Elevated Anxiety Relates to Future Executive Dysfunction: A Cross-Lagged Panel Network Analysis of Psychopathology and Cognitive Functioning Components

Abstract

Background: Vulnerability models posit that reduced cognitive functioning abilities (e.g., verbal fluency, working memory (WM)) precede and relate to future heightened psychopathology. Conversely, scar theory postulates that elevated psychopathology coincides with subsequent reduced cognitive functioning. However, most studies so far have been cross-sectional and tested global cognitive functioning-psychopathology relations. Objective: Thus, we used cross-lagged panel network analysis (CLPN) to facilitate causal inferences and differentiation of components on this topic. Method: Community adults (n = 856) participated in this eight-year study across four waves of assessment, each spaced about two years apart. Nine psychopathology components (aberrant motor behaviors (AMB), agitation, apathy, anxiety, delusions, depression, disinhibition, hallucinations, irritability) and seven cognitive functioning (attention, episodic memory, global cognition, language, processing speed, verbal fluency, WM) multi-item nodes were assessed with various performance-based cognitive functioning tests and the caregiver-rated Neuropsychiatric Inventory. Results: Contemporaneous networks consistently showed negative associations among global cognition/verbal fluency and agitation, AMB, or hallucinations, during all waves of assessment. Nodes that were most influential across communities in contemporaneous networks were delusions, depression, WM, and verbal fluency. For temporal networks, heightened anxiety (versus other neuropsychiatric nodes), had the largest negative relations with future decreased executive and related cognitive functioning nodes. Further, executive function nodes (e.g., verbal fluency) tended to be impacted by, rather than influential on, other nodes, across all time-points. Discussion: Findings supported scar (vs. vulnerability) model. The efficacy of evidence-based cognitive-behavioral and related psychopharmacological treatments may be enhanced by adding executive function training. Other theoretical and clinical implications were discussed.