Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
Psychol Med. 2021 Jul;51(10):1676-1686. doi: 10.1017/S0033291720000422. Epub 2020 Mar 19.
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.
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).
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).
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.
情感神经科学和疤痕理论提出，过度担忧的增加，广泛性焦虑障碍（GAD）的标志性症状，预测未来执行功能（EF）的下降。然而，用于检查个体间慢性担忧-EF 关系的横断面设计占主导地位，阻碍了理解它们潜在因果关系的进展。因此，本研究使用双变量双潜在变化分数（LCS）模型来检验个体内 GAD 严重程度的增加是否与未来 EF 的降低有关。
社区居住的成年人（N=2581 人，平均年龄 46 岁，标准差=11.40，54.71%为女性）在三个时间点（相隔约 9 年）接受 GAD 症状严重程度（复合国际诊断访谈-简短形式）评估。EF 的三个方面[抑制、定势转移和混合成本（MC；与一般 EF 相关的衡量标准）]通过停止和启动切换任务进行评估。参与者对 20 个正常和 20 个反向单一任务块试验和 32 个混合任务切换块试验做出反应。EF 测试在时间 2（T2）和时间 3（T3）进行，但不在时间 1（T1）进行。
在控制了 T1 抑郁之后，LCS 模型显示，个体内 T1-T2 GAD 严重程度的增加显著预测了未来 T2-T3 抑制和定势转移（均由准确性和潜伏期表示）以及 MC（由潜伏期表示）的降低，具有中等至较大的效应量（|d|=0.51-0.96）。
结果在很大程度上支持了疤痕理论，提供了初步的个体自然主义证据，表明过度担忧的增加可以负面预测未来认知灵活性的不同方面。有效地针对病理性担忧可能会防止执行功能障碍引起的困难。
