Cited by 169Autism Spectrum Disorder ResearchAttention Deficit Hyperactivity DisorderDevelopmental and Educational Neuropsychology

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Everyday executive function impairments predict comorbid psychopathology in autism spectrum and attention deficit hyperactivity disorders

Lawson, Rachel A., Papadakis, Alison A., Higginson, Christopher I., Barnett, Jeffrey E., Wills, Meagan C., Strang, John F., Wallace, Gregory L., Kenworthy, Lauren·2015·Neuropsychology

DOI 10.1037/neu0000145

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Abstract

OBJECTIVE: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) both have psychiatric comorbidities and distinctive profiles of executive dysfunction. Although there is evidence that executive function (EF) plays a role in the expression of specific behaviors and psychiatric symptoms, it is not known whether specific EF deficits in ASD and ADHD may be pathways to comorbidities in the disorders. This study examines whether parent reported problems with flexibility in ASD and inhibition in ADHD mediate the disorders' associations with anxiety/depression and oppositional/aggressive behavior, respectively. METHOD: Parent report data from the Behavior Rating Inventory of Executive Function (BRIEF) and the Child Behavior Checklist (CBCL) were obtained for 125 children (70 ASD, 55 ADHD Hyperactive/Impulsive or Combined type) as part of a neuropsychological assessment. Diagnostic status, BRIEF Shift (shifting/flexibility) and Inhibit (behavioral inhibition) scale scores, and CBCL Anxious/Depressed (anxiety/depression) and Aggressive Behavior (oppositionality/aggression) scale scores were analyzed with a path analysis to investigate the relation of flexibility and inhibition to comorbid symptoms in children with ASD and ADHD. RESULTS: In a path model with good fit ASD predicted greater inflexibility which predicted greater anxiety/depression, while ADHD predicted greater disinhibition that predicted greater aggression, consistent with our mediational hypotheses. Unexpectedly, the greater inflexibility associated with ASD also predicted greater aggression. CONCLUSIONS: Findings support the importance of everyday EF problems in ASD and ADHD as predictors of comorbid psychopathology and as crucial intervention targets for potential prevention and mitigation of comorbid symptoms.

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Russell, L. A., Williams, S., Shaw, K. A., DiRienzo, M., Pas, E. T., Bakian, A. V., Howerton, E. M., Bilder, D. A., Esler, A., Hallas, L., et al. (2026) · Pediatrics Open Science · doi:10.1542/pedsos.2026-001469
The Unique Roles of Executive Function in Co‐Occurring Psychopathologies in Autism
Ng, S., Leung, J., Lee, K., Lam, A. M. W., Wong, I. H. W., Ng, S., Gabrysiak, M., Lau, P., Chan, S. S. M., Moore, T. M., et al. (2026) · Autism Research · doi:10.1002/aur.70296 · Cited by 2
“Prior studies have linked EF impairments to ADHD, anxiety, and depressive symptoms (Lawson et al. 2015), and generalized psychopathology (Wong et al. 2023) in ASD.”
Executive Functioning Is Linked to Internalizing Symptoms in Autistic Adults With Higher Support Needs
Greenstein, E., Lee, N., McQuaid, G. A., & Wallace, G. L. (2026) · Autism · doi:10.1177/13623613261466302
“…mental health challenges, including internalizing symptoms (e.g., anxiety and depression), in autistic youth without ID (Berkovits et al., 2017; Lawson et al., 2015; Lei et al., 2022; Mahmud et al., 2025; Rieffe et al., 2014; Vogan et al., 2018) as well as in mixed-IQ samples that include…”
Self-citation
Relative Impact of Family Processes and Child and Systemic Factors on Behavioral and Academic Outcomes for Autistic Children in Mainstream Education
Fitzgerald, B., McCusker, C. G., Dempsey, M., & Galvin, A. D. (2026) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-026-07362-9
“…examined mainly include age, gender, autistic traits, and other common developmental and medi - cal problems including but not limited to executive func - tioning (Lawson et al., 2015), low intellectual functioning (Witwer & Lecavalier, 2010), and sleep problems (Mazurek & Sohl, 2016).”
Neurocognitive endophenotypes in neurodevelopmental disorders: social cognition and executive functions in children with Autism Spectrum Disorder Level 1 and Attention-Deficit/Hyperactivity Disorder
Pastorino, G. M. G., Olivieri, M., Aquino, A., Mungo, N., Suriano, R., & Operto, F. F. (2026) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2026.1920753
“Conversely, ecological questionnaires consistently reveal more severe everyday executive difficulties in ADHD, particularly in inhibition and organization (30 – 32).”

Authors: Lawson, R. A., Papadakis, A. A., Higginson, C. I., Barnett, J. E., Wills, M. C., Strang, J. F., Wallace, G. L., & Kenworthy, L.
Affiliations: Loyola University Maryland (US)
Children's National (US)
George Washington University (US)
ORCID: Higginson, Christopher I.
Barnett, Jeffrey E.
Strang, John F.
Wallace, Gregory L.
Kenworthy, Lauren
Venue: Neuropsychology
Publisher: American Psychological Association (APA)
Published: 2015-05
Volume: 29
Issue: 3
Pages: 445-453
ISSN: 0894-4105 (ISSN-L)
1931-1559
DOI: 10.1037/neu0000145
OpenAlex: W2084269933
Cited by: 169
References: 68
Citations by year: 2026: 13 · 2025: 13 · 2024: 16 · 2023: 20 · 2022: 19 · 2021: 14 · 2020: 18 · 2019: 16 · 2018: 8 · 2017: 13 · 2016: 10 · 2015: 6
FWCI: 5.39
Type: journal article
Language: en
Open access: closed
Locations: Neuropsychology (publishedVersion)
PubMed (publishedVersion)
Funders: Isadore and Bertha Gudelsky Foundation
Frederick and Elizabeth Singer Foundation
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords: executive function, autism spectrum disorder, attention deficit hyperactivity disorder, psychiatric comorbidity, flexibility, behavioral inhibition, inflexibility, disinhibition, anxiety and depression, mediation, children
MeSH terms: Autism Spectrum Disorder, Adolescent, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Depression, Female, Humans, Inhibition, Psychological, Male, Models, Psychological, Neuropsychological Tests, Executive Function

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Everyday executive function impairments predict comorbid psychopathology in autism spectrum and attention deficit hyperactivity disorders

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