Untangling relationships between cognitive development and child and adolescent mental health: Findings from the ABCD Study

Adolescence marks a period of profound neurocognitive maturation, during which cognitive, neural, and biological systems dynamically interact with emerging mental health symptoms. The Adolescent Brain Cognitive Development (ABCD) Study provides a unique opportunity to examine these relationships across late childhood and adolescence using large-scale, longitudinal, multimodal data. This review synthesizes research using the ABCD dataset to investigate links between cognitive processes and mental health across five longitudinal assessment waves (ages 9-14), covering externalizing and internalizing symptoms, depression, anxiety, ADHD, psychotic-like experiences, obsessive-compulsive symptoms, suicidality, substance use, and autism spectrum disorder. We summarize evidence linking core cognitive domains-including executive function, working memory, attention, and processing speed-to mental health symptoms, and highlight studies integrating neuroimaging and genetic data to elucidate underlying mechanisms. Findings revealed common and distinct cognitive impairment patterns across conditions: executive function and working memory impairments were consistently associated with externalizing symptoms, ADHD, and disruptive behavior disorders, while internalizing relationships were more heterogeneous. Psychotic-like experiences had consistent and persistent cognitive associations, with stronger longitudinal coupling between cognitive trajectories and symptom progression, compared to other symptom domains. Data-driven approaches were commonly used, and neuroimaging and genetic findings identified converging mechanisms within some disorders. Effect sizes were predominantly small, as expected in a large community sample, yet consistent replication across analytic approaches suggests these estimates reflect population-level relationships. Collectively, findings from the ABCD Study position cognition as a key component within multimodal developmental models of psychiatric risk, with implications for identifying early cognitive markers that may inform targeted intervention.