University of Pittsburgh; Institute of Living, Hartford Hospital.
Institute of Living, Hartford Hospital; Yale University School of Medicine.
Behav Ther. 2019 Nov;50(6):1150-1163. doi: 10.1016/j.beth.2019.04.002. Epub 2019 Apr 23.
Clinically significant anxiety is associated with an array of attentional symptoms (e.g., difficulty concentrating; unwanted thought) that are subjectively experienced as severe. However, neuropsychological findings are mixed with respect to the presence of cognitive deficits that can account for these symptoms. Contextualizing predictions from established clinical theories (e.g., Attentional Control Theory) within contemporary, neurobiologically derived models of cognitive control (Dual Mechanisms of Control Theory), the present study investigated the relationship between "cold" proactive and reactive cognitive control, task effort, and subjective attentional symptoms (difficulty concentrating; unwanted thought) in a mixed clinical sample of individuals with generalized anxiety disorder (GAD) and/or obsessive-compulsive disorder (OCD) and a comparison sample of healthy controls. Clinical status moderated the relationship between attentional symptoms (attentional focusing and trait worry) and proactive cognitive control response time. Clinical status also moderated the relationship between trait worry and task effort. Higher trait worry was associated with slower proactive control and lower effort in healthy participants, but faster proactive control in clinical participants. Self-reported attentional focusing showed differential validity vis-à-vis proactive control response time in clinical versus healthy participants. Post-hoc conditional effects analysis suggested more accurate self-appraisals in healthy controls, but was not significant after correction for multiple comparisons. Preliminary evidence suggested that differences in task effort in anxious versus healthy adults may relate to subjective attentional symptoms in GAD and OCD.
临床上明显的焦虑与一系列注意力症状有关（例如，注意力不集中；杂念），这些症状被主观地认为是严重的。然而，神经心理学的研究结果在认知缺陷的存在上存在分歧，这些缺陷可以解释这些症状。本研究将已建立的临床理论（如注意力控制理论）的预测置于当代神经生物学衍生的认知控制模型（双机制控制理论）中，调查了广泛性焦虑障碍（GAD）和/或强迫症（OCD）的混合临床样本以及健康对照组中“冷”主动和反应性认知控制、任务努力和主观注意力症状（注意力不集中；杂念）之间的关系。临床状况调节了注意力症状（注意力集中和特质担忧）与主动认知控制反应时间之间的关系。临床状况也调节了特质担忧与任务努力之间的关系。较高的特质担忧与健康参与者的主动控制较慢和努力较低有关，但与临床参与者的主动控制较快有关。与健康参与者相比，自我报告的注意力集中在临床参与者中表现出相对于主动控制反应时间的差异有效性。事后条件效应分析表明，健康对照组的自我评估更准确，但在进行多次比较校正后并不显著。初步证据表明，焦虑症和健康成年人在任务努力方面的差异可能与 GAD 和 OCD 中的主观注意力症状有关。
