Inhibitory control, working memory and coping with stress: Associations with symptoms of anxiety and depression in adults with Huntington’s disease.

Abstract

Objective: Huntington's disease (HD) is an autosomal dominant neurodegenerative disease characterized by neuropsychiatric symptoms (e.g., anxiety and depression), where individuals suffer high levels of stress from the social, physical, and cognitive burden of the disease. The present study examined two factors associated with increased risk for symptoms of anxiety and depression: executive function skills (inhibitory control/attention and working memory) and skills to cope with stress. Method: Adults with HD completed the NIH Toolbox measures of inhibitory control/attention and working memory, as well as self-report measures of coping with HD-related stress and symptoms of anxiety and depression. Path analyses were used to test direct and indirect associations among the subtypes of executive functioning, coping, and symptoms. Results: No significant associations were found in the full sample (n = 47), due to a significant portion of the sample with very low executive function abilities. Additional analyses were conducted on a subset of the sample (participants in the top three quartiles on both measures of executive functioning, n = 32). Significant indirect associations emerged among inhibitory control/attention skills, secondary control coping (e.g., acceptance and reappraisal), and symptoms of anxiety and depression in the subsample. Higher inhibitory control/attention skills were associated with greater use of secondary control coping, and greater use of these coping skills was related to lower symptoms of anxiety and depression. No direct or indirect associations were found among working memory skills, coping, and symptoms of anxiety and depression. Conclusions: Implications for interventions to enhance executive function and coping skills in adults with HD are highlighted. Key PointsQuestion: What is the relationship between aspects of executive functioning, specifically inhibitory control/attention and working memory skills, coping with stress, and neuropsychiatric symptoms in adults with Huntington's disease (HD)? Findings: Better performance on an inhibitory control/attention task was associated with greater use of secondary control coping skills (e.g., acceptance, cognitive reappraisal, and positive thinking), which in turn was related to lower symptoms of anxiety and depression in a subsample of adults with HD. Importance: These findings have potentially important This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Abagail E. Ciriegio https://orcid.

Guided self-help for anxiety among Huntington’s disease gene expansion carriers (GUIDE-HD) compared to treatment as usual: a randomised controlled feasibility trial

“…In a systematic review of anxiety among HD gene expansion carriers, it was concluded that anxiety was associated with several modi able targets of change used in evidence-based psychological treatments, such as CBT [10]. Another recent study found that people with HD who used greater coping strategies involving adapting to the stress of having HD experienced fewer symptoms of anxiety [24]. These coping strategies include acceptance, changing the unhelpful appraisals and undertaking positive activities, all of which are included in cognitive behaviour therapies such as traditional second-wave CBT and third wave therapies, such as Acceptance and Commitment Therapy (ACT).…”