Depression, Executive Dysfunction, and Prior Economic and Social Vulnerability Associations in Incarcerated African American Men

Low executive function (EF) and depression are each determinants of health. This study examined the synergy between deficits in EF (impaired cognitive flexibility; >75th percentile on the Wisconsin Card Sorting Test perseverative error score) and depressive symptoms (modified Centers for Epidemiologic Studies–Depression) and preincarceration well-being among incarcerated African American men (N = 189). In adjusted analyses, having impaired EF and depression was strongly associated with pre-incarceration food insecurity (odds ratio [OR] = 3.81, 95% confidence interval [CI] = [1.35, 10.77]), homelessness (OR = 3.00, 95% CI [1.02, 8.80]), concern about bills (OR = 3.76, 95% CI [1.42, 9.95]), low significant other support (OR = 4.63, 95% CI [1.62, 13.24]), low friend support (OR = 3.47, 95% CI [1.30, 9.26]), relationship difficulties (OR = 2.86, 95% CI [1.05, 7.80]), and binge drinking (OR = 3.62, 95% CI [1.22, 10.80]). Prison-based programs to treat depression and improve problem-solving may improve postrelease success.