Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States.
Psychol Med. 2023 Jul;53(9):4160-4171. doi: 10.1017/S0033291722000848. Epub 2022 May 10.
Scar theory proposes that heightened depression and anxiety precede and predict worse cognitive functioning outcomes, whereas the vulnerability theory posits the opposite pathway. However, most investigations on this topic have been cross-sectional, precluding causal inferences. Thus, we used cross-lagged prospective network analyses to facilitate causal inferences in understanding the relations between psychopathology and cognitive functioning components.
Racially-diverse midlife women ( = 1816) participated in the Study of Women's Health Across the Nation at two time-points, spanning one year apart. Five psychopathology (anxiety severity, depressed mood, somatic symptoms, positive affect, interpersonal problems) and four cognitive functioning nodes (working memory (WM), processing speed (PS), facial recognition (FCR), and verbal memory (VRM)) were assessed. All analyses adjusted for age, menopausal status, estradiol, and follicle-stimulating hormones.
Contemporaneous networks yielded notable inverse between-node relations () between interpersonal problems and reduced FCR and PS, and between depressed mood and lower FCR, VRM, or PS. Nodes that had the highest likelihood to bridge other constructs were positive affect, anxiety severity, WM, and VRM. Temporal networks produced edges consistent with the scar (. vulnerability) hypotheses. Higher somatic symptoms were related to reduced PS and WM, and greater depressed mood was correlated with lower future PS and WM. Also, higher anxiety severity coincided with decreased future PS and WM. Greater positive affect was associated with stronger future PS, FCR, and WM. Also, positive affect had the strongest relations with other nodes.
Findings suggest the importance of targeting symptoms and cognitive functioning simultaneously.
瘢痕理论提出，抑郁和焦虑程度的升高先于并预测认知功能结果更差，而脆弱性理论则提出相反的途径。然而，关于这个主题的大多数调查都是横断面的，排除了因果推断。因此，我们使用交叉滞后前瞻性网络分析来促进因果推断，以理解心理病理学和认知功能成分之间的关系。
种族多样化的中年女性（n = 1816）在国家妇女健康研究中参加了两次，两次相隔一年。评估了五种心理病理学（焦虑严重程度、抑郁情绪、躯体症状、积极情绪、人际关系问题）和四种认知功能节点（工作记忆（WM）、处理速度（PS）、面部识别（FCR）和言语记忆（VRM））。所有分析均调整了年龄、绝经状态、雌二醇和卵泡刺激激素。
同期网络产生了显著的节点间负相关（），人际问题与 FCR 和 PS 降低以及抑郁情绪与 FCR、VRM 或 PS 降低有关。最有可能桥接其他结构的节点是积极情绪、焦虑严重程度、WM 和 VRM。时间网络产生的边缘与瘢痕（脆弱性）假设一致。更高的躯体症状与 PS 和 WM 降低有关，而更高的抑郁情绪与未来 PS 和 WM 降低有关。此外，更高的焦虑严重程度与未来 PS 和 WM 的降低同时发生。更多的积极情绪与更强的未来 PS、FCR 和 WM 相关。此外，积极情绪与其他节点的关系最强。
研究结果表明，同时针对症状和认知功能非常重要。
