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A meta-analysis of the relationship between anxiety and attentional control
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
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Metadata
- Authors
- Shi, R., Sharpe, L., & Abbott, M.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Sharpe, Louise
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 72
- Pages
- 101754
- ISSN
- 0272-7358 (ISSN-L)
- 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
- 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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