Within-person increase in pathological worry predicts future depletion of unique executive functioning domains

Abstract

Background Affective neuroscience and scar theories propose that increased excessive worry, the hallmark symptom of generalized anxiety disorder (GAD), predicts future declines in executive functioning (EF). However, the preponderance of cross-sectional designs used to examine between-person chronic worry–EF relationships has blocked progress on understanding their potentially causal within-person associations. Accordingly, this study used bivariate dual latent change score (LCS) models to test whether within-person increased GAD severity might relate to future reduced EF. Methods Community-dwelling adults (N = 2581, 46 years on average, s.d. = 11.40, 54.71% female) were assessed for GAD symptom severity (Composite International Diagnostic Interview-Short Form) across three waves, spaced about 9 years apart. Three aspects of EF [inhibition, set-shifting, and mixing costs (MCs; a measure related to common EF)], were assessed with stop-and-go switch tasks. Participants responded to 20 normal and 20 reverse single-task block trials and 32 mixed-task switch block trials. EF tests were administered at time 2 (T2) and time 3 (T3), but not at time 1 (T1). Results After controlling for T1 depression, LCS models revealed that within-person increased T1 − T2 GAD severity substantially predicted future reduced T2 − T3 inhibition and set-shifting (both indexed by accuracy and latency), and MC (indexed by latency) with moderate-to-large effect sizes (|d| = 0.51–0.96). Conclusions Results largely support scar theories by offering preliminary within-person, naturalistic evidence that heightened excessive worry can negatively predict future distinct aspects of cognitive flexibility. Effectively targeting pathological worry might prevent difficulties arising from executive dysfunction.

Depression and executive functioning bidirectionally impair one another across 9 years: Evidence from within-person latent change and cross-lagged models

“…Relatedly, the cross-sectional, between-person negative associations between anxiety or depression and EF in this study may be accounted for by the attentional control theory (121) and attentional scope model of rumination (122). Note that these theories are inappropriate for explaining the within-person, cross-lagged, and long-term change-to-future change relations between EF and depression severity found herein as they argue that symptom-EF perturbation relations occur across brief durations or at one time-point (61,123). Further, these models assert that elevated symptoms could deplete finite EF resources for task-pertinent processing and increased anxiety and depression would be reliably linked to greater cognitive rigidity (i.e., difficulty disengaging from threats or distractions) at a single time-point.…”

Larger increase in trait negative affect is associated with greater future cognitive decline and vice versa across 23 years

“…Extending that finding, Australian residential care older adults’ 2‐year increase in depressive symptoms was related to subsequent 2‐ to 4‐year decreased perceptual speed across 15 years (Bielak, Gerstorf, Kiely, Anstey, & Luszcz, 2011). Similarly, within‐person 9‐year rise in pathological worry was related to future 9‐year reduced global and specific executive functioning (Zainal & Newman, in press). Our 23‐year study extends these investigations by testing reciprocal relations between 3‐ and 14‐year change in unique cognitive constructs (processing speed, verbal WM, and spatial cognition) and future 3‐ to 14‐year change in trait NA.…”

Heightened Depression and Executive Functioning Bidirectionally Impair One Another: Evidence from Within-Person Latent Change and Cross-Lagged Models

“…Unmeasured third variables (e.g., genetics; 127) may have contributed to observed outcomes. Additionally, although other studies have observed within-or between-person relations between depression and EF domains of shifting and inhibition(61), consistent with theory and neuroanatomical evidence(128), these EF facets were not measured herein. Also, as no psychiatric diagnostic measures were included, future studies that include diagnostic instruments could determine if the results would be similar.…”

“…The latter possibility can only be captured by using within-person methods that also capture change. Moreover, the foregoing scar and vulnerability theories posit that EF-symptom relations unfold within persons across long durations (46)(47)(48)(49)(50)(51). Awareness of within-person prolonged trajectories of increased depression or anxiety, EF decrements, and their covariation may guide the design of personalized MENTAL HEALTH AND EXECUTIVE FUNCTIONING 6 prevention, diagnostic, and treatment efforts that rely on idiographic (or within-person) more than between-person data, as part of precision psychiatry (52)(53)(54).…”

“…Using BLCS, increase in anxiety was related to cognitive functioning decline in older adults (57); despite that, the two-wave study prevented understanding of how symptom change predicted MENTAL HEALTH AND EXECUTIVE FUNCTIONING 7 subsequent EF change (and conversely). Relatedly, BLCS models across three waves showed that 9-year growth in excessive worry dovetailed with future 9-year decline in global and unique EF facets (61); however, whether change in EF forecasted later change in worry was not examined. Another five time-point study demonstrated that rise in trait neuroticism at one timelag preceded and linked to reductions in spatial processing, WM, and processing speed at the next time-lag (57); nonetheless, one-item assessments of cognitive functioning were used in the study.…”