An investigation of the association between adverse childhood experiences and cognitive functioning and an exploration of cognitive disengagement syndrome, daily functioning, intolerance of uncertainty, executive functioning, and worry

Abstract

Adverse childhood experiences (ACEs) influence mental and physical health throughout the lifespan, and a wealth of literature attests to its impact on neurodevelopment. This has implications for cognitive functioning in adulthood, including executive functioning (EF), which is conceptualized as an overarching cognitive domain accounting for such functions as response inhibition, working memory and cognitive flexibility. Previous reviews have sought to qualitatively study the relationship between ACEs and EF in adulthood, though this research sought to expand on this by providing the first quantitative synthesis of this body of research. A systematic review and meta-analysis was conducted. Twenty-five eligible studies (N = 8073) were extracted, with 55 effect sizes (Pearson’s r). Overall, a small and significant association was found between ACEs and EF (r = - .126, 95%CI: -.152, -.10) and heterogeneity was high (I2 = 99.50, p < .001). Type of EF measure and EF domain were established as small but significant moderators on the ACE-EF relationship. The findings are consistent with prior narrative syntheses of the ACE-EF relationship, and with meta-analyses which have explored the impact of ACEs on distinct EF subgroups. Methodological issues across this body of research, and in relation to the current meta-analysis are discussed as potential influences on the results of this study. A separate and unrelated empirical study was conducted exploring cognitive disengagement syndrome (CDS). Growing interest in CDS as a distinct set of symptoms from ADHD has prompted research exploring its impact on functional abilities, mental health and cognitive functioning. These broadly point to CDS negatively impacting these domains, though it remains scarcely considered in clinical practice. This study aimed to expand the understanding of CDS by considering its association with daily functioning, executive functioning (EF), intolerance of uncertainty (IU), and worry. This cross-sectional study utilized self-report measures of CDS (ACI), daily functioning (IWPQ-A), IU (IUS-R), worry (PWSQ-3), and executive function (ADEXI). The main analysis included adult participants (N = 399, Age range: 18 – 79). The findings suggest a direct CDS-daily functioning relationship, and established this is moderated by EF. IU was not found to be a mediator of this relationship, though IU was found to mediate the relationship between CDS and worry, as was daily functioning. Alongside the key findings, this study provides further evidence for CDS operating independently from ADHD, and discusses the implications for clinical practice and for future research.