and verbal fluency (<i>g</i> = 0.08; 95% CI = -0.03, 0.19). We conclude that cognitive impairments remain stable over time, consistent with the neurodevelopmental view of psychotic disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e198"},"PeriodicalIF":5.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midlife diseases of despair and cardiometabolic risk: Testing shared origins in adolescent psychopathology - CORRIGENDUM.","authors":"Kallisse R Dent, Grace M Brennan, Lara Khalifeh, Leah S Richmond-Rakerd","doi":"10.1017/S0033291725101086","DOIUrl":"10.1017/S0033291725101086","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e196"},"PeriodicalIF":5.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling the biological mechanisms underlying the effects of physical exercise in major depressive disorder: a comprehensive systematic review of randomized controlled trials.","authors":"Rosana Carvalho Silva, Mattia Meattini, Giulia Perusi, Sara Carletto, Marco Bortolomasi, Massimo Gennarelli, Bernhard T Baune, Alessandra Minelli","doi":"10.1017/S0033291725100743","DOIUrl":"10.1017/S0033291725100743","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is a disabling psychiatric condition in which physical activity provides clinical benefits. While exercise effectively alleviates depressive symptoms, its biological mechanisms remain unclear.</p><p><strong>Methods: </strong>This systematic review investigated the neurobiological effects of physical exercise on biomarkers in adults with MDD through randomized controlled trials, including studies assessing exercise interventions and reporting data on their biological effects.</p><p><strong>Results: </strong>A total of 30 studies, including 2194 participants, were included, examining the effects of physical exercise on various biological systems in patients with MDD. Exercise interventions had mixed effects on inflammatory markers, including interleukins, C-reactive protein, and tumor necrosis factor-α, suggesting a potential but inconsistent anti-inflammatory role. Neurotrophic factors, such as brain-derived neurotrophic factor showed promise as biomarkers of treatment response, but their role in clinical improvements remained inconclusive. Findings for the stress-response system, including cortisol and monoaminergic systems, primarily involving serotonin and dopamine, were limited and variable. Exercise demonstrated potential benefits in reducing oxidative stress and enhancing β-endorphin levels, although these effects were not consistently observed.</p><p><strong>Conclusion: </strong>This systematic review adopted a broader perspective than prior studies, exploring less-studied biological systems and identifying several limitations in the included studies, including small sample sizes, varying methodologies, and a predominant focus on biochemical markers. Future research should prioritize larger, standardized trials and particularly employ omics approaches to better understand the biological mechanisms underlying the effects of exercise in MDD. The findings highlight the complexity of exercise's biological effects and emphasize the need for further research to clarify its mechanisms.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e197"},"PeriodicalIF":5.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating risk factor and consequence accounts of executive functioning impairments in psychopathology: an 8-year study of at-risk individuals in Brazil.","authors":"René Freichel, Sacha Epskamp, Peter J de Jong, Janna Cousijn, Ingmar Franken, Giovanni A Salum, Pedro Mario Pan, Ilya M Veer, Reinout W Wiers","doi":"10.1017/S0033291725100639","DOIUrl":"10.1017/S0033291725100639","url":null,"abstract":"<p><strong>Background: </strong>Executive functioning (EF) impairments are widely known to represent transdiagnostic risk factors of psychopathology. However, a recent alternative account has been proposed, according to which EF impairments emerge as consequences of psychopathology.</p><p><strong>Methods: </strong>Using a longitudinal cross-lagged panel network analysis approach, we tested these competing theoretical accounts at different stages during adolescence. We used data from the Brazilian High-Risk Cohort Study for the Development of Childhood Psychiatric Disorders, in which 61% of individuals at wave 1 were selected due to their high risk for psychopathology. Participants were assessed across three assessment waves during early (wave 1: <i>n</i> = 1,992, mean age = 10.20 years) and middle adolescence (wave 2: <i>n</i> = 1,633, mean age = 13.48 years; wave 3: <i>n</i> = 1,439, mean age = 18.20 years). We examined associations between working memory, inhibitory control, and broad-band measures of psychopathology.</p><p><strong>Results: </strong>During early adolescence, lower inhibitory control was a risk factor for externalizing problems that, in turn, predicted lower working memory capacity. During middle adolescence, bidirectional associations became more prominent: inhibitory control and working memory functioned as both risk factors and consequences. Externalizing problems both predicted and were predicted by poor inhibitory control. Internalizing and externalizing symptoms showed bidirectional associations over time. Externalizing problems predicted more internalizing symptoms, whereas internalizing symptoms predicted fewer externalizing problems during middle adolescence.</p><p><strong>Conclusions: </strong>Our results corroborate dynamic theories that describe executive dysfunctions as precursors and consequences of psychopathology in middle adolescence.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e192"},"PeriodicalIF":5.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}