Messerlie Amanda E, Guidotti Breting Leslie M, Calamari John E, Sweet Jerry J, Geary Elizabeth K, Axelrod Jenna, Neale Alec C, Waszczuk Monika A
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Department of Psychiatry and Behavioral Sciences, NorthShore University Health System, Evanston, IL, USA.
Arch Clin Neuropsychol. 2025 Jan 21;40(1):94-101. doi: 10.1093/arclin/acae069.
Attentional Control Theory (ACT) posits that anxiety impacts cognitive functioning through interference in working memory and processing efficiency, resulting in performance deficits in set-shifting and inhibition. Few studies have examined the effects of anxiety on set-shifting and inhibition in clinical samples or how these relationships might be affected by age. The current study tested whether increased age, elevated anxiety, and their interaction were associated with reduced performance on measures of set-shifting and inhibition.
Symptom and neuropsychological testing data were obtained from outpatient participants presenting at an academic medical center (N = 521; mean age = 50.39 years, SD = 22.35, range = 18-90; 47.4% female; 78.3% White). The Trail Making Test Difference score was used to assess set-shifting and the Stroop Color-Word Test Interference score was used to assess inhibition.
After controlling for demographic variables, ADHD diagnosis, depression symptoms, and Mild Cognitive Impairment (MCI), both age and anxiety were significant predictors of set-shifting (β = 0.45 and β = 0.18, respectively, ps < 0.001) and inhibition (β = -0.37, p < 0.001 and β = -0.19, p = 0.001, respectively). No interaction was found between age and anxiety in the prediction of set-shifting or inhibition.
Congruent with ACT, anxiety was associated with worse performance on measures of set-shifting and inhibition. Older age was an independent predictor of worse set-shifting and inhibition but did not moderate the relationship between anxiety and attentional control, suggesting that anxiety adversely affected working memory and processing efficiency equivalently across the adult lifespan. The results highlight the importance of anxiety assessment in neuropsychological evaluation in patients of all ages.
注意控制理论（ACT）认为，焦虑通过干扰工作记忆和处理效率来影响认知功能，从而导致在任务转换和抑制方面的表现缺陷。很少有研究考察焦虑对临床样本中任务转换和抑制的影响，或者这些关系如何受到年龄的影响。本研究测试了年龄增长、焦虑加剧及其相互作用是否与任务转换和抑制测量指标上的表现降低有关。
从一家学术医疗中心的门诊参与者那里获取症状和神经心理学测试数据（N = 521；平均年龄 = 50.39岁，标准差 = 22.35，范围 = 18 - 90岁；47.4%为女性；78.3%为白人）。使用连线测验差异分数来评估任务转换，使用斯特鲁普色词测验干扰分数来评估抑制。
在控制了人口统计学变量、注意力缺陷多动障碍诊断、抑郁症状和轻度认知障碍（MCI）后，年龄和焦虑都是任务转换（β分别为0.45和0.18，p值均 < 0.001）和抑制（β分别为 -0.37，p < 0.001和 -0.19，p = 0.001）的显著预测因素。在预测任务转换或抑制时，未发现年龄与焦虑之间存在相互作用。
与ACT一致，焦虑与任务转换和抑制测量指标上的较差表现相关。年龄较大是任务转换和抑制较差的独立预测因素，但并未调节焦虑与注意力控制之间的关系，这表明在整个成年期，焦虑对工作记忆和处理效率产生了同等程度的不利影响。结果强调了在各年龄段患者的神经心理学评估中进行焦虑评估的重要性。
