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Transdiagnostic Disruptions of Dorsolateral Prefrontal Engagement in Cognitive Reflection

Poster Session F - Tuesday, March 10, 2026, 8:00 – 10:00 am PDT, Fairview/Kitsilano Ballroom

Teffina Zheng¹ (), Yueyue Lydia Qu¹, Jutta Joormann¹; ¹Yale University

Cognitive reflection, the ability to override intuitive but incorrect responses, relies heavily on executive control processes supported by the dorsolateral prefrontal cortex (dlPFC). The Stroop task similarly requires inhibition of prepotent, automatic responses. Although deficits in cognitive reflection have been observed across psychiatric disorders, the associated neural correlates remain unclear. This study examines whether cognitive reflection performance is associated with right dlPFC activation during the Stroop task, and whether this relationship is moderated by psychiatric diagnoses. Cognitive reflection was assessed using the Cognitive Reflection Test (CRT). Functional MRI data were obtained from 123 adults currently diagnosed with a broad range of psychiatric illnesses and 81 healthy participants from the Transdiagnostic Connectome Project. We extracted the right-dlPFC BOLD signal during the Stroop task (incongruent > congruent) using the Schaefer (17-network) parcellation between patients and healthy participants. Patients and healthy participants did not differ in right dlPFC activation during the Stroop task (t = −0.43, p = 0.67). Healthy participants performed better on the CRT (t = −2.49, p = 0.014) than patients, although there were no group differences in total response time (t = 1.85, p = 0.066). Among healthy participants, higher right dlPFC activation during the Stroop task was positively associated with CRT performance (r = 0.26, p = 0.017), whereas this association was not observed in patients (r = −0.13, p = 0.16). These findings suggest that while the right dlPFC supports cognitive reflection in the healthy population, such prefrontal engagement may be disrupted in people with psychiatric disorders.

Topic Area: EXECUTIVE PROCESSES: Monitoring & inhibitory control