Cognitive functioning in anxiety and depression: Results from the ALSPAC cohort

Background: Understanding the nature of cognitive deficits in anxiety and depression may identify intervention targets and help prevent functional decline. This study used observational and genetic methods to investigate the association of anxiety and depression with emotion recognition, response inhibition, and working memory, in young adulthood. Methods: The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large prospective birth cohort study. Participants completed regular postal questionnaires and in-clinic assessments, starting from September 6, 1990. Data collection is ongoing. Linear regression was used to assess 1) cross-sectional associations between anxiety, depression, and cognition at age 24 (n = 2,187) and 2) prospective associations between anxiety and depression at age 18 and cognition at age 24 (n = 1,855). Mendelian randomization analyses were conducted to assess causal pathways between anxiety, depression, and cognition. Results: Primary analyses were conducted on 3,087 participants following multiple imputation. There was evidence for anxiety being associated with a decreased recognition of happiness (b = -0.27, 95% CI -0.54 to 0.01, p = .045), and depression being associated with an increased recognition of sadness (b = 0.35, 95% CI 0.07 to 0.64, p = .016). Anxiety was negatively associated with working memory (b = -0.14, 95% CI -0.24 to 0.04, p = .005), but no association was found for depression (b = 0.06, 95% CI -0.05 to 0.16, p = .284). There was no evidence for any association with response inhibition. Results from Mendelian randomization analyses were inconclusive, likely due to low statistical power. Conclusions: There was little evidence that anxiety and depression are associated with significant impairments in executive functioning. However, both anxiety and depression were associated with altered emotion recognition. This may inform the development of interventions that target psychosocial functioning.