Sex Differences in Anxiety: An Investigation of the Moderating Role of Sex in Performance Monitoring and Attentional Bias to Threat in High Trait Anxious Individuals

Abstract

Anxiety disorders are more predominant in women than men, however there is a lack of understanding as to what neurocognitive mechanisms drive this sex difference. Recent investigation has found a potential moderating role of sex in the relationship between anxiety and the error related negativity (ERN)—a component of error-monitoring that is prevalent in high anxiety individuals—such that females display a positive relationship between anxiety/worry and ERN amplitude. We strove to further explore the influence of sex on the relationship between trait anxiety and performance monitoring, specifically with ERN, as well as extend this work to include another hallmark of anxiety, attentional bias to threat. To meet this end, participants performed the flanker and dot-probe tasks, respectively. We did not find a significant difference in the relationship between attention bias scores and anxiety for female vs. males participants. Furthermore, ΔERN amplitudes were greater in males compared to females, and males had more positive CRN amplitudes than females. There were no significant associations between ERN or ΔERN with anxiety in both male and female participants. However, there was a significant relationship between CRN amplitudes and trait anxiety in male but not female participants. Given these results, the effect of sex on the relationship between components of performance monitoring—namely the CRN and ERN—and anxiety may be more nuanced than the current understanding. Our study was limited to detecting medium to large sized moderation effects. Our findings may be important for future meta-analysis on sex differences in anxiety.

The questionable validity of attention bias variability: Evidence from two conceptually unrelated cognitive tasks

“…These specific accuracy requirements were maintained in the flanker task due to the collection of EEG data to measure the error-related negativity (ERN) as part of the larger study. While the EEG/ERN data is not relevant for the scope of this manuscript, additional details regarding this component can be found in previous publications ( Carlson et al, 2021 ; Gilbertson et al, 2021 ; Strand et al, 2021 ).…”

Effects of perceived social isolation, fear of social isolation, and gratitude during COVID-19 pandemic on anxiety in Malaysia

“…We acknowledge that our sampling is not a gender-balanced sample and that our results might skew to one gender, “female.” Past studies showed a gender difference in gratitude (Yue et al, 2017) and anxiety (Strand et al, 2021) in which females reported higher gratitude and anxiety compared to males. Other than gender balance, future studies should include a more inclusive and diverse sampling for example, inclusion of sexual minorities as evidence has shown differential access to healthcare between heterosexual individuals and sexual minorities, especially during the pandemic, for example myths relating to homosexual individuals as the source of COVID-19 or fear of discrimination among the lesbian, gay, transgender, and queer communities as potential barriers for early diagnosis and prompt treatment for COVID-19 (Chatterjee et al, 2020).…”

Rumination Moderates the Association between Neuroticism, Anxiety and Depressive Symptoms in Indian Women

“…17 Additionally, neuroticism has also been associated with rumination, 18 which further magnifies the negative effects of neuroticism on mental health issues. 19,20 Similar to the differences across the two sexes in the case of depressive symptoms, research has shown that women score higher on neuroticism, 21 anxiety, 22 and rumination. 23 Furthermore, the previous findings show that the effect of dispositional traits on depressive symptoms increases if other conditions, such as anxiety and rumination, are also present.…”