Back to The Future: Linking Early Psychiatric Symptoms to Transdiagnostic Cognitive Impairments in At-Risk Youth from the Adolescent Brain Cognitive Development Study

Cognitive impairment (problems in thinking, learning, remembering, judging, and decision-making) is central to many mental health disorders and often appears long before the onset of psychiatric symptoms. As psychiatric disorders are often heritable, children with first-degree relatives affected by severe mental illness are at higher risk for future psychiatric disorders, potentially showing early psychiatric symptoms. Our study explored the potential association between cognitive impairments and early subsyndromal psychiatric symptoms in at-risk youths from a transdiagnostic perspective. We analyzed 970 at-risk youth (aged nine to ten) with 970 matched controls from the Adolescent Brain Cognitive Development (ABCD) study and found they performed worse in some cognitive domains and exhibited more psychiatric symptoms than controls. Our multivariate analyses revealed a pattern most strongly linking emotional dysfunction symptoms and cognitive language abilities in at-risk youth, suggesting a link between cognitive impairment in at-risk youth and a higher prevalence of early psychiatric symptoms. Such association could potentially guide prediction, prevention and early intervention for children who are more at risk of developing mental illness later in life.