Executive Function Deficits in Daily Life Prospectively Predict Increases in Depressive Symptoms

May combine two claims.

DAST-10 and AUDIT scores were not significantly correlated with depressive-symptom change scores or with T1 BRIEF Shift, Inhibit, or working-memory scores.

“Neither DAST-10 nor AUDIT scores were significantly correlated with depression change scores or T1 BRIEF Shift, Inhibit, or WM.”

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The correlations of T1 Shift and Inhibit scores with depressive-symptom change were in the expected direction but were not statistically significant, with p=0.09 for both.

“The correlations between Shift and MASQ-AD change scores and between Inhibit and MASQ-AD change scores were also in the expected direction though not significant (for both, p = 0.09).”

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Age was not significantly related to depressive-symptom change scores, and age did not predict working memory, Inhibit, or Shift scores.

“Age was not significantly related to depression change scores [R2 = 0.007, F (1,48) = 0.33, p = n.s.], and age did not predict WM [R2 = 0.001, F (1,48) = 0.05, p = n.s.], nor did it predict Inhibit or Shift.”

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When all three T1 executive-function scores predict depressive-symptom change, BRIEF working memory is a marginally significant predictor, total R2=0.13, ΔR2=0.06, t(50)=1.68, p=0.10, while Shift and Inhibit do not approach significance.

“Second, a hierarchical regression was conducted with all three T1 EF scores (BRIEF Shift, Inhibit, and WM) as predictors of depression change scores. When added last, BRIEF WM remained a marginally significant predictor of MASQ-AD change scores [total R2 = 0.13, ΔR2 = 0.06, t (50) = 1.68, p = 0.10], whereas the other two did not approach significance.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

T1 depressive symptoms were zero-order predictors of T2 BRIEF Shift, Inhibit, and working-memory scores, with r(49)=0.52, p<0.001; r(49)=0.28, p<0.05; and r(49)=0.28, p<0.05, respectively.

“Although zero-order correlations indicated that T1 MASQ-AD was a predictor of T2 BRIEF Shift, Inhibit, and WM [r (49) = 0.52, p < 0.001, r (49) = 0.28, p < 0.05, and r (49) = 0.28, p < 0.05, respectively]”

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At both time points, higher self-reported executive-function problems on the Shift, Inhibit, and working-memory subscales are positively associated with higher anhedonic depressive symptoms.

“Zero-order correlations revealed that the T1 and T2 BRIEF Shift, Inhibit, and WM scores were each positively correlated with MASQ-AD scores at T1 and T2 (see Table 2).”

• Also stated in: § Discussion · plain

  “Prior studies have reported associations between EF deficits and depression cross-sectionally and this was confirmed in the present study.”

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After controlling for T1 depressive symptoms, T1 BRIEF working-memory scores account for significant variance in T2 depressive symptoms, total R2=0.60, ΔR2=0.10, F-change(1,48)=11.67, p<0.01.

“First, depression change was captured via a hierarchical regression with T1 MASQ-AD scores entered in the first step and WM scores entered in the second step, predicting T2 MASQ-AD scores. T1 BRIEF WM scores again accounted for significant variance [total R2 = 0.60, ΔR2 = 0.10, F-change (1, 48) = 11.67, p < 0.01].”

May combine two claims.

With T1 depressive symptoms entered first and all three T1 executive-function scores entered second to predict T2 depressive symptoms, BRIEF working memory is a marginally significant predictor, total R2=0.61, ΔR2=0.11, t(50)=1.89, p=0.07, while Shift and Inhibit do not approach significance.

“Third, T1 MASQ-AD scores were entered first, and all three T1 EF scores were entered second, predicting T2 MASQ-AD. BRIEF WM remained a marginally significant predictor of T2 MASQ-AD scores [total R2 = 0.61, ΔR2 = 0.11, t (50) = 1.89, p = 0.07]. In contrast, neither Shift nor Inhibit approached significance.”

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T1 BRIEF working memory predicts T2 depressive symptoms above and beyond T2 rumination while controlling for T1 depressive symptoms; both T2 rumination and T1 working memory add significant variance, with rumination total R2=0.67, ΔR2=0.17, F-change(1,48)=23.73, p<0.001, and working memory total R2=0.69, ΔR2=0.03, F-change(1,48)=4.27, p=0.04.

“Both RRQ-Rumination [total R2 = 0.67, ΔR2 = 0.17, F-change (1, 48) = 23.73, p < 0.001], and T1 BRIEF WM [total R2 = 0.69, ΔR2 = 0.03, F-change (1, 48) = 4.27, p = 0.04] added significant variance.”

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Individuals with depression commonly show abnormal brain activity in regions thought to implement executive function.

“For example, individuals with depression commonly exhibit abnormal brain activity in brain regions purported to implement EF (Engels et al. 2010; Herrington et al. 2010; Warren et al. 2013).”

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• cites Herrington et al. 2010 sourceNot checked yet

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In older adults, executive dysfunction has been associated with poorer outcomes, depression recurrence, and relapse.

“For example, in older adults executive dysfunction has been associated with poorer outcomes, as well as depression recurrence and relapse (Alexopoulos 2003).”

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Executive function, and perhaps especially working memory, anticipates changes in depression.

“Thus, EF, and perhaps especially WM, anticipates changes in depression.”

• AssumptionRests on an assumption: The undergraduate sample selected for a range of affect scores is sufficiently representative to support conclusions about depression onset, maintenance, and recurrence more generally.

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In adults with mild cognitive impairment, BRIEF self-reports and informant reports show similar patterns of executive-function deficits, indicating that self-reports can capture perceived difficulties confirmed by others.

“Furthermore, in a sample of adults with mild cognitive impairment, BRIEF self-reports and informant reports revealed similar patterns of EF deficits, indicating that self-reports can capture perceived EF difficulties that are confirmed by others (Rabin et al. 2006).”

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Cognitive deficits such as memory and attention problems are common during depressive episodes.

“Investigations of cognition-emotion interactions have revealed that cognitive deficits, such as problems with memory and attention, are common during depressive episodes (Gotlib and Joormann 2010; Levin et al. 2007).”

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Working memory's prediction of depression was confirmed concurrently, prospectively, and for change in depression over time.

“Specifically, WM predicting depression was confirmed not only for concurrent (T1 WM and T1 depression, p < 0.01) and prospective (T1 WM and T2 depression, p < 0.001) measurement, but for change in depression over time (T1 WM and T2 depression minus T1 depression, p < 0.05).”

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It has been suggested that executive-function deficits play an active role in depressive episodes.

“Once considered an epiphenomenon of depression (Austin et al. 2001), it has been suggested that EF deficits play an active role in depressive episodes (Gotlib and Joormann 2010).”

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Executive function is not unitary; a prominent framework identifies at least three related but distinct sub-processes: shifting, inhibition, and updating of working-memory representations.

“Of the various processes that have been considered to fall under the umbrella of EF, one prominent EF framework suggests that there are at least three clearly definable EF sub-processes that are related but distinct; specifically, shifting, inhibition, and updating of working memory (WM) representations (Miyake et al. 2000).”

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Hypoactivation in dorsolateral prefrontal cortex and anterior cingulate cortex is a common finding in the depression literature.

“Hypoactivation in dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), brain regions theorized to maintain task set and to select and evaluate responses respectively (Banich 2009), are common findings in the literature (for reviews, see Rogers et al. 2004; Murrough et al. 2011).”

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Poorer executive function at T1 prospectively predicts increases in depressive symptoms, and this relationship is specific to working memory.

“Analyses indicated that poorer EF at T1 predicted increases in depressive symptoms and furthermore that this relationship was specific to WM.”

• AssumptionRests on an assumption: The roughly three-month interval between T1 and T2 is long enough for executive-function deficits to influence changes in depressive symptoms.

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A bidirectional relationship was not evident because depressive symptoms did not prospectively predict changes in executive function.

“In contrast, a bidirectional relationship was not evident, as depressive symptoms did not prospectively predict changes in EF.”

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Executive-function deficits have commonly been found in individuals with depression using neuropsychological tests, other behavioral tasks, and self-report measures.

“Deficits purported to fall within the domain of EF have commonly been found in individuals with depression using neuropsychological tests (Channon et al. 1993; Gohier, et al. 2009; Porter et al. 2003; Purcell et al. 1997; for a review see, Snyder 2013), other behavioral tasks (Joormann and Gotlib 2008; Rose and Ebmeier 2006), and self-report measures (Warren, Heller, and Miller, under review).”

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• cites Joormann and Gotlib 2008 sourceNot checked yet

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Cognitive deficits associated with depression are typically evident during tasks that require effortful rather than automatic processing.

“Cognitive deficits associated with depression are typically evident during tasks that require effortful, rather than automatic, processing (Hartlage et al. 1993).”

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Individuals may be unable to infer cognitive processes such as executive function.

“they may be unable to infer cognitive processes such as EF (Nisbett and Wilson 1977)”

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The interval between Time 1 and Time 2 varied across participants (M = 96 days, SD = 60 days), which was a limitation of the study.

“there was variability in how long individuals completed T2 after T1 in the time between T1 and T2 (M = 96 days, SD = 60 days)”

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Connolly et al. (2014) assessed executive function with conventional laboratory neuropsychological tasks, whereas the present study used a self-report measure.

“Connolly et al. (2014) used conventional laboratory neuropsychological tasks to assess EF, whereas the present study used a self-report measure.”

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Some aspects of executive function may mature during adolescence, while others may not mature until early adulthood.

“Finally, it has been suggested that some aspects of EF may mature during adolescence (e.g., inhibition of perseveration), while others may not mature until early adulthood (e.g., verbal fluency; Romine and Reynolds 2005).”

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The BRIEF is a self-report measure designed to assess executive function over the previous six months in an ecologically sensitive way.

“The BRIEF is a self-report measure intended to assess EF over the past 6 months in an ecologically sensitive manner.”

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The mechanism through which impaired working memory may contribute to later depressive symptoms is not clear.

“However, the mechanism by which impaired WM may contribute to future depressive symptoms is unclear.”

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Self-reported executive function is associated with important functional outcomes measured by self-report and independent measures, including criminal activity, occupational impairment, academic procrastination and psychopathology.

“self-reported EF is associated with important functional outcomes as measured by both self-report and independent measures (e.g., driving records of DUI citations, informant reports), including criminal activity (Barkley and Murphy 2011), occupational impairment (Barkley and Murphy 2010), academic procrastination (Rabin et al. 2011), and psychopathology (Knouse et al. 2013).”

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Rumination has consistently been associated with higher levels of depressive symptoms.

“Rumination has been defined as a perserverative focus on one’s symptoms of distress (Nolen-Hoeksema 1991) and has consistently been associated with higher levels of depressive symptoms (Michl et al. 2013; Nolan et al. 1998; Segerstrom et al. 2000).”

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• cites Nolan et al. 1998 sourceNot checked yet

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Executive function deficits have been associated with higher levels of rumination, and greater executive function deficits in depressed individuals have been associated with higher rumination.

“EF deficits have been associated with higher levels of rumination and greater EF deficits in individuals with depression have been associated with higher levels of rumination (Davis and Nolen-Hoeksema 2000; Joormann and Gotlib 2008).”

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• cites Joormann and Gotlib 2008 sourceNot checked yet

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Self-report is subject to biases, including social desirability and inaccurate recollection.

“it is subject to biases including social desirability (Furnham 1986) and inaccurate recollection”

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In Harvey et al. (2004), shifting, inhibition and working memory were significantly impaired in depressed patients, but only n-back working memory performance was significantly negatively associated with patients' number of previous hospitalizations.

“Shifting, inhibition, and WM were significantly impaired in patients. However, only the n-back task performance (purportedly an index of WM) was significantly negatively associated with patients’ number of previous hospitalizations.”

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Recent work indicates that training can improve executive function and improve outcomes of psychopathology.

“Recent work indicates that training can improve EF (for a review, see Crocker et al. 2013) and improve outcomes of psychopathology.”

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Past studies have found impairments in cognitive control in individuals with depression when they are confronted with emotional information.

“Past studies have found impairments in cognitive control in individuals with depression when confronted with emotional information (Beevers et al. 2010; Ditcher et al. 2009; Fales et al. 2008).”

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Prior working memory deficits play an important role in current depressive symptoms, as indicated by Time 1 executive function predicting Time 2 depressive symptoms above and beyond initial depression and rumination reported at Time 2.

“That T1 predicted T2 depressive symptoms above and beyond initial depression and rumination reported at T2 suggests that prior WM deficits play an important role in current depressive symptoms.”