Executive Function and Emotion Regulation in Depressive and Anxiety Disorders: A Cross-sectional Study

Executive function (EF) and emotion regulation (ER) deficits are prevalent in depressive and anxiety disorders, suggesting a transdiagnostic role. Given their role in treatment engagement, symptom reduction, and relapse prevention, we examine EF and ER interrelationships in these disorders.

Participants (n = 27 depressive/anxiety disorders, n = 27 nonclinical group) underwent psychiatric screening and assessments of symptom severity, EF (set-shifting, response inhibition [RI], working memory [WM], verbal fluency, planning), and ER (severity, strategies, situational ER following emotion induction). Mann-Whitney U-test/t-test was used for group comparisons, and Pearson's/Spearman's test was used for correlations.

The clinical group showed lower WM (Cohen's d = 0.94, p = .001), verbal fluency (Cohen's d = 0.7, p = .01), and RI (Cohen's d = 0.35, p = .02); greater ER difficulties (Cohen's d = -1.40, p < .001), greater negative ER strategy use of catastrophizing (Cohen's d = 0.55, p < .001); and on the emotion-induction task-higher use of acceptance, other-blame, but no positive reappraisal. The nonclinical group showed greater positive ER strategy use of refocus on plan (Cohen's d = 0.53, p < .001) and no use of rumination on the emotion-induction task. The severity of ER difficulties correlated with poorer WM (p = .006); acceptance as an ER strategy correlated with poorer RI (p = .02). EF and ER difficulties and maladaptive strategies were significantly higher in the depression/anxiety group.

The findings extend prior research by providing actionable insights for tailored interventions and merit testing in larger samples. With poorer WM linked to greater ER difficulties and inefficient RI to passive acceptance, interventions such as cognitive training may enhance ER.