B – 107 Executive Function as a Predictor of Adult Psychosocial Outcomes in Congenital Heart Disease: Findings from the Boston Circulatory Arrest Study

Abstract Objective As survival rates improve for individuals with congenital heart disease, there is an increasing need to examine neurocognitive and psychosocial outcomes from a lifespan perspective. While these domains are often studied separately, other chronic illness research suggests their interaction may influence adult psychosocial functioning. This study examined longitudinal and cross-sectional associations among executive functioning (EF), social cognition (SC), and psychosocial outcomes in individuals with dextro-Transposition of the Great Arteries (d-TGA) followed by the Boston Circulatory Arrest Study (BCAS), a longitudinal investigation of neurodevelopmental and psychosocial outcomes in individuals with d-TGA. It was hypothesized that EF at age 16 would predict adult SC, which would mediate the relationship between EF and adult psychosocial outcomes. Method Data were drawn from the BCAS cohort at age 16 (n = 80) and adulthood (n = 87; M = 28.95 ${\upbeta}\square\!\!\!?$ 1.26), along with an age-matched adult control group (n = 41; M = 28.92 ${\upbeta}\square\!\!\!?$ 2.02). EF and psychosocial maturity were assessed using self-report measures; SC was measured with the Reading the Mind in the Eyes Test. Results In the d-TGA group, EF and SC remained stable from age 16 to adulthood. EF at age 16 did not predict adult SC, and SC did not mediate the relationship between EF and psychosocial outcomes. Across groups, EF was the strongest predictor of adult psychosocial outcomes, with no effect of group membership. Conclusion EF is a key predictor of adult psychosocial functioning, supporting its relevance as a target for intervention in this population.