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Executive Dysfunction Across Anxiety Severity Level: Evidence for Cognitive Plateau.

Shreyansh Srivastava1, Tatsat Vanzara1, Asha Srivastava1

  • 1School of Behavioural Forensics, National Forensic Sciences University, Gandhinagar, Gujarat, India.

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Summary

Executive dysfunction in anxiety disorders worsens with severity, impacting working memory and inhibitory control. Cognitive decline plateaus between moderate and severe anxiety levels in Indian patients.

Keywords:
Anxiety severityStroopWCSTWMS-IVconceptual processingexecutive functioninginhibitory controlworking memory

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Area of Science:

  • Neuroscience
  • Clinical Psychology
  • Psychiatry

Background:

  • Anxiety disorders are increasingly linked to neurocognitive deficits in executive functions like working memory, inhibitory control, and cognitive flexibility.
  • Indian research has historically focused on emotional and behavioral aspects, neglecting the neuropsychological underpinnings of anxiety severity.

Purpose of the Study:

  • To examine the relationship between anxiety severity and executive functioning.
  • To identify differences in executive functioning across mild, moderate, and severe anxiety groups.

Main Methods:

  • A cross-sectional study involving 60 patients categorized by anxiety severity (mild, moderate, severe) using the PROMIS Anxiety-Adult Short Form.
  • Neuropsychological assessments included the Wechsler Memory Scale (WMI), Stroop Test (inhibitory control), and Wisconsin Card Sorting Test (conceptual processing).
  • Statistical analyses comprised ANOVA, post hoc tests, chi-square, Pearson's correlations, and linear regression.

Main Results:

  • Significant differences in WMI, Stroop Test, and WCST performance were observed across anxiety severity groups (p < .001).
  • Individuals with mild anxiety outperformed those with moderate and severe anxiety; no significant difference was found between moderate and severe groups.
  • Anxiety severity showed a negative correlation with executive functioning (r = -0.45 to -0.61, p < .01), predicting 20%-37% of performance variance.

Conclusions:

  • Executive dysfunction escalates with anxiety severity, with cognitive decline stabilizing between moderate and severe levels.
  • Anxiety severity is a critical determinant of working memory, inhibitory control, and conceptual processing.
  • The findings advocate for integrating neuropsychological assessment and cognitive rehabilitation into anxiety management protocols in India.