Attention, memory, visuoconstructive, and executive task performance in adolescents with anxiety disorders: a case-control community study

Abstract

Objective: The aim of the present study was to assess children and adolescents with mild and severe anxiety disorders for their performance in attention, verbal episodic memory, working memory, visuoconstructive skills, executive functions, and cognitive global functioning and conduct comparative analyses with the performance of children free from anxiety disorders. Methods: Our sample comprised 68 children and adolescents aged 10 to 17 years (41 with current diagnoses of anxiety disorders and 27 controls) selected from a larger cross-sectional community sample of adolescents. Children and adolescents with anxiety disorders were categorized into two groups on the basis of anxiety severity (mild or severe). All participants underwent a neuropsychological assessment battery to evaluate attention, verbal episodic memory, working memory, visuoconstructive skills, and executive and cognitive functions. Results: No differences were found in any neuropsychological tests, with the single exception that the group with mild anxiety had better performance on the Digit Span backward test compared to subjects with severe anxiety and to controls (p = 0.041; η2 = 0.11). Conclusions: Not only might anxiety disorders spare main cognitive functions during adolescence, they may even enhance certain working memory processes. Keywords: Neuropsychological assessment, anxiety disorders, cognitive functions, adolescents. ResumoObjetivo: Este estudo objetivou avaliar crianças e adolescentes com transtornos de ansiedade leve e moderada nas funções neuropsicológicas de atenção, memória episódica verbal, memória de trabalho, habilidades visuoconstrutivas, funções executivas e cognição global, comparando o seu desempenho ao de crianças com desenvolvimento típico. Métodos: Participaram do estudo 68 crianças e adolescentes com idade de 10 a 17 anos (41 com diagnósticos clínicos atuais de transtornos de ansiedade e 27 controles), selecionados de uma amostra transversal mais ampla de adolescentes da comunidade. Os adolescentes com diagnóstico foram divididos ainda em dois grupos com base na gravidade dos transtornos (leve ou moderado). Todos os participantes realizaram uma avaliação neuropsicológica individual das funções de atenção, memória episódica verbal, memória de trabalho, habilidades visuoconstrutivas, funções executivas e cognição global. Resultados: Nenhum dos testes neuropsicológicas demonstrou diferenças significativas, sendo a única exceção a tarefa de span de dígitos ordem inversa, na qual o grupo com ansiedade leve apresentou desempenho superior ao do grupo com ansiedade moderada e também ao dos controles (p = 0.041; η 2 = 0.11). Conclusão: Os resultados sugerem que não só os transtornos de ansiedade podem preservar as principais funções cognitivas durante a adolescência, mas que podem até melhorar certos processos de memória de trabalho.

Memory and language impairments are associated with anxiety disorder severity in childhood

“…In a study evaluating attention, verbal episodic memory, working memory, visuoconstructive skills, and executive functions, no differences were found in patients with anxiety disorders as compared to a non-anxious control group, except for the digit span backward task. 12 Furthermore, the group with mild anxiety disorder presented higher performance than the control group in this task. 12 Another study, using the same community sample, showed that youths with anxiety had higher deficits in verbal fluency when compared with the non-anxious group.…”

“…[9][10][11] Comprehensive investigations of distinct aspects of memory (i.e., semantic and episodic verbal memory) and language (i.e., oral and written) are scarce, with some exceptions. 12,13 It is also known that most researches did not evaluate the role of severity when investigating neuropsychological impairments in children with anxiety disorders. Some studies have shown, for example, that severity is very important when investigating the role of threat bias in anxiety disorders, as well as when investigating deficits in distinct aspects of memory.…”

Effects of working memory training on emotion regulation: Transdiagnostic review

“…Self‐reported and experimentally induced anxiety are associated with poorer working memory performance (Moran, ). Mild anxiety in adolescents appears to be related to better working memory performance, compared to those with severe anxiety and healthy adolescents (Jarros et al, ). On the other hand, poorer working memory performance is related to higher anxiety levels in those with clinical anxiety disorders (Waechter et al, ).…”

Cognitive performance of youth with primary generalized anxiety disorder versus primary obsessive-compulsive disorder

“…In contrast, Jarros et al. () found no differences in attention, verbal episodic memory, working memory, or executive functioning when comparing youth with a mild or severe anxiety disorder (i.e., GAD, social, separation, and panic) to a comparison group of youth with no anxiety disorder (although some were diagnosed with other psychiatric conditions like ADHD, specific phobia, and oppositional defiant disorder), all treatment‐naïve and community‐recruited. Again, no known studies exist comparing children with primary GAD to those with another primary anxiety disorder, such as OCD.…”

“…We hypothesized that youth with OCD or GAD would demonstrate neurocognitive deficits across multiple domains compared to TDC. Drawing on prior work in GAD and/or OCD, we hypothesized that youth with OCD would demonstrate greater deficits in executive functioning (cognitive flexibility and planning ability) and visuospatial memory compared to youth with GAD, whereas youth would demonstrate greater deficits in working memory compared to the OCD group (Andrés et al., ; Ferreri, Lapp, & Peretti, ; Jarros et al., ; Kashyap, Kumar, Kandavel, & Reddy, ; Shin & Liberzon, ; Toren et al., ).…”