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Executive function (EF) deficits have been proposed as transdiagnostic risk factors for psychopathology, and recent research suggests EF impairments are associated with what is shared across forms of psychopathology (p factor). However, most research has not employed methods that differentiate between EF components, and little is known about the mediating mechanisms linking EF and psychopathology dimensions. The current study tested associations between the latent unity/diversity model of EF and latent dimensions of psychopathology and investigated mediating mechanisms in a community sample of 292 youth age 13–22. The results confirmed the finding that poor EF is associated with internalizing psychopathology in older youth via higher dependent stress and rumination, and showed that this pathway was transdiagnostic, predicting the p factor rather than internalizing specifically. Links with psychopathology were specific to the common EF factor, rather than updating- or shifting-specific EF.

Nearly 30–50% of people living with HIV experience HIV-Associated Neurocognitive Disorder (HAND). HAND indicates performance at least one standard deviation below the normative mean on any two cognitive domains. This method for diagnosing or classifying cognitive impairment has utility, however, cognitive intraindividual variability provides a different way to understand cognitive impairment. Cognitive intraindividual variability refers to the scatter in cognitive performance within repeated measures of the same cognitive test (i.e., inconsistency) or across different cognitive tests (i.e., dispersion). Cognitive intraindividual variability is associated with cognitive impairment and cognitive decline in various clinical populations. This integrative review of 13 articles examined two types of cognitive intraindividual variability in people living with HIV, inconsistency and dispersion. Cognitive intraindividual variability appears to be a promising approach to detect subtle cognitive impairments that are not captured by traditional mean-based neuropsychological testing. Greater intraindividual variability in people living with HIV has been associated with: 1) poorer cognitive performance and cognitive decline, 2) cortical atrophy, both gray and white matter volume, 3) poorer everyday functioning (i.e., driving simulation performance), specifically medication adherence, and 4) even mortality. This inspires future directions for research. First, greater cognitive intraindividual variability may reflect a greater task demand on executive control to harness and regulate cognitive control over time. By improving executive functioning through cognitive training, it may reduce cognitive intraindividual variability which could slow down cognitive decline. Second, cognitive intraindividual variability may be reconsidered in prior cognitive intervention studies in which only mean-based cognitive outcomes were used. It is possible that such cognitive interventions may actually improve cognitive intraindividual variability, which could have clinical relevance.

The coronavirus (COVID-19) pandemic is still evolving, causing hundreds of millions of infections around the world. The long-term sequelae of COVID-19 and neurologic syndromes post COVID remain poorly understood. The present study aims to characterize cognitive performance in patients experiencing cognitive symptoms post-COVID infection. Patients evaluated at a post COVID clinic in Northern Israel who endorsed cognitive symptoms were referred for neurologic consultation. The neurologic work-up included detailed medical history, symptom inventory, neurological examination, the Montreal Cognitive Assessment (MoCA), laboratory tests and brain CT or MRI. Between December 2020 and June 2021, 46 patients were referred for neurological consultation (65% female), mean age 49.5 (19–72 years). On the MoCA test, executive functions, particularly phonemic fluency, and attention, were impaired. In contrast, the total MoCA score, and memory and orientation subscores did not differ from expected ranges. Disease severity, premorbid condition, pulmonary function tests and hypoxia did not contribute to cognitive performance. Cognitive decline may affect otherwise healthy patients post-COVID, independent of disease severity. Our examination identified abnormalities in executive function, attention, and phonemic fluency. These findings occurred despite normal laboratory tests and imaging findings.

Psychiatric disorders are typically classified using categorical diagnostic systems based on symptom clusters. However, these frameworks often fail to capture the cognitive and neurobiological mechanisms that transcend diagnostic boundaries and influence everyday functioning. Executive dysfunction, encompassing impairments in inhibitory control, working memory, cognitive flexibility, planning, and emotion regulation, was historically linked to focal damage in prefrontal brain regions. Converging evidence from neuropsychology, cognitive neuroscience, genetics, and clinical research indicates that executive dysfunction is prevalent across multiple psychiatric conditions and closely linked to functional impairment. This theory-driven article proposes that executive dysfunction represents a transdiagnostic dimension of psychopathology reflecting a shared neurocognitive vulnerability. Disruptions in both “cool” executive processes (e.g., cognitive control and working memory) and “hot” executive processes (e.g., emotion regulation and motivational control) may constitute a common pathway through which diverse psychiatric disorders impair adaptive functioning. Executive dysfunction is further conceptualized as an intermediate phenotype linking genetic liability, distributed neural circuit disruption, and everyday behavioral regulation. This perspective supports a shift toward transdiagnostic, mechanism-based mental health interventions that prioritize executive functioning as a central target for improving real-world functioning and long-term recovery.

The functional roles of the precuneus are unclear. Focal precuneus lesions are rare, making it difficult to identify robust brain–behavior relationships. Distinct functional subdivisions of the precuneus have been proposed based on unique connectivity profiles. This includes an association of the anterior division with bodily awareness, the central region with complex cognition, and the posterior division with visual processing. Our goal was to test the hypothesis that the central precuneus is preferentially involved (compared to the other sectors of the precuneus) in executive function, as estimated from performance on the trail-making test (TMT). 35 patients with focal brain lesions involving the precuneus were included from the University of Iowa and Montpellier University. Multivariate lesion symptom mapping of TMT performance was performed to evaluate whether lesion location was associated with impaired task performance. Lesion symptom mapping revealed a statistically significant association of central precuneus lesions with impaired TMT performance (r = 0.43, p < 0.01). Further, a functional network derived from this precuneus region showed connectivity to other cortical areas implicated in executive function, including the dorsolateral prefrontal cortex and inferior parietal lobe. This analysis provides support for the role of the central precuneus in executive function, consistent with the unique connectivity pattern of the central precuneus with a broader network implicated in cognitive control and executive function.

Hypertension (HTN) affects over 1.2 billion individuals worldwide and is defined as systolic blood pressure (BP) ≥ 140 mmHg and diastolic BP ≥ 90 mmHg. Hypertension is also considered a high risk factor for cerebrovascular diseases, which may lead to vascular cognitive impairment (VCI). VCI is associated with executive dysfunction and is also a transitional stage between hypertension and vascular dementia. Hence, it is essential to establish a reliable approach to diagnosing the severity of VCI. In 28 HTN (51–83 yrs; 18 males, 10 females) and 28 healthy controls (HC) (51–75 yrs; 7 males, 21 females), we investigated which regions demonstrate alterations in the resting-state functional connectome due to vascular cognitive impairment in HTN by using the amplitude of the low-frequency fluctuations (ALFF), regional homogeneity (ReHo), graph theoretical analysis (GTA), and network-based statistic (NBS) methods. In the group comparison between ALFF/ReHo, HTN showed reduced spontaneous activity in the regions corresponding to vascular or metabolic dysfunction and enhanced brain activity, mainly in the primary somatosensory cortex and prefrontal areas. We also observed cognitive dysfunction in HTN, such as executive function, processing speed, and memory. Both the GTA and NBS analyses indicated that the HTN demonstrated complex local segregation, worse global integration, and weak functional connectivity. Our findings show that resting-state functional connectivity was altered, particularly in the frontal and parietal regions, by hypertensive individuals with potential vascular cognitive impairment.

: This article will address how anomalies of executive function after traumatic brain injury (TBI) can translate into altered social behavior that has an impact on a person's capacity to live safely and independently in the community. : Review of literature on executive and neurobehavioral function linked to cognitive ageing in neurologically healthy populations and late neurocognitive effects of serious TBI. Information was collated from internet searches involving MEDLINE, PubMed, PyscINFO and Google Scholar as well as the authors' own catalogs. : The conventional distinction between cognitive and emotional-behavioral sequelae of TBI is shown to be superficial in the light of increasing evidence that executive skills are critical for integrating and appraising environmental events in terms of cognitive, emotional and social significance. This is undertaken through multiple fronto-subcortical pathways within which it is possible to identify a predominantly dorsolateral network that subserves executive control of attention and cognition (so-called cold executive processes) and orbito-frontal/ventro-medial pathways that underpin the hot executive skills that drive much of behavior in daily life. TBI frequently involves disruption to both sets of executive functions but research is increasingly demonstrating the role of hot executive deficits underpinning a wide range of neurobehavioral disorders that compromise relationships, functional independence and mental capacity in daily life.

Cardiovascular diseases such as coronary artery disease (CAD) have a high prevalence of psychiatric comorbidities, that may impact clinically relevant outcomes (e.g., cognitive impairment and executive dysfunction). Obsessive-compulsive personality disorder (OCPD) is a common psychiatric comorbidity in CAD. It has a distinct cognitive profile characterised by inflexible thinking and executive dysfunction, which in turn may affect treatment adherence. However, the impact of OCPD on cognitive functioning in CAD is under-researched. We aimed to investigate the impact of OCPD on executive function in individuals with CAD undergoing rehabilitation, using cognitive tests relating to inflexibility and executive planning. Seventy-eight adults (median age 59 [53.0–66.0] years) with CAD were tested within three days of hospital admission for cardiac rehabilitation occurring within two weeks of experiencing an episode of unstable angina or myocardial infarction. The Compulsive Personality Assessment Scale (CPAS) was used to evaluate OCPD traits. Neurocognitive testing was performed using the Cambridge Automated Neuropsychological Test Battery (CANTAB) including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting), and executive planning (Stockings of Cambridge [SOC]). Ten individuals with CAD fulfilled the operational criteria for DSM-5 OCPD. Individuals with comorbid OCPD made more IED intra-dimensional shift reversal errors (2.0 [2.0–4.0] vs. 1.0 [1.0–2.0], p = .004), reflecting a difficulty inhibiting previously learnt responses. When all participants were analysed as a group, negative associations were found between individual OCPD traits and other aspects of cognitive performance. Hoarding trait was associated with increased initial thinking time on the SOC at five moves (ρ = 0.242, p = .033), while the need for control and rigidity traits were each associated with increased initial thinking time on the SOC at two moves (respectively, ρ = 0.259, p = .022; ρ = 0.239, p = .035), reflecting slower executive planning. A preoccupation with details trait was associated with fewer errors on a compound discrimination stage of the IED (ρ = −0.251, p = .026). After controlling these correlations for gender and age, significant associations remained with hoarding (β = 0.243, p = .036), need for control (β = 0.341, p = .005) and rigidity (β = 0.259, p = .038) traits. Preliminary evidence suggests that individuals with CAD and comorbid OCPD traits show greater inflexibility than those without OCPD. Several OCPD traits were associated with slower planning, even after controlling them for age and gender. This may have implications for the success of rehabilitation. •We investigated the impact of OCPD on executive function in individuals with CAD undergoing rehabilitation.•Individuals with comorbid OCPD had more difficulties in inhibiting previously learned responses.•Traits hoarding, rigidity, and need for control showed slower executive planning.•Individuals with CAD and comorbid OCPD and its traits show greater cognitive inflexibility than those without OCPD.