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.