Abstract
While investigations have sought to identify the distinct and shared contributions of anxiety and depression to neurocognitive processes in late life, less is known regarding the further contribution of worry, a unique and critical dimension of affective dysregulation. Capturing the full range of symptoms, as inspired by the NIH Research Domain Criteria (RDoC), may provide finer-grained information on inter-relationships among worry, anxiety and depression on neurocognitive processing in later life. The objective of this study was to determine if the dimensional trait of worry intensifies known negative associations of dimensional measures of anxiety and depressive symptoms with neurocognitive processes, specifically cognitive control and memory processes. Using a cross-sectional and observational design, this study was conducted within a translational research center located with a Veterans medical center in Northern California. One hundred and nineteen community-residing older adults ages 65–91 years participated, and were characterized with psychiatric and neurocognitive dimensional measures. Affective symptom severity was assessed with the Penn State Worry Questionnaire, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II. Primary neurocognitive outcomes were inhibitory control assessed using a Stroop paradigm and delayed verbal memory assessed with the Rey Auditory Verbal Learning Test. Secondary outcomes included other less frequently examined cognitive control mechanisms (working memory, information processing, and verbal fluency) and memory processes (visual delayed memory). Contrary to prediction, the dimensional trait of worry attenuated negative associations between anxiety and depressive symptoms and inhibitory control on the one hand, and between depressive symptoms and delayed verbal memory processes on the other. In the secondary models, symptom dimensions were not associated with other cognitive control or visual delayed memory processes. Our fine-grained approach, in line with the NIMH RDoC model, suggests the neurocognitive processes associated with dimensional measures of late-life affective symptoms are dissociable. Specifically, dimensional measures of worry operate independently from other anxiety and depression symptoms to reveal differential patterns of neurocognitive processes associated with affective dysregulation.
Highlights
Perseverative negative thought in the form of worry represents an essential feature of affective processing (McEvoy et al, 2013)
We examined additional cognitive control abilities and visual memory recall to determine if the effects of worry are broadly associated with cognitive control and memory processes, or if associations were specific to inhibitory control and verbal memory
Worry interacted with anxiety symptoms to predict Stroop CWIT self-corrected errors, t(108) = 3.05, p = 0.003, whereby less worry and greater severity of anxiety were associated with more CWIT self-corrected errors
Summary
Perseverative negative thought in the form of worry represents an essential feature of affective processing (McEvoy et al, 2013). It lowers efficient processing of goal-directed information, which can impair inhibitory control and shifting on tasks (Derakshan and Eysenck, 2009), or what are commonly referred to as cognitive control deficits Another pathway implicated in studies of worry or rumination is impaired attentional control predisposing to perseverative negative thinking (Armstrong et al, 2011; Fox et al, 2015; Hsu et al, 2015; Macatee et al, 2016). Among middleaged and older adults, worry symptom severity, but not global anxiety, uniquely predicted abnormal neural connectivity of the salience detection network (Andreescu et al, 2015) This network of brain structures (amygdala, parts of the insula, anterior cingulate cortex, thalamus) monitors relevance and importance of stimuli (Menon and Uddin, 2010). These investigations provide a neurobiological basis for cognitive control deficits being associated with elevated worry, suggestive of worry as both a cognitive and affective symptom
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