Are Executive Functioning Deficits Concurrently and Predictively Associated with Depressive and Anxiety Symptoms in Adolescents?

The central objective of the current study was to evaluate how executive functions (EF), and specifically cognitive flexibility, were concurrently and predictively associated with anxiety and depressive symptoms in adolescence. Adolescents (N = 220) and their parents participated in this longitudinal investigation. Adolescents' EF was assessed by the Wisconsin Card Sorting Test (WCST) during the initial assessment, and symptoms of depressive and anxiety disorders were reported by mothers and youths concurrently and 2 years later. Correlational analyses suggested that youths who made more total errors (TE), including both perseverative errors (PE) and nonperseverative errors (NPE), concurrently exhibited significantly more depressive symptoms. Adolescents who made more TE and those who made more NPE tended to have more anxiety symptoms 2 years later. Structural equation modeling analyses accounting for key explanatory variables (e.g., IQ, disruptive behavior disorders, and attention deficit hyperactive disorder) showed that TE was concurrently associated with parent reports of adolescent depressive symptoms. The results suggest internalizing psychopathology is associated with global (TE) and nonspecific (NPE) EF difficulties but not robustly associated with cognitive inflexibility (PE). Future research with the WCST should consider different sources of errors that are posited to reflect divergent underlying neural mechanisms, conferring differential vulnerability for emerging mental health problems.

A working memory training to decrease rumination in depressed and anxious individuals: a double-blind randomized controlled trial

BACKGROUND

Rumination is one of the hallmark characteristics of both anxiety disorders and depression, and has been linked to deficient executive functioning, particularly working memory (WM). Previous findings show that working memory capacity can be increased through training.

METHODS

The current study explored whether an adaptive stand-alone WM training could increase WMC and consequently reduce rumination, anxiety and depression by means of a double-blind randomized controlled trial in a sample of 98 patients with symptoms of anxiety and/or depression.

RESULTS

No positive effect of training on WMC was found. In addition, the results show that a WM training was not associated with a reduction of rumination, depression, nor anxiety.

LIMITATIONS

The high drop-out rate in both groups (20.11% from pre- to post-training) and the overrepresentation of men and use of anti-depressants in the placebo group might have influenced the results. Furthermore, expectations and perceptions about the training might have interacted with performance on WM tasks.

CONCLUSIONS

Overall, results show that a stand-alone WM training in patients with symptoms of anxiety and/or depression does not result in reduced rumination nor in reduced symptoms of depression and anxiety. We discuss potential explanations for these findings.

The neural substrates of response inhibition to negative information across explicit and implicit tasks in GAD patients: electrophysiological evidence from an ERP study

Background: It has been established that the inability to inhibit a response to negative stimuli is the genesis of anxiety. However, the neural substrates of response inhibition to sad faces across explicit and implicit tasks in general anxiety disorder (GAD) patients remain unclear.

Methods: Electrophysiological data were recorded when subjects performed two modified emotional go/no-go tasks in which neutral and sad faces were presented: one task was explicit (emotion categorization), and the other task was implicit (gender categorization).

Results: In the explicit task, electrophysiological evidence showed decreased amplitudes of no-go/go difference waves at the N2 interval in the GAD group compared to the control group. However, in the implicit task, the amplitudes of no-go/go difference waves at the N2 interval showed a reversed trend. Source localization analysis on no-go/N2 components revealed a decreased current source density (CSD) in the right dorsal lateral prefrontal cortex in GAD individuals relative to controls. In the implicit task, the left superior temporal gyrus and the left inferior parietal lobe showed enhanced activation in GAD individuals and may compensate for the dysfunction of the right dorsal lateral prefrontal cortex.

Conclusion: These findings indicated that the processing of response inhibition to socially sad faces in GAD individuals was interrupted in the explicit task. However, this processing was preserved in the implicit task. The neural substrates of response inhibition to sad faces were dissociated between implicit and explicit tasks.

Effect of trait anxiety on prefrontal control mechanisms during emotional conflict

Converging evidence points to a link between anxiety proneness and altered emotional functioning, including threat-related biases in selective attention and higher susceptibility to emotionally ambiguous stimuli. However, during these complex emotional situations, it remains unclear how trait anxiety affects the engagement of the prefrontal emotional control system and particularly the anterior cingulate cortex (ACC), a core region at the intersection of the limbic and prefrontal systems. Using an emotional conflict task and functional magnetic resonance imaging (fMRI), we investigated in healthy subjects the relations between trait anxiety and both regional activity and functional connectivity (psychophysiological interaction) of the ACC. Higher levels of anxiety were associated with stronger task-related activation in ACC but with reduced functional connectivity between ACC and lateral prefrontal cortex (LPFC). These results support the hypothesis that when one is faced with emotionally incompatible information, anxiety leads to inefficient high-order control, characterized by insufficient ACC-LPFC functional coupling and increases, possibly compensatory, in activation of ACC. Our findings provide a deeper understanding of the pathophysiology of the neural circuitry underlying anxiety and may offer potential treatment markers for anxiety disorders.

Three key regions for supervisory attentional control: evidence from neuroimaging meta-analyses

The supervisory attentional system has been proposed to mediate non-routine, goal-oriented behaviour by guiding the selection and maintenance of the goal-relevant task schema. Here, we aimed to delineate the brain regions that mediate these high-level control processes via neuroimaging meta-analysis. In particular, we investigated the core neural correlates of a wide range of tasks requiring supervisory control for the suppression of a routine action in favour of another, non-routine one. Our sample comprised n=173 experiments employing go/no-go, stop-signal, Stroop or spatial interference tasks. Consistent convergence across all four paradigm classes was restricted to right anterior insula and inferior frontal junction, with anterior midcingulate cortex and pre-supplementary motor area being consistently involved in all but the go/no-go task. Taken together with lesion studies in patients, our findings suggest that the controlled activation and maintenance of adequate task schemata relies, across paradigms, on a right-dominant midcingulo-insular-inferior frontal core network. This also implies that the role of other prefrontal and parietal regions may be less domain-general than previously thought.

Impact of working memory load on cognitive control in trait anxiety: an ERP study

Whether trait anxiety is associated with a general impairment of cognitive control is a matter of debate. This study investigated whether and how experimentally manipulated working memory (WM) load modulates the relation between trait anxiety and cognitive control. This question was investigated using a dual-task design in combination with event-related potentials. Participants were required to remember either one (low WM load) or six letters (high WM load) while performing a flanker task. Our results showed that a high WM load disrupted participants' ability to overcome distractor interference and this effect was exacerbated for the high trait-anxious (HTA) group. This exacerbation was reflected by larger interference effects (i.e., incongruent minus congruent) on reaction times (RTs) and N2 amplitudes for the HTA group than for the low trait-anxious group under high WM load. The two groups, however, did not differ in their ability to inhibit task-irrelevant distractors under low WM load, as indicated by both RTs and N2 amplitudes. These findings underscore the significance of WM-related cognitive demand in contributing to the presence (or absence) of a general cognitive control deficit in trait anxiety. Furthermore, our findings show that when limited WM resources are depleted by high WM load, HTA individuals exhibit less efficient recruitments of cognitive control required for the inhibition of distractors, therefore resulting in a greater degree of response conflict.

Interaction Effects of the COMT and DRD4 Genes with Anxiety-Related Traits on Selective Attention

The study investigated whether the DRD4 and COMT genes can modify relations between trait anxiety and selective attention. Two hundreds and sixty-six subjects performed a visual search task in which they had to find words looking through a sheet with rows of letters. After finishing the first sheet the subject was presented the second one, this time with an instruction to perform the task as quickly and accurate as possible. To study top-down attention, the number of correctly identified words (accuracy) and the time for completion of each trial were analyzed. To study bottom-up attention, the letters ‘o’ and ‘n’ were written in green, whilst the others were in black, and subjects were asked whether they had noticed that 2–3 minutes after the task completion. Genotypes for the COMT Val158Met and DRD4 VNTR-48 polymorphisms and TCI Harm Avoidance and MMPI Depression scales’ scores were obtained as well. High anxious individuals showed a more pronounced increase in accuracy in the second trial and more profound processing of irrelevant stimuli (colored letters). There was a significant interaction effect of DRD4 and Harm avoidance on the accuracy dynamics F(1, 210), = 7.65, p = .006, η2 = .04. Among DRD4 long allele carriers, high anxious subjects significantly improved accuracy (p = .013) and tended to slow speed, while those with lower Harm avoidance demonstrated the opposite trend. These effects were more robust in less educated individuals. It was concluded that the DRD4 polymorphism may modify the influence of trait anxiety on the speed-accuracy tradeoff.

Précis on The Cognitive-Emotional Brain

In The Cognitive-Emotional Brain (Pessoa 2013), I describe the many ways that emotion and cognition interact and are integrated in the brain. The book summarizes five areas of research that support this integrative view and makes four arguments to organize each area. (1) Based on rodent and human data, I propose that the amygdala's functions go beyond emotion as traditionally conceived. Furthermore, the processing of emotion-laden information is capacity limited, thus not independent of attention and awareness. (2) Cognitive-emotional interactions in the human prefrontal cortex (PFC) assume diverse forms and are not limited to mutual suppression. Particularly, the lateral PFC is a focal point for cognitive-emotional interactions. (3) Interactions between motivation and cognition can be seen across a range of perceptual and cognitive tasks. Motivation shapes behavior in specific ways – for example, by reducing response conflict or via selective effects on working memory. Traditional accounts, by contrast, typically describe motivation as a global activation independent of particular control demands. (4) Perception and cognition are directly influenced by information with affective or motivational content in powerful ways. A dual competition model outlines a framework for such interactions at the perceptual and executive levels. A specific neural architecture is proposed that embeds emotional and motivational signals into perception and cognition through multiple channels. (5) A network perspective should supplant the strategy of understanding the brain in terms of individual regions. More broadly, in a network view of brain architecture, “emotion” and “cognition” may be used as labels of certain behaviors, but will not map cleanly into compartmentalized pieces of the brain.

Neural substrates underlying learning-related changes of the unconditioned fear response

The ability to predict an impending threat during Pavlovian conditioning diminishes the emotional response that is produced once the threat is encountered. Diminution of the threat response appears to be mediated by somewhat independent associative learning and expectancy-related processes. Therefore, the present study was designed to better understand the neural mechanisms that support associative learning processes, independent of expectancy, that influence the emotional response to a threat. Healthy volunteers took part in a Pavlovian conditioning procedure during which trait anxiety, expectation of the unconditioned stimulus (UCS), skin conductance response (SCR), and functional magnetic resonance imaging (fMRI) signal were assessed. The results showed no evidence for associative learning that was independent of expectation. Threat-related SCR expression was diminished on predictable trials vs. unpredictable trials of the UCS (i.e. conditioned UCR diminution). Similar to SCR, conditioned UCR diminution was observed within the left dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and left anterior insula. In contrast, potentiation of the threat-related fMRI signal response was observed within left dorsolateral PFC, inferior parietal lobule (IPL), and posterior insula. A negative relationship was observed between UCS expectancy and UCR expression within the dorsomedial PFC, ventromedial PFC, and anterior insula. Finally, the anticipatory fMRI signal responses within the PFC, posterior cingulate, and amygdala showed an inverse relationship with threat-related activation within the brain regions that showed UCR diminution. The current findings suggest that the PFC and amygdala support learning-related processes that impact the magnitude of the emotional response to a threat.

Sleep and cortisol interact to support memory consolidation

Separate lines of research have demonstrated that rises in cortisol can benefit memory consolidation, as can the occurrence of sleep soon after encoding. For the first time, we demonstrate that pre-learning cortisol interacts with sleep to benefit memory consolidation, particularly for negative arousing items. Resting cortisol levels during encoding were positively correlated with subsequent memory, but only following a period of sleep. There was no such relation following a period of wakefulness. Using eye tracking, we further reveal that for negative stimuli, this facilitative effect may arise because cortisol strengthens the relationship between looking time at encoding and subsequent memory. We suggest that elevated cortisol may "tag" attended information as important to remember at the time of encoding, thus enabling sleep-based processes to optimally consolidate salient information in a selective manner. Neuroimaging data suggest that this optimized consolidation leads to a refinement of the neural processes recruited for successful retrieval of negative stimuli, with the retrieval of items attended in the presence of elevated cortisol and consolidated over a night of sleep associated with activity in the amygdala and vmPFC.

On the relationship between anxiety and error monitoring: a meta-analysis and conceptual framework

Research involving event-related brain potentials has revealed that anxiety is associated with enhanced error monitoring, as reflected in increased amplitude of the error-related negativity (ERN). The nature of the relationship between anxiety and error monitoring is unclear, however. Through meta-analysis and a critical review of the literature, we argue that anxious apprehension/worry is the dimension of anxiety most closely associated with error monitoring. Although, overall, anxiety demonstrated a robust, “small-to-medium” relationship with enhanced ERN (r = −0.25), studies employing measures of anxious apprehension show a threefold greater effect size estimate (r = −0.35) than those utilizing other measures of anxiety (r = −0.09). Our conceptual framework helps explain this more specific relationship between anxiety and enhanced ERN and delineates the unique roles of worry, conflict processing, and modes of cognitive control. Collectively, our analysis suggests that enhanced ERN in anxiety results from the interplay of a decrease in processes supporting active goal maintenance and a compensatory increase in processes dedicated to transient reactivation of task goals on an as-needed basis when salient events (i.e., errors) occur.

Affective attention under cognitive load: reduced emotional biases but emergent anxiety-related costs to inhibitory control

Trait anxiety is associated with deficits in attentional control, particularly in the ability to inhibit prepotent responses. Here, we investigated this effect while varying the level of cognitive load in a modified antisaccade task that employed emotional facial expressions (neutral, happy, and angry) as targets. Load was manipulated using a secondary auditory task requiring recognition of tones (low load), or recognition of specific tone pitch (high load). Results showed that load increased antisaccade latencies on trials where gaze toward face stimuli should be inhibited. This effect was exacerbated for high anxious individuals. Emotional expression also modulated task performance on antisaccade trials for both high and low anxious participants under low cognitive load, but did not influence performance under high load. Collectively, results (1) suggest that individuals reporting high levels of anxiety are particularly vulnerable to the effects of cognitive load on inhibition, and (2) support recent evidence that loading cognitive processes can reduce emotional influences on attention and cognition.

Intrinsic connectivity networks and personality: the temperament dimension harm avoidance moderates functional connectivity in the resting brain

Recent functional imaging studies that examined functional connectivity in the resting brain have demonstrated various intrinsic connectivity networks (ICNs). Certain patterns of over- and underactivity in various ICNs have been hypothesized to form the neural basis of psychiatric disorders. Furthermore, activity in the ICNs does not reflect ongoing mental activity but the maintenance of neural circuits in a ready state suggesting not only relationships between ICNs and disorders but also correlations between ICNs and personality. In the present study, we assess the relationship between trait anxiety, a well established endophenotype of anxiety disorders, and functional connectivities within the insular salience ICN in a sample of healthy female subjects. Based on a previous study that demonstrated the functional relevance of the insular salience ICN for state anxiety, we used the harm avoidance scale from the Temperament and Character Inventory (TCI) as a trait marker to demonstrate increased functional connectivity within the insular salience ICN. Specifically, the functional connectivity between the anterior insula and the anterior cingulate and between the anterior insula and the dorsolateral prefrontal cortex were positively correlated with individual harm avoidance scores. The results fit into previous work, provide evidence for a potential biomarker of anxiety disorders and, most importantly, demonstrate a direct neural correlate of the personality trait harm avoidance in the absence of external stimulation.

Trait anxiety and the neural efficiency of manipulation in working memory

The present study investigates the effects of trait anxiety on the neural efficiency of working memory component functions (manipulation vs. maintenance) in the absence of threat-related stimuli. For the manipulation of affectively neutral verbal information held in working memory, high- and low-anxious individuals (N = 46) did not differ in their behavioral performance, yet trait anxiety was positively related to the neural effort expended on task processing, as measured by BOLD signal changes in fMRI. Higher levels of anxiety were associated with stronger activation in two regions implicated in the goal-directed control of attention—that is, right dorsolateral prefrontal cortex (DLPFC) and left inferior frontal sulcus—and with stronger deactivation in a region assigned to the brain’s default-mode network—that is, rostral–ventral anterior cingulate cortex. Furthermore, anxiety was associated with a stronger functional coupling of right DLPFC with ventrolateral prefrontal cortex. We interpret our findings as reflecting reduced processing efficiency in high-anxious individuals and point out the need to consider measures of functional integration in addition to measures of regional activation strength when investigating individual differences in neural efficiency. With respect to the functions of working memory, we conclude that anxiety specifically impairs the processing efficiency of (control-demanding) manipulation processes (as opposed to mere maintenance). Notably, this study contributes to an accumulating body of evidence showing that anxiety also affects cognitive processing in the absence of threat-related stimuli.

Functional network dysfunction in anxiety and anxiety disorders

A recent paradigm shift in systems neuroscience is the division of the human brain into functional networks. Functional networks are collections of brain regions with strongly correlated activity both at rest and during cognitive tasks, and each network is believed to implement a different aspect of cognition. We propose here that anxiety disorders and high trait anxiety are associated with a particular pattern of functional network dysfunction: increased functioning of the cingulo-opercular and ventral attention networks as well as decreased functioning of the fronto-parietal and default mode networks. This functional network model can be used to differentiate the pathology of anxiety disorders from other psychiatric illnesses such as major depression and provides targets for novel treatment strategies.

Attentional control deficits in trait anxiety: why you see them and why you don't

Attentional Control Theory (ACT; Eysenck et al., 2007; Derakshan and Eysenck, 2009) posits that trait anxiety interferes with the inhibition, shifting and updating processes of working memory. Consequently, high anxious individuals are predicted to perform worse on cognitively demanding tasks requiring efficient cognitive processing. Whilst a growing number of studies have provided support for this view, the possible underlying mechanisms of this deficiency are far less understood. In particular, there is conflicting neuroscientific evidence with some work showing associations between anxiety and increased neural activity over frontal areas, while others report reduced activity. We review recent evidence that has helped elucidate the cognitive hallmarks of trait anxiety, and suggest how previous discrepancies can be accommodated within ACT's prediction that reduced cognitive efficiency may be ameliorated by strategies such as compensatory effort. Finally, we discuss if ACT's distinction on efficiency and effectiveness can be applied to threat-related processing, often shown to additively override attentional control in anxiety.