Data-Driven Profiles of Youth Executive Function and Their Longitudinal Associations With Externalizing Problems.

OBJECTIVE: Executive function (EF) deficits are observed in externalizing disorders. However, research has yet to explore the specificity of these associations for externalizing symptom dimensions and their potential utility in identifying subgroups of youth at risk for persistent problems. The current study leverages unsupervised learning methods to investigate longitudinal relationships between EF domains of inhibitory control and working memory and externalizing dimensions of hyperactivity, impulsivity, and aggression. METHOD: We include 5,501 youth from the Adolescent Brain Cognitive Development Study who participated in the baseline through 3- year follow-up (T0-T3) assessments. Youth EF was assessed with the Stop Signal and Emotional N-Back tasks. Externalizing problems were captured with the Child Behavior Checklist (CBCL) and parent-report Kiddie Schedule for Affective Disorders and Schizophrenia. RESULTS: A 2-cluster k-means solution optimally fit the data at T0 and T2. At both timepoints, the largest cluster (nT0= 2,927; nT2=3,089) was characterized by higher EF, while the smaller cluster (nT0= 2,574; nT2=2,412) was characterized by lower EF. Temporal stability of group membership was moderate (Cohen's k=0.41). Membership in the lower EF group at both timepoints was significantly associated with greater CBCL attention problems concurrently (T0, T2) and longitudinally (T0-T3; qs<0.05, Rank Biserial rs=0.6-0.11), and was associated with a greater proportion of ADHD diagnoses at T1 (qs≤0.001, Odds Ratios=1.65-1.71). Associations were not observed for aggressive or rule-breaking behaviors. CONCLUSION: These findings suggest multifaceted and specific cognitive performance deficits in youth attention problems that may inform tailoring and development of personalized treatment and cognitive interventions.