Characteristics associated with the discrepancy between subjective and objective executive functioning in depression

Abstract

Major depressive disorder (MDD) is associated with both self-reported (subjective) cognitive complaints and deficits in neurocognitive (objective) measures, but the correspondence between subjective and objective measures of cognition is low. This cross-sectional study aimed to (1) assess the association between subjective and objective measures of executive functions (EFs), and (2) explore factors associated with the discrepancy between subjective and objective EFs in MDD. Sixty-two participants with current or previous mild to moderate MDD and subjective EF complaints completed a clinical trial baseline assessment. An objective EF composite score was drawn from six neurocognitive measures, while the Behavior Rating Inventory of Executive Function-Adult version was applied as a measure of subjective EF. The association between the subjective and objective composites was evaluated using Spearman's rank order correlation. A discrepancy score was calculated to quantify the difference between subjective and objective EF. Factors associated with the discrepancy score were analyzed using regression analysis (p < .05). Participants reported extensive EF difficulties, but most performed in the normal range on objective EF measures. A weak correlation was detected between the subjective and objective measures (r s ¼ .015). More rumination (b ¼ À.364) and higher IQ (b ¼ À.420) were associated with reporting more subjective complaints than was evident from objective measures of EF (i.e., underestimation). Subjective and objective EF measures are weakly overlapping in MDD. Findings underscore recommendations to include both subjective and objective measures when assessing EFs in depression. In addition, findings suggest that targeting ruminative processes could help correct underestimation.

Improvement in self-reported cognitive functioning but not in rumination following online working memory training in a two-year follow-up study of remitted major depressive disorder

“…Little is known, however, about the long-term effects of interventions targeting cognition following MDD, as was evident by a recent meta-analysis ( 23 ). There is also a lack of research reporting long-term outcomes in subjective cognitive deficits, with a few exceptions ( 24–28 ). Overall, the results from these studies reporting short- and long-term outcomes have been mixed Thus, exploring how new interventions influence subjective deficits over time is of importance.…”

“…Rumination is an emotion regulation strategy were one passively brood over self-related negative experiences and is hypothesized to be related to deficits in working memory (WM) for negative material, sometimes termed hot-cognition ( 26 , 29–31 ). Associations between objective cognitive tests and rumination are small, but significant associations have been established for WM ( 3 ), and subjective cognition ( 24 ). Rumination is a central risk factor following remission of mood symptoms ( 32 ), and predict relapse in remitted populations ( 4 , 33 , 34 ).…”

“…Rumination is a central risk factor following remission of mood symptoms ( 32 ), and predict relapse in remitted populations ( 4 , 33 , 34 ). Thus, deficits in cognition are suspected to be related to rumination, however, relationships to subjective deficits are unclear ( 24 ), and a recent review suggested that subjective deficits could cause rumination about not living up to one’s premorbid level, and thus increase relapse risk following MDD ( 19 ). Interventions improving cognition could thus reduce subjective deficits and rumination following MDD.…”

Connecting residual depressive symptoms to self-reported executive functioning: A network analytical approach

“…Even if performance-based measures allow to assess an individual's optimal capacity and efficiency of EF in a highly controlled setting (Toplak et al, 2012), such measures likely suffer from limited ecological validity when aiming to investigate impairments in EF domains in daily life (e.g., Barkley and Fischer, 2011;Snyder et al, 2021). This, among other things (e.g., method variance), may explain the relatively poor correspondence between performance-based measures and subjective indicators of EF (e.g., Hagen et al, 2021;Serra-Blasco et al, 2019;Snyder et al, 2021), which may more closely capture success in goal pursuit in daily life (Toplak et al, 2012). As such, it has been argued that self-report measures for EF, such as the Behavior Rating Inventory of Executive Function -Adult version (BRIEF-A; Roth et al, 2005), may better reflect experienced EF difficulties in daily life (Schmid and Hammar, 2021).…”

Neuroscientific insights into executive functions

“…As previously noted, self-reported EFs in daily life do not necessarily align with objective EF performance measured by standardized tests in the general population (e.g., Buchanan, 2016;Meltzer et al, 2017) and clinical samples (e.g., Vlagsma et al, 2017;Ingulfsvann Hagen et al, 2021). Thus, self-report measures of EFs cannot serve as a reliable proxy for objective EF performance as assessed by these standardized tests.…”