The Role of Inhibitory Control in the Hospitalization of Children with Severe Psychiatric Disorders

Abstract

Objective: Inhibitory control is a heterogeneous domain involving multiple inhibitory processes at levels of behavior, attention/cognition, and emotion/motivation. Prior studies have identified an underlying role of inhibitory control in the manifestation of childhood-onset psychiatric symptoms. This study investigated the inhibitory control abilities of children within a severe, childhood psychiatric sample. Method: A medical chart review was conducted for 100 children who received a neuropsychological evaluation during a children’s psychiatric inpatient program hospitalization from 2010 to 2014. Three measures neurocognitive of inhibitory control, Stroop Color–Word Score, CPT-II Commission Errors, and WCST Failure to Maintain Set were used in the present study. The presence of externalizing behaviors at hospital admission was classified as poor behavioral/self-control. Results: Forty-eight percent of the sample displayed evidence of inhibitory control impairment on neurocognitive measures, with 40% displaying response inhibition impairment and only 5–7% displaying interference control impairment. Similarly elevated rates of impairment were found in those children without attention deficit hyperactivity disorder (ADHD). Depressive disorders were associated with interference control, while ADHD was associated with interference control and response inhibition. Receiver Operating Characteristic analysis found that response inhibition predicted a prolonged hospitalization in an older males subgroup but not in the younger males or females subgroups. Conclusions: Current findings suggest that inhibitory control impairments are highly prevalent in the children’s psychiatric inpatient setting and associated with specific psychiatric disorders, although the influence of these impairments on subsequent outcome may be limited to a select portion of children. These findings highlight the importance of neuropsychological evaluation and management in childhood psychiatric disorders.

Keywords:

• Neuropsychology
• Pediatric
• Psychiatry
• Inhibitory control
• Inpatient.

View correction statement:

The role of inhibitory control in the hospitalization of children with severe psychiatric disorders

Disclosure statement

None of the authors has any conflict of interest to disclose.