Cognitive Control in Generalized Anxiety Disorder: Relation of Inhibition Impairments to Worry and Anxiety Severity
- 1.3k Downloads
Cognitive models of generalized anxiety disorder (GAD) propose that cognitive control, broadly construed, and inhibition specifically, play a role in the maintenance of GAD symptoms. However, few studies have explicitly investigated inhibition, and in particular “cold” (non-emotional) inhibition, and its relation to worry and anxiety severity in GAD. Adults with GAD (n = 35) and healthy controls (n = 21) completed computerized Stroop and Go/NoGo tasks, two widely-used tests of inhibition. GAD status predicted significantly worse (slower and less accurate) performance on the Stroop but not the Go/NoGo task. Clinician-rated anxiety severity predicted slower and less accurate Stroop performance over and above the effect of GAD diagnosis but did not predict Go/NoGo performance. Trait worry did not incrementally predict performance on either task. These findings provide qualified support for theoretical models of inhibition impairments in GAD and suggest that inhibition could be a promising target for novel neurocognitive interventions.
KeywordsGeneralized anxiety disorder Inhibition Inhibitory control Cognitive control Worry Anxiety
This study was funded by Grant #129522 from the Hartford HealthCare Research Funding Initiative to G. J. D.
Compliance with Ethical Standards
Conflict of Interest
Lauren S. Hallion declares no conflict of interest. David F. Tolin declares no conflict of interest. John Goethe declares no conflict of interest. Gretchen J. Diefenbach receives material support from Neuronetics for research.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York: The Guilford Press.Google Scholar
- Doniger, G. (2011). Mindstreams: Survey Responses. In support of P. J. Snyder, C. E. Jackson, R. C. Petersen, A. S. Khachaturian, J. Kaye, M. Albert, S. Weintraub (2011). The PAD2020 Survey of Cognitive Instruments for the Study of Mild Cognitive Impairment. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. Retrieved from http://www.pad2020.org/CTCR/CTCRSummaries/.
- Guy, W. (1976). Assessment manual for psychopharmacology: US Government Printing Office.Google Scholar
- Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Dunbar, G. C., et al. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12(5), 224–231.CrossRefGoogle Scholar
- López-Pina, J. A., Sánchez-Meca, J., & Rosa-Alcázar, A. I. (2009). The Hamilton rating scale for depression: A meta-analytic reliability generalization study. International Journal of Clinical and Health Psychology, 9, 143–159.Google Scholar
- Raven, J., Raven, J. C., & Court, J. H. (2003). Manual for Raven’s progressive matrices and vocabulary scales. San Antonio, TX: Harcourt Assessment.Google Scholar
- Riccio, C. A., Reynolds, C. R., & Lowe, P. A. (2001). Clinical applications of continuous performance tests: Measuring attention and impulsive responding in children and adults. John Wiley & Sons Inc.Google Scholar
- Shear, M. K., Vanderbilt, J., Rucci, P., Endicott, J., Lydiard, B., Otto, M. W., Pollack, M. H., Chandler, L., Williams, J., Alli, A., & Frank, B. M. (2001). Reliability and validity of a structured guard for the Hamilton Anxiety Rating Scale (SIGH-A). Anxiety, 13, 166–178.CrossRefPubMedGoogle Scholar
- Stange, J. P., Connolly, S. L., Burke, T. A., Hamilton, J. L., Hamlat, E. J., Abramson, L. Y., & Alloy, L. B. (2016). Inflexible cognition predicts first onset of major depressive episodes in adolescence. Depression and Anxiety,1–8.Google Scholar
- Tempesta, D., Mazza, M., Serroni, N., Moschetta, F. S., Di Giannanto, M., Ferrara, M., & De Berardis, D. (2013). Neuropsychological functioning in young subjects with generalized anxiety disorder with and without pharmacotherapy. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 45, 236–241.CrossRefPubMedGoogle Scholar