A biobehavioural and social-structural model of inflammation and executive function in pediatric chronic health conditions

ABSTRACT

Evidence indicates that pediatric chronic health conditions (CHCs) often impair executive functioning (EF) and impaired EF undermines pediatric CHC management. This bidirectional relationship likely occurs due to biobehavioural and social-structural factors that serve to maintain this feedback loop. Specifically, biobehavioural research suggests that inflammation may sustain a feedback loop that links together increased CHC severity, challenges with EF, and lower engagement in health promoting behaviours. Experiencing social and environmental inequity also maintains pressure on this feedback loop as experiencing inequities is associated with greater inflammation, increased CHC severity, as well as challenges with EF and engagement in health promoting behaviours. Amidst this growing body of research, a model of biobehavioural and social-structural factors that centres inflammation and EF is warranted to better identify individual and structural targets to ameliorate the effects of CHCs on children, families, and society at large. This paper proposes this model, reviews relevant literature, and delineates actionable research and clinical implications.

KEYWORDS:

• Executive function
• systemic inequity
• chronic health conditions
• inflammation
• pediatric psychology
• health behaviour

Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the University of Alabama at Birmingham Nutrition Obesity Research Centre and National Institute of Diabetes and Digestive and Kidney Diseases [grant numbers P30DK056336, T32DK062710] and the National Institute of General Medical Sciences [grant number P20GM103644].