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Cited by 243Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology StudiesCognitive Abilities and Testing

A meta-analysis of the relationship between anxiety and attentional control

Shi, Ran, Sharpe, Louise, Abbott, Maree·2019·Clinical Psychology Review
DOI 10.1016/j.cpr.2019.101754
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Abstract

Attentional Control Theory (ACT) (Eysenck & Derakshan, 2011) proposes that attention control (AC) deficits are central to the development of anxiety. This meta-analysis investigated the size and nature of AC deficits in anxious compared to non-anxious participants. We made the following hypotheses based on ACT: i) anxiety-related AC deficits occur in the AC components of inhibition and switching, but not updating; ii) deficits will be more pronounced for AC efficiency (reaction times) than effectiveness (accuracy); iii) studies with high cognitive load conditions will observe greater deficits than studies with normal cognitive load; iv) age and anxiety level will moderate the effect of anxiety on AC. Fifty-eight studies (N = 8292) met inclusion criteria. The meta-analysis revealed a significant AC deficit for high compared to low anxiety participants (Hedges' g = -0.58). Overall, results supported assumptions of ACT: anxiety produced significant deficits in AC efficiency but not effectiveness; these deficits occurred in inhibition and switching but not updating and studies with high cognitive load conditions found larger anxiety related AC deficits. Age moderated the relationship between anxiety and AC in behavioural studies and anxiety severity moderated this relationship in self-report studies. Theoretical implications of the results are discussed, and future directions for research are proposed. This meta-analysis has been registered with PROSPERO in 2016, Registration number: CRD42016036927.

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Crossref · 10.1016/j.cpr.2019.101754

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138 of 139 references verified0 citation errors · 0 not checkable

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  • Use of an anxiety disorder group as the clinical comparison group may produce a slight overestimate of ADHD-related working memory deficits (based on accuracy data) and may either not affect or produce a small underestimate of ADHD-related inhibition deficits.

    “Applied to the current study’s outcome data, these meta-analytic estimates suggest that our use of an anxiety disorder group as the clinical comparison group may produce a slight overestimate of ADHD-related working memory deficits (based on accuracy data).”

    From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [80]

  • Effect sizes for anxiety and executive function tended to be similar across anxiety disorder categories, anxiety severity, and/or state versus trait anxiety.

    “However, when examined, effect sizes tended to be similar across anxiety disorder categories, anxiety severity, and/or state versus trait anxiety (80–82), at least for the diagnoses included in the current study (please see Method section below).”

    From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [80]

  • Recent meta-analyses diverge in documenting a small magnitude working memory impairment in children with anxiety disorders, no significant impairment, or no significant impairment based on response time data but a small, significant strength based on accuracy data.

    “Regarding working memory, recent meta-analyses diverge in documenting a small magnitude impairment in children with anxiety disorders (d=-0.24; 82), no significant impairment (ns; 80), or no significant impairment based on response time data (ns) but a small, significant strength based on accuracy data (d=0.38; 81) that was also found in a recent empirical study controlling for ADHD status (d=0.19”

    From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [80]

  • Meta-analytic evidence indicates that anxiety disorders are not associated with inhibitory control impairments or are associated with small magnitude impairments that are significant based on response times but not accuracy.

    “Regarding inhibitory control, meta-analytic evidence indicates that anxiety disorders are not associated with impairments (ns; 79) or are associated with small magnitude impairments (d=-0.31; 80) that are significant based on analysis of response times (d=-0.27) but not accuracy data (ns; 81).”

    From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [80]

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Baddeley, 1986, Oxford psychology series, no. 11
  2. Derakshan, 2009, Anxiety, inhibition, efficiency, and effectiveness: An investigation using the antisaccade task, Experimental Psychology, 56, 48, 10.1027/1618-3169.56.1.48 · DOI
  3. Rosenthal, 1991, Vol. 6

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Authors
Shi, R., Sharpe, L., & Abbott, M.
Affiliations
The University of Sydney (AU)
Corresponding author
Sharpe, Louise
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2019-08
Volume
72
Pages
101754
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2019.101754
OpenAlex
W2962111751
Semantic Scholar
b312dd21af5ee9de7056fac69c55083410cd8f83
Cited by
243
References
138
Citations by year
2026: 37 · 2025: 44 · 2024: 44 · 2023: 36 · 2022: 41 · 2021: 25 · 2020: 15 · 2019: 1
FWCI
2.95
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
Funders
Faculty of Science, Monash University
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
Keywords
anxiety, attentional control, attentional control theory, inhibition, cognitive shifting, working memory updating, cognitive load, reaction time, accuracy, age moderation, anxiety levels
MeSH terms
Anxiety Disorders, Attention, Humans, Inhibition, Psychological, Executive Function

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