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GENERAL COMMENTARY article

Front. Psychol., 06 August 2015
Sec. Psychopathology

Looking under the hood of executive function impairments in psychopathology: A commentary on “Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches”

  • 1Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
  • 2Division of Clinical Neuroscience, Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium

A commentary on
Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches

by Snyder, H. R., Miyake, A., and Hankin, B. L. (2015). Front. Psychol. 6:328. doi: 10.3389/fpsyg.2015.00328

Of critical importance for clinical psychological science is why do people differ in their very ability to govern and regulate their thoughts and behaviors? This concern speaks to the paramount nature of executive function (EF) that encompasses a set of general-purpose cognitive control mechanisms regulating lower-level processes and, in turn, enabling self-regulation and self-directed behavior toward a goal (Banisch, 2009). Consequently, EF has been shown to have far-reaching implications for nearly all of our daily activities. At a theoretical level, EF is best characterized as consisting of separable but related processes, with both unique and shared individual differences (Miyake and Friedman, 2012). This unity/diversity model focuses on three aspects of EF, namely updating working memory, shifting, and inhibition, as well as on a common unitary EF ability which spans these components and is posited to be the ability to actively maintain task goals and to use this information to provide top-down support for task-relevant responses (Miyake and Friedman, 2012).

We are thankful to Snyder et al. (2015) for recently engaging in a much-needed comprehensive narrative review about the EF impairments in psychopathology. In their review, they concluded that most psychopathological conditions are associated with fairly uniform deficits in EF tasks, and advocated that this pattern of findings cements the view that there are broad and transdiagnostic impairments in the unitary component of EF, rather than impairments in a few individual specific aspects of EF.

Theoretically, Snyder et al. (2015) also upheld that their conclusions do conform to others who posited impairments in the functioning of attentional networks in psychopathology (e.g., Pacheco-Unguetti et al., 2011; Orellana et al., 2012; Maurage et al., 2014). According to the attentional networks approach (Posner and Rothbart, 2007; Petersen and Posner, 2012), attentional system can be subdivided into three functionally and anatomically independent networks, namely alerting (allowing to achieve and maintain a state of alertness), orienting (allowing to select sensory information by engaging, disengaging or shifting attention from one stimulus to another), and executive (involving the top-down control of attention to resolve response conflicts). Because the notion of “executive network of attention” is defined as similarly to common EF, Snyder et al. (2015) argued that psychopathology should thus predominantly be associated with impairment in this network, but neither with the alerting nor the orienting ones. Strikingly, based on this rationale, they also adjudicated that EF impairments in psychopathology are unlikely to reflect lower-level attentional difficulties. We argue that these conclusions are unjustified.

First, a strict reading of their account is at odds with previous evidence of alerting and orienting networks impairments in a wide range of distinct psychopathological conditions (e.g., Lundervold et al., 2011; Fan et al., 2012; Keehn et al., 2013; Heeren et al., 2015). Moreover, strong associations between the efficiency of these two networks and several key transdiagnostic processes have been recently portrayed. However, they were mostly devoid of any relation vis-à-vis the executive network. For instance, the efficiency of the orienting network predicts the intensity of ruminative thinking (Pẽcher et al., 2011; Tortella-Feliu et al., 2014), which is an established transdiagnostic process involved in the maintenance of several psychopathological conditions (Mansell et al., 2009). Besides, enhanced alerting network functioning is predictive of a greater risk of suppressing distress-related cognitions (Tortella-Feliu et al., 2014), which is known as a maladaptive emotion-regulation strategy (Magee et al., 2012). Finally, situational anxiety and distressing feelings were associated with both alerting (Pacheco-Unguetti et al., 2010) and orienting networks efficiency (Moriya and Tanno, 2009), but not with the executive one. We are thus encouraging researchers to dig far beyond a mere diagnostic-based group-comparison approach to grasp the very nature of the connections among EF, attentional networks, and psychopathology.

Second, because psychopathology is associated with impairments in the executive network of attention, Snyder et al. (2015) argued that this suggests that EF deficits are not due to lower-level attentional difficulties. We believe this inference is too strong. Indeed, there are several publications evidencing lower-level attentional processes impairments (e.g., perceptual processes) across several distinct psychopathological conditions, including autism (e.g., Behrmann et al., 2006), social anxiety (e.g., Rossignol et al., 2012; Peschard et al., 2013), schizophrenia (e.g., Silverstein et al., 2014), depression (e.g., Desseilles et al., 2009), and addictions (e.g., D'Hondt et al., 2014). Although we agree that uncertainty still abounds regarding the elusive connections between lower- and higher-level processes, one cannot rule out the possibility, as recently suggested (e.g., Noël et al., 2013; Peschard and Philippot, 2015), that these interactions do play key roles in the maintenance of psychopathology.

Altogether, although we agree with Snyder et al. (2015) that an audit of EF impairments in psychopathology is timely, our commentary challenges their claim that psychopathology is typically associated with impaired executive network of attention. It also calls for a reconsideration of the role of attention, including lower-level processes, in the conceptualization of EF impairments in psychopathology. Yet it remains to be seen whether a unified theory of the interactions between attentional networks and both diverse and unitary executive components can be achieved, even beyond the case of psychopathology. On the other hand, at a methodological level, extant procedures often used for assessing the structures of EF, such as exploratory and confirmatory factor analyses, are insufficiently robust to delve into the communalities shared by attentional and executive processes. New methods for conceptualizing psychological phenomena as networks of interacting processes, rather than indicators of a latent common variable, have emerged (e.g., Borsboom and Cramer, 2013). Since these methods have more robust validity vis-à-vis construct simulation models that mimic network dynamic of psychological phenomena (e.g., Schmittmann et al., 2013), reasonable next steps would thus be their application for reliably modeling common jointures of attentional networks, EF, and psychopathology.

Author Contributions

AH had the initial ideas and wrote the first draft of the manuscript. All authors then revised the manuscript critically and contributed to and have approved the final manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

AH (Postdoctoral Research Fellow) and PM (Research Associate) are founded by the Belgian National Fund for Scientific Research (F.R.S.-FNRS, Belgium). This work also received the support from the Belgian Foundation for Vocation (“Vocatio”) and from the Bourse d'Excellence Scientifique de la Fédération Wallonie-Bruxelles, both awarded to AH. These foundations did not exert any editorial direction or censorship on any part of this manuscript.

References

Banisch, M. T. (2009). Executive function: the search for an integrated account. Curr. Dir. Psychol. Sci. 18, 89–94. doi: 10.1111/j.1467-8721.2009.01615.x

CrossRef Full Text | Google Scholar

Behrmann, M., Thomas, C., and Humphreys, K. (2006). Seeing it differently: visual processing in autism. Trends Cogn. Sci. 10, 258–263. doi: 10.1016/j.tics.2006.05.001

PubMed Abstract | CrossRef Full Text | Google Scholar

Borsboom, D., and Cramer, A. O. (2013). Network analysis: an integrative approach to the structure of psychopathology. Annu. Rev. Clin. Psychol. 9, 91–121. doi: 10.1146/annurev-clinpsy-050212-185608

PubMed Abstract | CrossRef Full Text | Google Scholar

D'Hondt, F., Lepore, F., and Maurage, P. (2014). Are visual impairments responsible for emotion decoding deficits in alcohol-dependence? Front. Hum. Neurosci. 8:128. doi: 10.3389/fnhum.2014.00128

PubMed Abstract | CrossRef Full Text | Google Scholar

Desseilles, M., Balteau, E., Sterpenich, V., Dang-Vu, T. T., Darsaud, A., Vandewalle, G., et al. (2009). Abnormal neural filtering of irrelevant visual information in depression. J. Neurosci. 29, 1395–13403. doi: 10.1523/JNEUROSCI.3341-08.2009

PubMed Abstract | CrossRef Full Text | Google Scholar

Fan, J., Bernardi, S., Van Dam, N. T., Anagnostou, E., Gu, X., Martin, L., et al. (2012). Functional deficits of the attentional networks in autism. Brain Behav. 2, 647–660. doi: 10.1002/brb3.90

PubMed Abstract | CrossRef Full Text | Google Scholar

Heeren, A., Maurage, P., and Philippot, P. (2015). Revisiting attentional processing of non-emotional cues in social anxiety: a specific impairment for the orienting network of attention. Psychiatry Res. 228, 136–142. doi: 10.1016/j.psychres.2015.04.030

PubMed Abstract | CrossRef Full Text | Google Scholar

Keehn, B., Müller, R. A., and Townsend, J. (2013). Atypical attentional networks and the emergence of autism. Neurosci. Biobehav. Rev. 37, 164–183. doi: 10.1016/j.neubiorev.2012.11.014

PubMed Abstract | CrossRef Full Text | Google Scholar

Lundervold, A. J., Adolfsdottir, S., Halleland, H., Halmøy, A., Plessen, K., and Haavik, J. (2011). Attentional network test in adults with ADHD—The impact of affective fluctuations. Behav. Brain Funct. 7:27. doi: 10.1186/1744-9081-7-27

PubMed Abstract | CrossRef Full Text | Google Scholar

Magee, J. C., Harden, K. P., and Teachman, B. A. (2012). Psychopathology and thought suppression: a quantitative review. Clin. Psychol. Rev. 32, 189–201. doi: 10.1016/j.cpr.2012.01.001

PubMed Abstract | CrossRef Full Text | Google Scholar

Mansell, W., Harvey, A., Watkins, E., and Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. J. Cogn. Psychother. 23, 6–19. doi: 10.1891/0889-8391.23.1.6

CrossRef Full Text | Google Scholar

Maurage, P., de Timary, P., Billieux, J., Collignon, M., and Heeren, A. (2014). Attentional alterations in alcohol dependence are underpinned by specific executive controls deficits. Alcoholism 38, 20105–20112. doi: 10.1111/acer.12444

PubMed Abstract | CrossRef Full Text | Google Scholar

Miyake, A., and Friedman, N. P. (2012). The nature and organization of individual differences in executive functions: four general conclusions. Curr. Dir. Psychol. Sci. 21, 8–14. doi: 10.1177/0963721411429458

PubMed Abstract | CrossRef Full Text | Google Scholar

Moriya, J., and Tanno, Y. (2009). Dysfunction of attentional networks for non-emotional processing in negative affect. Cogn. Emot. 23, 1090–1105 doi: 10.1080/02699930802335018

CrossRef Full Text | Google Scholar

Noël, X., Brevers, D., and Bechara, A. (2013). A triadic neurocognitive approach to addiction for clinical interventions. Front. Psychiatry 4:179. doi: 10.3389/fpsyt.2013.00179

PubMed Abstract | CrossRef Full Text

Orellana, G., Slachevsky, A., and Peña, M. (2012). Executive attention impairment in first-episode schizophrenia. BMC Psychiatry 12:154. doi: 10.1186/1471-244X-12-154

PubMed Abstract | CrossRef Full Text | Google Scholar

Pacheco-Unguetti, A. P., Acosta, A., Callejas, A., and Lupiáñez, J. (2010). Attention and Anxiety: Different attentional functioning under state and trait anxiety. Psychol. Sci. 21, 298–304. doi: 10.1177/0956797609359624

PubMed Abstract | CrossRef Full Text | Google Scholar

Pacheco-Unguetti, A. P., Acosta, A., Marqués, E., and Lupiáñez, J. (2011). Alterations of the attentional networks in patients with anxiety disorders. J. Anxiety Disord. 25, 888–895. doi: 10.1016/j.janxdis.2011.04.010

PubMed Abstract | CrossRef Full Text | Google Scholar

Pẽcher, C., Quaireau, C., Lemercier, C., and Cellier, J.-M. (2011). The effects of inattention on selective attention: how sadness and ruminations alter attention functions evaluated with the attention network test. Eur. Rev. Appl. Psychol. 61, 43–50. doi: 10.1016/j.erap.2010.10.003

CrossRef Full Text | Google Scholar

Peschard, V., and Philippot, P. (2015). Social anxiety and information processing biases: an integrated theoretical perspective. Cogn. Emot. doi: 10.1080/02699931.2015.1028335. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Peschard, V., Philippot, P., Joassin, F., and Rossignol, M. (2013). The impact of the stimulus features and task instructions on facial processing in social anxiety: an ERP investigation. Biol. Psychol. 93, 88–96. doi: 10.1016/j.biopsycho.2013.01.009

PubMed Abstract | CrossRef Full Text | Google Scholar

Petersen, S. E., and Posner, M. I. (2012). The attention system of the human brain: 20 years after. Ann. Rev. Neurosci. 35, 73–89. doi: 10.1146/annurev-neuro-062111-150525

PubMed Abstract | CrossRef Full Text | Google Scholar

Posner, M. I., and Rothbart, M. K. (2007). Research on attention networks as a model for the integration of psychological science. Annu. Rev. Psychol. 58, 1–23. doi: 10.1146/annurev.psych.58.110405.085516

PubMed Abstract | CrossRef Full Text | Google Scholar

Rossignol, M., Campanella, S., Maurage, P., Heeren, A., Falbo, L., and Philippot, P. (2012). Enhanced perceptual responses during visual processing of facial stimuli in young socially anxious individuals. Neurosci. Lett. 526, 68–73. doi: 10.1016/j.neulet.2012.07.045

PubMed Abstract | CrossRef Full Text | Google Scholar

Schmittmann, V. D., Cramer, A. O. J., Waldorp, L. J., Epskamp, S., Kievit, R. A., and Borsboom, D. (2013). Deconstructing the construct: a network perspective on psychological phenomena. New Ideas Psychol. 31, 43–53. doi: 10.1016/j.newideapsych.2011.02.007

CrossRef Full Text | Google Scholar

Silverstein, S. M., Keane, B. P., Papathomas, T. V., Lathrop, K. L., Kourtev, H., Feigenson, K., et al. (2014). Processing of spatial-frequency altered faces in schizophrenia: effects of illness phase and duration. PLOS ONE 9:e114642. doi: 10.1371/journal.pone.0114642

PubMed Abstract | CrossRef Full Text | Google Scholar

Snyder, H. R., Miyake, A., and Hankin, B. L. (2015). Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches Front. Psychol. 6:328. doi: 10.3389/fpsyg.2015.00328

PubMed Abstract | CrossRef Full Text | Google Scholar

Tortella-Feliu, M., Morillas-Romero, A., Balle, M., Bornas, X., Llabrès, J., and Pacheco-Unguetti, A. P. (2014). Attentional control, attentional network functioning, and emotion regulation styles. Cogn. Emot. 28, 769–780. doi: 10.1080/02699931.2013.860889

PubMed Abstract | CrossRef Full Text | Google Scholar

Keywords: executive function, self-regulation, psychopathology, transdiagnostic processes, attentional processes, top-down attention control

Citation: Heeren A, Billieux J, Philippot P and Maurage P (2015) Looking under the hood of executive function impairments in psychopathology: A commentary on “Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches”. Front. Psychol. 6:1170. doi: 10.3389/fpsyg.2015.01170

Received: 10 June 2015; Accepted: 24 July 2015;
Published: 06 August 2015.

Edited by:

Anna Abraham, Leeds Beckett University, UK

Reviewed by:

Yoshifumi Ikeda, Joetsu University of Education, Japan

Copyright © 2015 Heeren, Billieux, Philippot and Maurage. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Alexandre Heeren, Alexandre.heeren@uclouvain.be; heeren.alexandre@gmail.com

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