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. 2022 Nov;44(6):558-566.
doi: 10.1177/02537176211072408. Epub 2022 Apr 6.

Neurocognition and Metacognition in Anxiety Disorders

Affiliations

Neurocognition and Metacognition in Anxiety Disorders

Ashwini Vishwanathan et al. Indian J Psychol Med. 2022 Nov.

Abstract

Background: Neurocognitive deficits are noted in anxiety disorders (ADs), albeit with several inconsistencies. The relationship between neurocognition and metacognition may have potential implications for understanding cognitive dysfunction but is poorly understood in ADs. This study aimed to examine the relationship between neurocognition and metacognition in ADs, with a cross-sectional design.

Methods: The sample included ADs (n = 25) and nonclinical (n = 25) groups matched on age, gender, and education. Neurocognition was assessed using tests for intelligence, attention, working memory, fluency, flexibility, set-shifting, inhibition, planning, and memory; and metacognition using Metacognition Questionnaire-30 (MCQ-30) and Metacognitive Awareness and Regulation Scale (MARS).

Results: Compared to comparison/normative scores, the anxiety group showed significantly poorer performance on zoo map test (low demand trial; P = 0.007), rule shift cards 1 (P ≤ 0.001), rule shift cards 2 (P ≤ 0.001), and logical memory immediate recall (P ≤ 0.001) and delayed recall (P ≤ 0.001); greater negative beliefs about worry (P = 0.005), and poorer metacognitive awareness and regulation (P = 0.01). Greater cognitive self-consciousness was correlated with better planning (Spearman's rho = -0.509, P = 0.009).

Conclusions: Individuals with ADs show neurocognitive difficulties in planning, set-shifting, and logical memory, dysfunctional metacognition, and reduced metacognitive awareness and regulation. Cognitive self-consciousness is linked to better planning. The interrelationships between neurocognition and metacognition may have potential implications for clarifying inconsistent findings and designing novel cognitive interventions in ADs.

Keywords: Anxiety disorders; Cognitive deficits; Metacognition; Neurocognition.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.. Flowchart depicting procedure
HAM-A – Hamilton Anxiety Rating Scale; MADRS – Montgomery Asberg Depression Rating Scale; COWAT – Controlled Oral Word Association test; ANT – Animal Names; AVLT – Auditory Verbal Learning Test; CFT – Complex Figure Test; MCQ – Metacognitions Questionnaire; MARS – Metacognitive Awareness and Regulation Scale.

References

    1. Sadock B, Sadock V, and Ruiz P. Synopsis of Psychiatry., 11th ed. Philadelphia, PA: Wolters Kluwer; 2015.
    1. Sharp PB, Miller GA, and Heller W.. Transdiagnostic dimensions of anxiety: Neural mechanisms, executive functions, and new directions. Int J Psychophysiol., 2015; 98(2): 365–377. - PubMed
    1. Waghorn G, Chant D, White P, and Whiteford H. Disability, employment and work performance among people with ICD-10 anxiety disorders. Aust N Z J Psychiatry, 2005; 39(1–2): 55–66. - PubMed
    1. Fett AJ, Viechtbauer W, Dominguez M, Penn DL, Os J Van, and Krabbendam L.. Neuroscience and biobehavioral reviews the relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis. Neurosci Biobehav Rev, 2011; 35(3): 573–588. - PubMed
    1. Woo YS, Rosenblat JD, Kakar R, Bahk WM, and McIntyre RS. Cognitive deficits as a mediator of poor occupational function in remitted major depressive disorder patients. Clin Psychopharmacol Neurosci, 2016; 14(1): 1–16. - PMC - PubMed