Phonemic verbal fluency and severity of anxiety disorders in young children

Abstract

Introduction: Previous studies have implicated impaired verbal fluency as being associated with anxiety disorders in adolescents. Objectives: To replicate and extend previously reported evidence by investigating whether performance in phonemic verbal fluency tasks is related to severity of anxiety symptoms in young children with anxiety disorders. We also aim to investigate whether putative associations are independent from co-occurring attention deficit hyperactivity disorder (ADHD) symptoms. Methods: Sixty children (6-12 years old) with primary diagnoses of anxiety disorders participated in this study. Severity of symptoms was measured using clinician-based, parent-rated and self-rated validated scales. Verbal fluency was assessed using a simple task that measures the number of words evoked in 1-minute with the letter F, from which we quantified the number of isolated words, number of clusters (groups of similar words) and number of switches (transitions between clusters and/or between isolated words). Results: There was a significant association between the number of clusters and anxiety scores. Further analysis revealed associations were independent from co-occurring ADHD symptoms. Conclusion: We replicate and extend previous findings showing that verbal fluency is consistently associated with severity in anxiety disorders in children. Further studies should explore the potential effect of cognitive training on symptoms of anxiety disorders.

Memory and language impairments are associated with anxiety disorder severity in childhood

“…5 Attention orienting towards threats has been one of the most replicable results for anxiety disorders. In addition to the role of symptoms in attention orienting, positive results have also been found for deficits in some executive function components, such as phonemic verbal fluency, 6,7 executive attention, 8 and working memory. [9][10][11] Comprehensive investigations of distinct aspects of memory (i.e., semantic and episodic verbal memory) and language (i.e., oral and written) are scarce, with some exceptions.…”

“…showing that verbal fluency is consistently associated with severity of anxiety disorders, regardless of the presence of attention-deficit/hyperactivity disorder (ADHD) symptoms. 7 Poor working memory performance is one of the neuropsychological functions most frequently associated with pediatric anxiety disorders. 9,10 Working memory is usually described as a framework for a series of interactive processes that comprise temporary storage and the manipulation of information.…”

“…19 It was also found that anxious children did not differ from normal controls with regard to performance in attentional and verbal memory functions. 14,20 Moreover, Hadwin et al 14 Considering these findings, there is some evidence that anxiety in children is associated with deficits in verbal fluency, 7 shifting and attention, 11,21 but data are inconsistent regarding working memory and its subcomponents. 14,18 26 We adapted some of the questions to reflect changes made in the DSM-5.…”

Verbal Fluency Development Across Childhood: Normative Data from Brazilian–Portuguese Speakers and Underlying Cognitive Processes

“…Usually, the score on VF tasks is the number of correct words produced. In LVF tasks, all words must begin with a certain letter, such as "M" (Charchat-Fichman, Oliveira, & Silva, 2011;Salles et al, 2011); or with one letter from a set, for instance, "F," "A," and "S" (Fonseca, Salles, & Parente, 2009;Toazza et al, 2016). In SVF tasks, the produced words must belong to a specific category, such as fruits, clothes, or animals, the latter being the category most frequently used (Chami et al, 2017;Tallberg et al, 2011).…”

“…In SVF tasks, the produced words must belong to a specific category, such as fruits, clothes, or animals, the latter being the category most frequently used (Chami et al, 2017;Tallberg et al, 2011). Deficits in VF performance in children have been observed to be negatively associated to academic achievement and learning of everyday activities (Tallberg et al, 2011) and to be clinically informative for developmental disorders and neuropsychiatric disorders such as Down syndrome (Nash & Snowling, 2008), oral language disorders (Henry, Messer, & Nash, 2012), and anxiety disorders (Toazza et al, 2016).…”