Importance Many studies have demonstrated an association between early-life adversity (ELA) and executive functioning in children and adolescents. However, the aggregate magnitude of this association is unknown in the context of threat and deprivation types of adversity and various executive functioning domains. Objective To test the hypothesis that experiences of deprivation are more strongly associated with reduced executive functioning compared with experiences of threat during childhood and adolescence. Data Sources Embase, ERIC, MEDLINE, and PsycInfo databases were searched from inception to December 31, 2020. Both forward and reverse snowball citation searches were performed to identify additional articles. Study Selection Articles were selected for inclusion if they (1) had a child and/or adolescent sample, (2) included measures of ELA, (3) measured executive functioning, (4) evaluated the association between adversity and executive functioning, (5) were published in a peer-reviewed journal, and (6) were published in the English language. No temporal or geographic limits were set. A 2-reviewer, blinded screening process was conducted. Data Extraction and Synthesis PRISMA guidelines were used to guide data extraction and article diagnostics (for heterogeneity, small study bias, and p-hacking). Article quality was assessed, and data extraction was performed by multiple independent observers. A 3-level meta-analytic model with a restricted maximum likelihood method was used. Moderator analyses were conducted to explore heterogeneity. Main Outcomes and Measures Primary outcomes included measures of the 3 domains of executive functioning: cognitive flexibility, inhibitory control, and working memory. Results A total of 91 articles were included, representing 82 unique cohorts and 31 188 unique individuals. Deprivation, compared with threat, was associated with significantly lower inhibitory control (F1,90 = 5.69; P = .02) and working memory (F1,54 = 5.78; P = .02). No significant difference was observed for cognitive flexibility (F1,36 = 2.38; P = .12). The pooled effect size of the association of inhibitory control with deprivation was stronger (Hedges g = -0.43; 95% CI, -0.57 to -0.29) compared with threat (Hedges g = -0.27; 95% CI, -0.46 to -0.08). The pooled effect size of the association of working memory with deprivation was stronger (Hedges g = -0.54; 95% CI, -0.75 to -0.33) compared with threat (Hedges g = -0.28; 95% CI, -0.51 to -0.05). Conclusions and Relevance Experiences of both threat and deprivation in childhood and adolescence were associated with reduced executive functioning, but the association was stronger for exposure to deprivation. Efforts to address the consequences of ELA for development should consider the associations between specific dimensions of adversity and specific developmental outcomes.

中文翻译：

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早期生活威胁和剥夺与儿童和青春期执行功能的关联：系统回顾和荟萃分析。

重要性 许多研究表明，儿童和青少年的早年逆境 (ELA) 与执行功能之间存在关联。然而，在威胁和剥夺类型的逆境和各种执行功能领域的背景下，这种关联的总规模是未知的。目的 检验以下假设：与童年和青春期的威胁经历相比，剥夺经历与执行功能下降的相关性更强。数据源 Embase、ERIC、MEDLINE 和 PsycInfo 数据库从开始到 2020 年 12 月 31 日进行了搜索。执行正向和反向雪球引文搜索以识别其他文章。研究选择文章如果 (1) 有儿童和/或青少年样本，(2) 包括 ELA 测量，(3) 测量执行功能，(4) 评估逆境与执行功能之间的关联，(5) 发表在同行评审期刊上，以及 (6) 以英文发表。没有设置时间或地理限制。进行了 2 位评审员的盲法筛选过程。数据提取和综合 PRISMA 指南用于指导数据提取和文章诊断（针对异质性、小研究偏差和 p-hacking）。评估文章质量，并由多个独立观察员进行数据提取。使用具有受限最大似然法的 3 级元分析模型。进行调节剂分析以探索异质性。主要成果和措施 主要成果包括执行功能的 3 个领域的措施：认知灵活性、抑制控制、和工作记忆。结果 共纳入 91 篇文章，代表 82 个独特的队列和 31 188 个独特的个体。与威胁相比，剥夺与明显较低的抑制控制（F1,90 = 5.69；P = .02）和工作记忆（F1,54 = 5.78；P = .02）相关。认知灵活性没有显着差异 (F1,36 = 2.38; P = .12)。与威胁（Hedges g = -0.27；95% CI，-0.46 至 -0.08）相比，抑制控制与剥夺关联的合并效应量更强（Hedges g = -0.43；95% CI，-0.57 至 -0.29） ). 与威胁（Hedges g = -0.28；95% CI，-0.51 至 -0.05）相比，工作记忆与剥夺关联的合并效应量更强（Hedges g = -0.54；95% CI，-0.75 至 -0.33） ). 结论和相关经历 童年和青春期的威胁和剥夺都与执行功能下降有关，但这种关联在暴露于剥夺时更强。解决 ELA 对发展的影响的努力应考虑逆境的特定维度与特定发展结果之间的关联。