A Cross-Lagged Prospective Network Analysis of Depression and Anxiety and Cognitive Functioning Components in Midlife Community Adult Women

Abstract

Background: The scar theory proposes that heightened depression and anxiety precede and predict worse cognitive functioning outcomes, whereas the vulnerability model posits the opposite pathway. However, most investigations on this topic have been cross-sectional, which precludes causal inferences. Thus, our study used both contemporaneous and temporal cross-lagged panel network analysis to facilitate causal inferences in understanding the relations between psychopathology components and cognitive functioning. Methods: Racially-diverse midlife women (n = 3,302) participated in the Study of Women's Health Across the Nation across two time-points, spanning one year apart. Five psychopathology (anxiety symptoms, depressed mood, somatic symptoms, positive affect, interpersonal problems) and cognitive functioning nodes (working memory (WM), processing speed (PS), visual memory (VSM), auditory memory (ARM)) were assessed. Results: Contemporaneous networks yielded notable inverse between-node relations (edges) for interpersonal problems and reduced VSM and PS, and between depressed mood or anxiety symptoms and VSM, ARM, or PS. Moreover, nodes that had the highest likelihood to bridge psychopathology and cognitive functioning constructs were positive affect, anxiety symptoms, WM, and ARM. Temporal networks produced edges inconsistent with the vulnerability theory. Higher depressed mood and somatic symptoms and lower positive affect were related to reduced future PS, WM, and/or VSM. Likewise, greater interpersonal issues and anxiety symptoms were linked to poorer future ARM and WM. Also, positive affect had the strongest effect on future nodes. Conclusions: These results provide stronger support for the scar theory than the vulnerability theory.