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

Abstract

Introduction: Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods: We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results: We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion: Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.

The effect of anxiety on working memory and language abilities in elementary schoolchildren with and without Additional Health and Developmental Needs

“…These findings demonstrate the association between anxiety and language abilities, showing that parents who rate their children as more anxious also perceive their children as having difficulty using language for functional communication in day-to-day settings. This is consistent with a recent study by Sbicigo et al (2020) , who found that more severe anxiety symptoms were associated with overall lower oral language abilities, in children with anxiety disorders. Although our high anxiety group contained a higher proportion of AHDN children, none of these children had a formal diagnosis of a clinical anxiety disorder, nor did the one-third of the high anxiety group who were NT children, indicating that anxiety may impact language abilities at a level below formal diagnosis of an anxiety disorder.…”

“…Additionally, our results are consistent with a large body of literature in adults, and a smaller number of studies in children, showing that trait anxiety is associated with poorer working memory performance for auditory and spatial information (see Moran, 2016 , for a review). To our knowledge, this study is amongst the first to show that anxiety is related to performances on visual working memory tasks that require minimal spatial processing, as previous research in children has largely focused only on spatial working memory, and mostly found no significant association with anxiety ( Hadwin et al, 2005 ; Owens et al, 2008 , 2014 ; Visu-Petra et al, 2011 , 2014 ; although see Visu-Petra et al, 2018 ; Sbicigo et al, 2020 ). Further, the few previous studies considering non-spatial, visuo-perceptual working memory (i.e.…”

Longitudinal predictions between executive function and general and specific psychiatric problems in school-age children.

“…Previous cross-sectional and longitudinal studies have consistently reported that worse working memory is associated with more internalizing problems (Hecker et al, 2016;Mannie et al, 2010;Ng & Lee, 2016;Opris et al, 2019;Owens et al, 2008;Sbicigo et al, 2020;Tajik-Parvinchi et al, 2021) but not more externalizing problems (Castellanos-Ryan et al, 2016;Quistberg & Mueller, 2020;Zohreh Yaghoub et al, 2007) in children and adolescents. Specifically, in Western children, working memory was negatively related to concurrent internalizing problems in both typically developing children (Hecker et al, 2016;Ng & Lee, 2016;Opris et al, 2019;Owens et al, 2008) and children diagnosed with neurodevelopmental disorders (Tajik-Parvinchi et al, 2021) and anxiety disorders (Sbicigo et al, 2020;Visu-Petra et al, 2014). Working memory at the age of 5 years did not predict externalizing problems approximately half a year later but significantly predicted internalizing problems (i.e., social anxiety, loneliness, and sadness) in U.S. preschoolers (Quistberg & Mueller, 2020).…”

“…Working memory involves filtering out interfering information and temporarily storing and manipulating target information, for example, ignoring emotional information and paying attention to task-specific information (Diamond, 2013). Previous cross-sectional and longitudinal studies have consistently reported that worse working memory is associated with more internalizing problems (Hecker et al, 2016;Mannie et al, 2010;Ng & Lee, 2016;Opris et al, 2019;Owens et al, 2008;Sbicigo et al, 2020;Tajik-Parvinchi et al, 2021) but not more externalizing problems (Castellanos-Ryan et al, 2016;Quistberg & Mueller, 2020;Zohreh Yaghoub et al, 2007) in children and adolescents. Specifically, in Western children, working memory was negatively related to concurrent internalizing problems in both typically developing children (Hecker et al, 2016;Ng & Lee, 2016;Opris et al, 2019;Owens et al, 2008) and children diagnosed with neurodevelopmental disorders (Tajik-Parvinchi et al, 2021) and anxiety disorders (Sbicigo et al, 2020;Visu-Petra et al, 2014).…”

Neuropsychology of Generalized Anxiety Disorder in Clinical Setting: A Systematic Evaluation

“…Furthermore, researchers have investigated the correlation between the severity of anxiety and neuropsychological functioning. One study [15] aimed to examine the correlation between the severity of anxiety disorders and neuropsychological impairments in a sample of children diagnosed with anxiety disorders. The research revealed a significant correlation between the intensity of anxiety disorders and decreased cognitive abilities in memory and language.…”