executive function

Specific learning disorder (SLD) affects 5 - 15% of children globally, disrupting their academic, social, and emotional development. Understanding how executive function (EF) influences leisure activities is essential for supporting adolescents with SLD in improving their overall quality of life. Leisure activities were categorized as structured (e.g., organized sports, classes), unstructured (e.g., casual play, TV watching), independent (done alone), and cooperative (done with others) activities.

This study aimed to explore the relationship between EF and participation in leisure activities among adolescents aged 12 to 17 with SLD. We hypothesized that lower EF scores would be associated with reduced leisure participation.

A cross-sectional study was conducted during the COVID-19 pandemic (2020 - 2021) in Tehran, Iran. Convenience sampling from five specialized SLD centers yielded 85 adolescents (12 - 17 years old) with a confirmed SLD diagnosis, who were able to read/write, and without comorbid conditions preventing participation. They completed a demographic questionnaire and two assessments: The Behavior Rating Inventory of EF-Self-Report Version (BRIEF-SR) and the children’s assessment of participation and enjoyment (CAPE). Pearson correlation coefficients (r) and multiple regression analyses were used in SPSS 22.

A total of 85 adolescents (mean age 14.01 ± 1.20 years; 47.1% female) completed the study. No significant correlation was found between EF and overall participation in leisure activities (R = -0.024, P > 0.05). These findings align with previous research (Sharifi & Rosenblum, 2014), which suggests that EF deficits may not necessarily hinder participation in unstructured or socially supported leisure activities. The EF did not predict specific subscales of leisure participation, including physical (R = -0.085, P = 0.439), social (R = 0.096, P = 0.383), and skill-based activities (R = -0.064, P = 0.561). Results may have been influenced by COVID-19 pandemic restrictions, which limited physical and social leisure activities.

The study found no significant link between EF and leisure participation in adolescents with SLD. It was hypothesized that social and environmental factors might have played a more influential role, warranting further research. Limitations include reliance on self-report questionnaires and the cross-sectional design, suggesting that future longitudinal or mixed-methods studies are needed.

In the present study, we investigated the executive functions (EFs) following suicide with acute poisoning.

In this cross-sectional study from April to August 2020 in Khorshid Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, adult poisoned patients (n = 120) suffering from suicide were selected by convenience sampling method and divided into three groups: recurrent suicide attempts, and suicide attempts for the first time with and without previous psychiatric disorders. Continuous performance tests (CPTs) including commission error components, omission response, correct response, and response time were used to evaluate EFs. Chi-square and Fisher's exact test were used to analyze qualitative variables. Moreover, multi-dimensional regression analysis was used to find the predictors of recurrent suicide in SPSS software.

A significant difference among the patients of the three groups regarding their all-subgroup CPT scores was observed (P < 0.05). The omission response and response time components were higher in patients with a history of psychiatric disorder than in the other two groups. However, in the commission error component, the mean scores were higher in the patients with recurrent suicide. There was also a significant difference in the omission response (P = 0.008), the response time (P = 0.04), and the correct answer (P = 0.016) concerning patients’ education. In multivariate regression analysis, the education level predicted recurrent suicide attempts. Patients with education less than high school [odds ratio (OR): 13.23, 95% confidence interval (CI): 1.5-115.7, P = 0.02] and diploma (OR: 11.35, 95% CI: 1.30-96.88, P = 0.026) had more chance of recurrent suicide.

This study provides important information regarding the interventions with an education that can help prevent suicide.

Despite receiving training on caring for burn wounds in the undergraduate nursing program, nursing students do not acquire enough knowledge and skills in wound dressing and debridement. This research was carried out to determine the effect of a training package on the nursing interns’ knowledge and executive functions regarding the dressing and mechanical debridement of burn wounds.

This quasi-experimental study was conducted on 60 nursing internship students in their 7th semester in Ilam, Iran, in 2023. A convenience sampling method was used, and participants were randomly assigned to groups using dice-throwing for simple randomization. Over six weeks, the intervention group received training on dressing burn wounds through a learning package, virtual gamification, a simulator, and clinical and real exercises. The control group received routine content through oral education by the same lecturer. Knowledge and executive function in mechanical debridement of burn wounds were assessed using the KMDBWT and EFMDBWT tools before and two weeks after the intervention. Data were analyzed with a standard error of 0.05 using Kolmogorov-Smirnov, independent t, paired t, chi-square, and analysis of covariance tests by SPSS V.16.

Before the intervention, no significant difference was observed between the mean and standard error of the control and intervention groups' knowledge and executive performance scores. However, after the intervention, the knowledge scores significantly increased in the intervention group (16.35 ± 0.288) compared to the control group (10.00 ± 0.356) (P=0.001). Moreover, after the intervention, the executive function scores in the intervention group (105.00 ± 0.939) were significantly increased compared to the control group (56.81 ± 0.738) (P=0.001).

The burn wound dressing and mechanical debridement training increased nursing students' knowledge and executive function. Hence, this educational package is recommended as a supplementary teaching resource.

Online gaming addiction can negatively affect academic performance. Thus, it is important to understand the factors that influence it. This study aimed to investigate the correlation between online gaming addiction and academic engagement with the mediating role of executive functions among secondary school students. The present cross-sectional study included all secondary high school students in Tehran, Iran in the academic year of 2023-2024. A total number of 384 students were selected using the random cluster sampling method, and they were asked to fill out the Internet Gaming Disorder Test (IGD-20), Student Engagement Questionnaire, Adult Executive Functioning Inventory (ADEXI), and Nejati Cognitive Abilities Questionnaire. Data were analyzed using Pearson correlation analysis and structural equation modeling (SEM) with SPSS version 26 and AMOS version 24. The results showed that online game addiction is negatively correlated with students’ academic engagement (r=-0.336) as well as all dimensions of executive function, including planning (r=-0.425), cognitive flexibility (r=-0.455), working memory (r=-0.420), and inhibition (r=-0.350). Furthermore, path analysis revealed that online game addiction does not directly predict academic engagement (β=-0.12, P=0.37). However, it can indirectly predict academic engagement through the mediation of working memory (β=-0.013, P=0.025) and inhibition functions (β=-0.013, P=0.016). Overall, addiction to online games and the dimensions of executive function collectively account for nearly 44% of students’ academic engagement. These results suggested that excessive online gaming is destructive to cognitive abilities and motivation toward learning and schooling among adolescent students. Consequently, parents, teachers, and school psychologists should develop suitable educational, training, and therapeutic strategies to mitigate these harmful effects.

It is well-established that executive function can be affected by a session of aerobic training. Our study aimed to determine how acute aerobic exercise affect executive function at different intensities in 9-10-year-old children.

The participants in this quasi-experimental study were 36 children (9.58 years±0.50) in Saqqez, Kurdistan Province, Iran in the first half of 2022. They were randomly assigned into 60% and 80% heart rate reserve (HRR) and a control group. All groups performed the Progressive Aerobic Cardiovascular Run (PACER) test in the first stage of study to ensure homogeneity. Then, in the pretest- posttest design, inhibitory control and working memory were assessed using the Stroop and N-back tests. During the 15-minute exercise session, participants exercised on a treadmill at different intensities of 60% and 80% of their HRR. One-way Analysis of Variance (ANOVA) and paired t-test were employed to analyze between-group and within-group differences in control and intervention groups.

According to the results, working memory scores of children improved significantly in 60% and 80% HRR groups (65.44±9.51 vs. 44.69±17.76) compared with the control group (31.00±2.02) (P<0.0001). Different exercise intensities; however, did not show any advantage over a control group in the interference score of correct answers, or reaction time (RT) of inhibition control (60% HRR: 4.08±3.77, 80% HRR: 1.16±3.32, Control: 4.25±3.62, P=0.074), (60% HRR: 52.00±65.91, 80% HRR: 85.66±59.75, Control: 27.16±106.46, P=0.215).

The study findings revealed that working memory in pre-adolescents can be improved by a 15-minute session of moderate or high-intensity aerobic exercise. However, there were no significant differences between the groups in terms of inhibitory control.

The present study examined the mediating role of emotion regulation difficulties and executive function deficits in the relationship between childhood traumas and identity disturbance in adolescent boys. 

This descriptive, cross-sectional study utilizes a correlational design employing structural equation modeling. A sample of 311 adolescent boys from Yazd City, Iran, was included in the study (mean age=16.95 years) and selected through convenience and purposive sampling. Data were collected through a childhood trauma questionnaire (CTQ), difficulties in emotion regulation scale (DERS) (short form), cognitive abilities questionnaire and adolescent identity development questionnaire.

The final model indicated that the direct relationship between childhood trauma and identity disturbance was not significant. Instead, this relationship was mediated by executive function deficits and difficulties in emotion regulation. The direct relationship between childhood trauma and emotion regulation difficulty was not significant; instead, childhood trauma affected difficulties in emotion regulation through the mediation of executive function deficits. Therefore, in the relationship between childhood trauma and identity disturbance, emotion regulation functioned as a second-order mediating variable.

Considering emotion regulation and executive functions in designing preventive and therapeutic interventions can be beneficial when working with adolescents experiencing identity disturbance and childhood traumatic experiences.

Substance abuse leads to blood-brain barrier dysfunction and activation of neuro-inflammatory pathways. However, the contribution of serum levels of Toll-like receptor 2 (TLR-2) and S100 calcium-binding protein B (S100B) to neuropsychological outcomes has not been clearly established. This study aims to explore the relationship between TLR-2 and S100B serum concentrations in individuals with substance abuse and their potential influence on neuropsychological results, specifically regarding the functioning of the frontal lobe.

 This study involved 28 individuals who were diagnosed with substance abuse at Loghman Hakim Hospital’s Toxicology Unit in 2022. Serum TLR-2 concentration and S100B levels, as neuroinflammatory markers, and the frontal assessment battery (FAB), as executive function markers, were measured.

Substance abuse patients exhibited elevated levels of both TLR-2 and S100B. In drug addicts, a strong positive relationship was detected between serum levels of TLR-2 and S100B (r=0.742, P=0.0021) levels. Nevertheless, no significant relationship was found between FAB scores and serum concentrations of S100B and TLR-2.

This study reveals increased serum TLR-2 and S100B levels in individuals with substance abuse. However, these elevated levels did not appear to be associated with risk factors related to substance abuse or frontal lobe function.

Cognitive impairments are fundamental characteristics of schizophrenia, significantly impacting the overall functioning of individuals with the disorder. However, the trajectory of cognitive deficits and the factors influencing their changes over the course of treatment remain poorly understood.

The present study aimed to investigate the changes in cognitive status of patients with schizophrenia and the factors that influence these changes following hospitalization and treatment.

The study utilized a longitudinal design, enrolling thirty hospitalized patients (15 males and 15 females) from the psychiatric inpatient unit of a general educational hospital. Cognitive assessments were conducted upon admission and discharge. A Generalized Estimating Equation (GEE) model was used to analyze the data, accounting for demographic and clinical variables such as age, gender, Body Mass Index (BMI), family history, and smoking status.

The findings revealed a reduction in cognitive deficits following hospitalization and treatment. Significant improvements were observed in verbal memory, working memory, and executive function. However, older patients showed poorer performance in motor speed, verbal fluency, and symbol coding compared to younger patients. Male patients and smokers demonstrated lower cognitive functioning, particularly in verbal fluency, symbol coding, and executive function.

This study highlighted the positive effect of comprehensive inpatient treatment on reducing cognitive impairments in individuals with schizophrenia. While improvements were noted in several cognitive domains, the persistence of certain deficits, particularly in relation to demographic factors (age, gender, and smoking status), underscores the need for further research and tailored cognitive rehabilitation interventions. A personalized, multidimensional approach to managing cognitive deficits in schizophrenia could lead to better functional outcomes and enhance the quality of life for affected individuals.

Executive functions (EFs) are essential in controlling thoughts, emotions, and behavior. Evaluating the effect of athletic activity on the EFs that lead to better quality of life and mental and physical health is essential.

This study aimed to compare the components of EFs, including response inhibition, attention, and processing speed among male adolescents. 

A multi-stage random sampling method was used among 48 athletes and 48 non-athlete male adolescents in Tehran City, Iran. Cognitive functioning was assessed by a series of cognitive measures, including the go/no-go task, integrated visual and auditory test (IVA) and Wechsler intelligence scale for children–the fourth edition. 

The results revealed significant differences in response omission and reaction time between the two groups (P=0.01). Nonetheless, no significant discrepancy in response error and the number of response inhibitions was detected (P=0.50). Regarding attention, the differences in visual and auditory attention and most related elements containing vigilance and processing speed were found to be significant (P<0.05). Furthermore, the findings indicate that more athletic activities are associated with better processing speed among athletes (P=0.029).

There is a significant relationship between the amount of regular athletic activities and better EFs in male athlete adolescents. Also, a significant difference was observed between the components of EFs in male athlete and non-athlete adolescents. The difference in reaction time in response inhibition, visual and auditory and vigilance in attention was stronger than other dimensions investigated between our study groups.

Obsessive-compulsive disorder (OCD) is a disabling condition with a lifetime prevalence of approximately 2 - 3% in the general population.

This paper presents the first controlled study that examines the effects of CBT compared with MCT in the treatment of OCD.

This paper presents an experimental study carried out individually with group-level comparison. Using a parallel design, participants were randomly assigned to either CBT or MCT. The study was conducted in the psychiatric clinic of Imam Hossein Hospital in Tehran, Iran. Of the 47 participants who were assessed, 27 started treatment (CBT = 13, MCT = 14), and 24 were available for a three-month follow-up. Participants were randomly assigned to either 10 weeks of CBT or MCT. Group differences were analyzed using MANCOVA.

Clinically significant changes on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) using Jacobson methodology/Asymptomatic criteria as the index of outcome were 16.7%/0% and 66.7%/41.7% in CBT and MCT, respectively. With respect to Y-BOCS, the effect sizes of MCT (3.28) at post-test and one-month follow-up were higher than that of CBT (1.66). Although both interventions were efficacious in reducing disorder severity, improving QoL, and functioning at post-test, MCT was statistically and clinically more significant. Both interventions led to equally high reductions in depression and anxiety that were apparent in the two follow-ups. Symptom reduction on the Y-BOCS was stable or slightly improving in MCT; however, recovery rates in CBT declined.

It is possible that change in MCT occurs through more direct alteration in the brain’s executive function (EF) and modification of EF inputs, addressing a major problem of OCD. Further replication is required as MCT offers a promising alternative treatment approach.

Executive functions and attention are often impaired in neurological, medical, and psychiatric disorders. This study aimed to, in addition to collecting Iranian normative data, examine whether the demographic variables are associated with performance in one of the most widely used neuropsychological tools to measure cognitive status.

The present study as part of the Iranian Brain Imaging Database project was conducted on 300 healthy individuals in the age range of 20 to 70 years, with an equal number of participants and an equal proportion of genders in each age decade. Independent and dependent variables, respectively, were age (classified by five decades including 20-30-year-olds, 31-40-year-olds, 41-50-year-olds, 51-60-year-olds, and 61-70-year-olds) and performance in the Trail Making Test (TMT; defined in terms of two scores of the completion time of TMT-A and TMT-B).

According to correlation coefficients, age and education had a significant negative and positive correlation with both TMT-A and TMT-B (p=0.01), respectively; however, no significant correlation was observed between gender and scores (p>0.05). According to multivariate analysis of variance, the interaction of age, gender, and education did not lead to a significant difference in the TMT scores (p=0.309). In addition, Tukey's post hoc test showed that participants under 40 took significantly less time to complete TMT-A than those over 50, while in TMT-B, participants under 30 years completed in a shorter time than those over 30 years old (p<0.01).

Our findings indicate that age and education have a significant association with the performance of the Iranian healthy population in the well-known measure of executive function and attention, and it is necessary to interpret TMT scores using regional normative data in clinical and research settings.

Emerging evidence suggests that lipoproteins levels are associated with cognitive health. This study examines the relationship between lipoprotein levels and cognitive performance in middle-aged and young adults. It addresses the impact of abnormal lipid levels and hypercholesterolemia on cognitive impairment.

We performed a cross-sectional study involving 123 healthy security guards aging 20- 60 years old. Lipid profiles included total cholesterol (TC), low-density lipoprotein, high-density lipoprotein (HDL) and triglyceride (TG) levels were measured in serum. EEG recording was used to obtain the cognitive indicators of attention, memory, salience, language, mood and executive function. Spearman correlation analysis was used to determine the correlation between lipoproteins and cognitive indices.

A significant relationship with executive function was found for TC (r = -0.2944, p = 0.0202) and LDL (r = -0.3687, p = 0.0032). Additionally, a significant relationship was found between attention and serum HDL levels (r = -0.1987, p = 0.0296). In middle-aged security guards, there was a significant correlation between attention and TC (r = -0.4338, p = 0.0187) and LDL (r = -0.3909, p = 0.0360). Also, there was a significant correlation between executive function and TC (r = -0.5475, p = 0.0368) as well as LDL (r = -0.6709, p = 0.0077).

Our findings suggest that executive function and attention are key cognitive indices significantly linked to lipoproteins. In the middle-age group, higher TC and LDL levels correlated with lower cognitive scores compared to the general population, indicating a potential role of lipoprotein factors in cognition.