Disentangling effects of remote mild traumatic brain injury characteristics and posttraumatic stress on processing speed and executive function in veterans.

Mild traumatic brain injury (mTBI) and posttraumatic stress are prevalent in military service members and share objective and subjective cognitive symptoms, complicating recovery. We investigated the effects of remote mTBI characteristics and current posttraumatic stress symptoms on neuropsychological performance in 152 veterans with a history of remote mTBI and current cognitive concerns. Participants completed clinical neuropsychological evaluations within a Veterans Affairs Level-II TBI/Polytrauma outpatient clinic (i.e. tertiary trauma care center for US military veterans outside of a research or teaching hospital setting). Archival data analysis of mTBI injury characteristics, clinical diagnoses, scores on the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and performance on tests of processing speed, attention and executive function was conducted. Hierarchical linear regression demonstrated that elevated PCL-M scores were associated with slower performance on trail making test (TMT) Parts A and B (p < .016). PCL-M symptoms moderated the effect of alteration of consciousness (AOC) on TMT performance, with endorsement of AOC associated with better performance, but only when PCL-M scores were high (p < .005). Follow-up mediation analyses demonstrated that PCL-M score fully mediated the relationship between AOC and TMT-A performance and partially mediated the relationship between AOC and TMT-B performance. Post-hoc analyses meant to separate the impact of processing speed on TMT-B were all non-significant. Remote mTBI characteristics, specifically AOC, were not associated with decrements in cognitive performance. Posttraumatic symptoms were associated with worse processing speed, suggesting that psychological distress and psychopathology are contributing factors in understanding and treating persistent cognitive distress following remote mTBI.

Developmental Trajectories of Internalizing and Externalizing Symptoms in Youth and Associated Gender Differences: A Directed Network Perspective.

Psychopathology in youth is highly prevalent and associated with psychopathology in adulthood. However, the developmental trajectories of psychopathology symptoms, including potential gender differences, are markedly underspecified. The present study employed a directed network approach to investigate longitudinal relationships and gender differences among eight transdiagnostic symptom domains across three years, in a homogenous age sample of youth participants (n = 6,414; mean baseline age = 10.0 years; 78.6% White; Adolescent Brain Cognitive Development study). Anxious/depressed problems and aggressive behaviors were central symptoms and most predictive of increases in other symptom clusters at later timepoints. Rule-breaking behaviors, aggressive behaviors, and withdrawn/depressed problems emerged as bridge symptoms between externalizing and internalizing problems. Results supported cascade models in which externalizing problems predicted future internalizing problems, but internalizing problems also significantly predicted future externalizing problems, which is contrary to cascade models. Network structure, symptom centrality, and patterns of bridge symptoms differed between female and male participants, suggesting gender differences in the developmental trajectories of youth psychopathology. Results provide new insights into symptom trajectories and associated gender differences that may provide promising pathways for understanding disorder (dis)continuity and co-occurrence. The central and bridge symptoms identified here may have important implications for screening and early intervention for youth psychopathology.

Both reactive and proactive control are deficient in children with ADHD and predictive of clinical symptoms.

Cognitive control deficits are a hallmark of attention deficit hyperactivity disorder (ADHD) in children. Theoretical models posit that cognitive control involves reactive and proactive control processes but their distinct roles and inter-relations in ADHD are not known, and the contributions of proactive control remain vastly understudied. Here, we investigate the dynamic dual cognitive control mechanisms associated with both proactive and reactive control in 50 children with ADHD (16F/34M) and 30 typically developing (TD) children (14F/16M) aged 9-12 years across two different cognitive controls tasks using a within-subject design. We found that while TD children were capable of proactively adapting their response strategies, children with ADHD demonstrated significant deficits in implementing proactive control strategies associated with error monitoring and trial history. Children with ADHD also showed weaker reactive control than TD children, and this finding was replicated across tasks. Furthermore, while proactive and reactive control functions were correlated in TD children, such coordination between the cognitive control mechanisms was not present in children with ADHD. Finally, both reactive and proactive control functions were associated with behavioral problems in ADHD, and multi-dimensional features derived from the dynamic dual cognitive control framework predicted inattention and hyperactivity/impulsivity clinical symptoms. Our findings demonstrate that ADHD in children is characterized by deficits in both proactive and reactive control, and suggest that multi-componential cognitive control measures can serve as robust predictors of clinical symptoms.

BDNF Val66Met Moderates the Effects of Hypertension on Executive Functioning in Older Adults Diagnosed With aMCI.

OBJECTIVE: To investigate whether the BDNF Val66Met polymorphism influences the associations of hypertension, executive functioning and processing speed in older adults diagnosed with amnestic Mild Cognitive Impairment (aMCI). DESIGN: Secondary data analysis using moderation modeling. SETTING: Veterans Affairs Hospital, Palo Alto, CA. PARTICIPANTS: Sample included 108 community-dwelling volunteers (mean age 71.3 ± 9.2 years) diagnosed with aMCI. MEASUREMENTS: Cognitive performance was evaluated from multiple baseline assessments (Trail Making Test; Stroop Color-Word Test; Symbol Digit Modality Test) and grouped into standardized composite scores representing executive function and processing speed domains. BDNF genotypes were determined from whole blood samples. Hypertension was assessed from resting blood pressures or by self-report. RESULTS: Controlling for age, BDNF Val66Met moderated the effects of hypertension on executive functioning, but added no significant variance to processing speed scores. Specifically, hypertensive carriers of the BDNF Met allele performed significantly below the sample mean on tasks of executive functioning, and evidenced significantly lower scores when compared to Val-Val homozygotes and normotensive participants. CONCLUSIONS: Results posit that the executive functioning of non-demented older adults may be susceptible to interactions between BDNF genotype and hypertension, and Val-Val homozygotes and normotensive older adults may be more resilient to these effects of cognitive change. Further research is needed to understand the underlying processes and to implement strategies that target modifiable risk factors and promote cognitive resilience.

Predictive utility of symptom measures in classifying anxiety and depression: A machine-learning approach.

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent, co-occurring disorders with significant symptom overlap, posing challenges in accurately distinguishing and diagnosing these disorders. The tripartite model proposes that anxious arousal is specific to anxiety and anhedonia is specific to depression, though anxious apprehension may play a greater role in GAD than anxious arousal. The present study tested the efficacy of the Mood and Anxiety Symptom Questionnaire anhedonic depression (MASQ-AD) and anxious arousal (MASQ-AA) scales and the Penn State Worry Questionnaire (PSWQ) in identifying lifetime or current MDD, current major depressive episode (MDE), and GAD using binary support vector machine learning algorithms in an adult sample (n = 150). The PSWQ and MASQ-AD demonstrated predictive utility in screening for and identification of GAD and current MDE respectively, with the MASQ-AD eight-item subscale outperforming the MASQ-AD 14-item subscale. The MASQ-AA did not predict MDD, current MDE, or GAD, and the MASQ-AD did not predict current or lifetime MDD. The PSWQ and MASQ-AD are efficient and accurate screening tools for GAD and current MDE. Results support the tripartite model in that anhedonia is unique to depression, but inclusion of anxious apprehension as a separate dimension of anxiety is warranted.

Associations of Family Distress, Family Income, and Acculturation on Pediatric Cognitive Performance Using the NIH Toolbox: Implications for Clinical and Research Settings.

OBJECTIVE: There is a growing recognition that the use of conventional norms (e.g., age, sex, years of education, race) as proxies to capture a broad range of sociocultural variability on cognitive performance is suboptimal, limiting sample representativeness. The present study evaluated the incremental utility of family income, family conflict, and acculturation beyond the established associations of age, gender,maternal years of education, and race on cognitive performance. METHOD: Hierarchical linear regressions evaluated the incremental utility of sociocultural factors on National Institutes of Health Toolbox in a nationally representative sample of pre-adolescent children (n = 11,878; Mage = 10.0 years; Adolescent Brain Cognitive Development Study). A regression-based norming procedure was implemented for significant models. Paired sample t-tests were used to compare original and newly created demographically corrected T-scores. RESULTS: Nearly all regression models predicted performance on the NIH-TB subtests and composite scores (p < .005). Greater family income and lower family conflict predicted better performance, although the effect sizes were small by traditional standards. Acculturation scores did not explain additional variance in cognitive performance. Lastly, there were no significant differences between the original and newly created demographically corrected T-scores (Mdiff < 0.50). CONCLUSIONS: The present study highlights that, although family income, family conflict, and acculturation have been shown to routinely influence cognitive performance in preadolescent children, the NIH-TB appears to be highly robust to individual differences in sociocultural factors in children between ages 9 and 10. Contextual and temporal implications of the present results are discussed.

Factor Structure, Measurement Invariance, and Concurrent Validity of the Penn State Worry Questionnaire Across Development, Psychopathology, and Culture.

The Penn State Worry Questionnaire (PSWQ) is a widely used assessment of excessive worry. American undergraduate samples have predominately been used to evaluate its factor structure, which may not generalize to other developmental, cultural, and psychopathology populations. The present study tested the PSWQ's factor structure across three diverse samples: American undergraduate students (n = 3,243), Dutch high school students (n = 3,906), and American adults with psychopathology (n = 384). Exploratory, confirmatory, and multigroup confirmatory factor analyses were conducted. Measurement invariance and concurrent validity were also tested. Method-factor and two-factor models were largely equivalent and superior to a one-factor model. Invariance tests supported configural and metric invariance but only partial scalar invariance. Positively worded items but not negatively worded items demonstrated concurrent validity with anxiety and depression symptom measures and diagnoses. Overall, the PSWQ appears to measure a unitary construct. Present results warrant further testing of the PSWQ across diverse samples.

Specificity of anhedonic alterations in resting-state network connectivity and structure: A transdiagnostic approach.

Anhedonia is a prominent characteristic of depression and related pathology that is associated with a prolonged course of mood disturbance and treatment resistance. However, the neurobiological mechanisms of anhedonia are poorly understood as few studies have disentangled the specific effects of anhedonia from other co-occurring symptoms. Here, we take a transdiagnostic, dimensional approach to distinguish anhedonia alterations from other internalizing symptoms on intrinsic functional brain circuits. 53 adults with varying degrees of anxiety and/or depression completed resting-state fMRI. Neural networks were identified through independent components analysis. Dual regression was used to characterize within-network functional connectivity alterations associated with individual differences in anhedonia. Modulation of between-network functional connectivity by anhedonia was tested using region-of-interest to region-of-interest correlational analyses. Anhedonia was associated with visual network hyperconnectivity and expansion of the visual, dorsal attention, and default networks. Additionally, anhedonia was associated with decreased between-network connectivity among default, salience, dorsal attention, somatomotor, and visual networks. Findings suggest that anhedonia is associated with aberrant connectivity and structural alterations in resting-state networks that contribute to impairments in reward learning, low motivation, and negativity bias characteristic of depression. Results reveal dissociable effects of anhedonia on resting-state network dynamics, characterizing possible neurocircuit mechanisms for intervention.

Latent brain state dynamics distinguish behavioral variability, impaired decision-making, and inattention.

Children with Attention Deficit Hyperactivity Disorder (ADHD) have prominent deficits in sustained attention that manifest as elevated intra-individual response variability and poor decision-making. Influential neurocognitive models have linked attentional fluctuations to aberrant brain dynamics, but these models have not been tested with computationally rigorous procedures. Here we use a Research Domain Criteria approach, drift-diffusion modeling of behavior, and a novel Bayesian Switching Dynamic System unsupervised learning algorithm, with ultrafast temporal resolution (490 ms) whole-brain task-fMRI data, to investigate latent brain state dynamics of salience, frontoparietal, and default mode networks and their relation to response variability, latent decision-making processes, and inattention. Our analyses revealed that occurrence of a task-optimal latent brain state predicted decreased intra-individual response variability and increased evidence accumulation related to decision-making. In contrast, occurrence and dwell time of a non-optimal latent brain state predicted inattention symptoms and furthermore, in a categorical analysis, distinguished children with ADHD from controls. Importantly, functional connectivity between salience and frontoparietal networks predicted rate of evidence accumulation to a decision threshold, whereas functional connectivity between salience and default mode networks predicted inattention. Taken together, our computational modeling reveals dissociable latent brain state features underlying response variability, impaired decision-making, and inattentional symptoms common to ADHD. Our findings provide novel insights into the neurobiology of attention deficits in children.

The Structure of Executive Dysfunction in Depression and Anxiety.

BACKGROUND: Although research has demonstrated that depression and anxiety are associated with problematic executive function (EF), results are often inconsistent and underspecified. Delineating specific EF impairments in depression and anxiety has the potential to provide a mechanistic account of symptom presentation and course in these highly co-occurring disorders. The present study evaluated associations between components of EF and symptom dimensions of depression (depressed mood) and anxiety (anxious apprehension, anxious arousal) using factor analyses and structural equation modeling. METHODS: Undergraduates (N = 1,123) completed self-report measures of EF in everyday life and of psychopathology. Based on a three-factor model (Miyake et al., 2000), item-level exploratory (n = 561) and confirmatory (n = 562) factor analyses were conducted on inhibition, shifting, and working memory scales chosen from the EF measure. Structural equation modeling tested the relationship of EF factors to dimensions of psychopathology using the total sample. RESULTS: A three-factor model of EF best fit the data and was replicated via confirmatory factor analysis. Depressed mood and anxious arousal evidenced broad deficits across all EF domains, whereas anxious apprehension evidenced shifting disruptions. LIMITATIONS: Perceived EF may not index the same constructs as performance-based EF tests. Further, the present study was restricted to college students, warranting replication in other samples. CONCLUSIONS: Findings suggest that depressed mood and anxious arousal are characterized by a general disruption in the ability to maintain task goals, whereas anxious apprehension is characterized by cognitive inflexibility. EF impairments are likely contributory factors in the maintenance of affective disorders.

Anxiety and Stress Alter Decision-Making Dynamics and Causal Amygdala-Dorsolateral Prefrontal Cortex Circuits During Emotion Regulation in Children.

BACKGROUND: Anxiety and stress reactivity are risk factors for the development of affective disorders. However, the behavioral and neurocircuit mechanisms that potentiate maladaptive emotion regulation are poorly understood. Neuroimaging studies have implicated the amygdala and dorsolateral prefrontal cortex (DLPFC) in emotion regulation, but how anxiety and stress alter their context-specific causal circuit interactions is not known. Here, we use computational modeling to inform affective pathophysiology, etiology, and neurocircuit targets for early intervention. METHODS: Forty-five children (10-11 years of age; 25 boys) reappraised aversive stimuli during functional magnetic resonance imaging scanning. Clinical measures of anxiety and stress were acquired for each child. Drift-diffusion modeling of behavioral data and causal circuit analysis of functional magnetic resonance imaging data, with a National Institute of Mental Health Research Domain Criteria approach, were used to characterize latent behavioral and neurocircuit decision-making dynamics driving emotion regulation. RESULTS: Children successfully reappraised negative responses to aversive stimuli. Drift-diffusion modeling revealed that emotion regulation was characterized by increased initial bias toward positive reactivity during viewing of aversive stimuli and increased drift rate, which captured evidence accumulation during emotion evaluation. Crucially, anxiety and stress reactivity impaired latent behavioral dynamics associated with reappraisal and decision making. Anxiety and stress increased dynamic casual influences from the right amygdala to DLPFC. In contrast, DLPFC, but not amygdala, reactivity was correlated with evidence accumulation and decision making during emotion reappraisal. CONCLUSIONS: Our findings provide new insights into how anxiety and stress in children impact decision making and amygdala-DLPFC signaling during emotion regulation, and uncover latent behavioral and neurocircuit mechanisms of early risk for psychopathology.

Limited Prediction of Performance Validity Using Embedded Validity Scales of the Neurobehavioral Symptom Inventory in an mTBI Veteran Sample.

OBJECTIVE: To test embedded symptom validity scales of the Neurobehavioral Symptom Inventory (NSI) as predictors of performance validity. SETTING: A Veterans Affairs Level II TBI/Polytrauma outpatient care unit in the Midwestern United States. PARTICIPANTS: Veterans with a history of mild traumatic brain injury undergoing neuropsychological assessment as part of their routine care within the TBI/Polytrauma clinic. DESIGN: Retrospective analysis of the existing clinical data. MAIN MEASURES: The NSI, the b Test, Test of Memory Malingering, Reliable Digit Span, California Verbal Learning Test-II Forced Choice. RESULTS: Embedded NSI validity scales were positively correlated with number of performance validity test failures. Participants identified as invalid responders scored higher on embedded NSI validity scales than participants identified as valid responders. Using receiver operating characteristic analysis, the embedded NSI validity scales showed poor sensitivity and specificity for invalid responding using previously published cutoff scores. Only 1 scale differentiated valid from invalid responders better than chance. CONCLUSION: The embedded NSI validity scales' usefulness in predicting invalid neuropsychological performance validity was limited in this sample. Continued measurement of both symptom and performance validity in clinical settings involving traumatic brain injury treatment is recommended, as the present results support the existing research suggesting symptom validity tests and performance validity tests tap into related but ultimately distinct constructs.

Executive function deficits associated with current and past major depressive symptoms.

BACKGROUND: Although there has been extensive research showing that depression is associated with executive function (EF) deficits, the nature of these deficits is not clearly delineated. Specifically, previous reviews on this topic have yielded different conclusions about the particular domains of EF that are disrupted in depressed individuals. Further, research on whether these deficits persist after depressed mood has remitted is less prevalent and not consistent. METHODS: In two independent samples of college students, we examined associations between clinical ratings of current and past symptoms of a Major Depressive Episode (MDE) and difficulties in two domains of EF: inhibition and shifting. In Study 1 (n=162), EF was measured using behavioral tasks shown to index these two domains. In Study 2 (n=95), EF was measured using a self-report questionnaire believed to capture EF difficulties experienced in daily life. RESULTS: In both studies, past MDE symptoms were associated with worse shifting. In contrast, current MDE symptoms were associated with worse inhibition, though only on the behavioral measure (in Study 1). LIMITATIONS: Both studies used college samples and retrospective assessments of past symptoms. Further, only two domains of EF were examined, and the EF measures employed in each study have their own unique methodological limitations. CONCLUSIONS: Findings suggest that inhibition deficits vary as a function of current symptoms and thus may be a by-product of distress rather than a causal contributor. In contrast, shifting deficits associated with depression appear to be more enduring, suggesting that they could contribute to risk for depression.

Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis.

Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). While there is growing evidence for EF impairments associated with OCD, results have been inconsistent, making the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 previous studies that compared participants with OCD to healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.

Interactive effects of trait and state affect on top-down control of attention.

Few studies have investigated how attentional control is affected by transient affective states while taking individual differences in affective traits into consideration. In this study, participants completed a color-word Stroop task immediately after undergoing a positive, neutral or negative affective context manipulation (ACM). Behavioral performance was unaffected by any ACM considered in isolation. For individuals high in trait negative affect (NA), performance was impaired by the negative but not the positive or neutral ACM. Neuroimaging results indicate that activity in primarily top-down control regions of the brain (inferior frontal gyrus and dorsal anterior cingulate cortex) was suppressed in the presence of emotional arousal (both negative and positive ACMs). This effect appears to have been exacerbated or offset by co-occurring activity in other top-down control regions (parietal) and emotion processing regions (orbitofrontal cortex, amygdala and nucleus accumbens) as a function of the valence of state affect (positive or negative) and trait affect (trait NA or trait PA). Neuroimaging results are consistent with behavioral findings. In combination, they indicate both additive and interactive influences of trait and state affect on top-down control of attention.

Distracted and down: neural mechanisms of affective interference in subclinical depression.

Previous studies have shown that depressed individuals have difficulty directing attention away from negative distractors, a phenomenon known as affective interference. However, findings are mixed regarding the neural mechanisms and network dynamics of affective interference. The present study addressed these issues by comparing neural activation during emotion-word and color-word Stroop tasks in participants with varying levels of (primarily subclinical) depression. Depressive symptoms predicted increased activation to negative distractors in areas of dorsal anterior cingulate cortex (dACC) and posterior cingulate cortex (PCC), regions implicated in cognitive control and internally directed attention, respectively. Increased dACC activity was also observed in the group-average response to incongruent distractors, suggesting that dACC activity during affective interference is related to overtaxed cognitive control. In contrast, regions of PCC were deactivated across the group in response to incongruent distractors, suggesting that PCC activity during affective interference represents task-independent processing. A psychophysiological interaction emerged in which higher depression predicted more positively correlated activity between dACC and PCC during affective interference, i.e. greater connectivity between cognitive control and internal-attention systems. These findings suggest that, when individuals high in depression are confronted by negative material, increased attention to internal thoughts and difficulty shifting resources to the external world interfere with goal-directed behavior.

Aberrant Neural Connectivity during Emotional Processing Associated with Posttraumatic Stress.

Given the complexity of the brain, characterizing relations among distributed brain regions is likely essential to describing the neural instantiation of posttraumatic stress symptoms. This study examined patterns of functional connectivity among key brain regions implicated in the pathophysiology of posttraumatic stress disorder (PTSD) in 35 trauma-exposed adults using an emotion-word Stroop task. PTSD symptom severity (particularly hyperarousal symptoms) moderated amygdala-mPFC coupling during the processing of unpleasant words, and this moderation correlated positively with reported real-world impairment and amygdala reactivity. Reexperiencing severity moderated hippocampus-insula coupling during pleasant and unpleasant words. Results provide evidence that PTSD symptoms differentially moderate functional coupling during emotional interference and underscore the importance of examining network connectivity in research on PTSD. They suggest that hyperarousal is associated with negative mPFC-amygdala coupling and that reexperiencing is associated with altered insula-hippocampus function, patterns of connectivity that may represent separable indicators of dysfunctional inhibitory control during affective processing.

Transdiagnostic dimensions of anxiety and depression moderate motivation-related brain networks during goal maintenance.

BACKGROUND: Advancing research on the etiology, prevention, and treatment of psychopathology requires the field to move beyond modular conceptualizations of neural dysfunction toward understanding disturbance in key brain networks. Although some studies of anxiety and depression have begun doing so, they typically suffer from several drawbacks, including: (1) a categorical approach ignoring transdiagnostic processes, (2) failure to account for substantial anxiety and depression comorbidity, (3) examination of networks at rest, which overlooks disruption manifesting only when networks are challenged. Accordingly, the present study examined relationships between transdiagnostic dimensions of anxiety/depression and patterns of functional connectivity while goal maintenance was challenged. METHODS: Participants (n = 179, unselected community members and undergraduates selected to be high/low on anxiety/depression) performed a task in which goal maintenance was challenged (color-word Stroop) while fMRI data were collected. Analyses examined moderation by anxiety/depression of condition-dependent coupling between regions of dorsolateral prefrontal cortex (dlPFC) previously associated with approach and avoidance motivation and amygdala/orbitofrontal cortex (OFC). RESULTS: Anxious arousal was positively associated with amygdala↔right dlPFC coupling. Depression was positively associated with OFC↔right dlPFC coupling and negatively associated with OFC↔left dlPFC coupling. CONCLUSIONS: Findings advance the field toward an integrative model of the neural instantiation of anxiety/depression by identifying specific, distinct dysfunctions associated with anxiety and depression in networks important for maintaining approach and avoidance goals. Specifically, findings shed light on potential neural mechanisms involved in attentional biases in anxiety and valuation biases in depression and underscore the importance of examining transdiagnostic dimensions of anxiety/depression while networks are challenged.

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

Executive function (EF) deficits are associated with depression. Given that few prospective studies have been conducted, it is unclear whether deficits contribute to depression or result from it. The present study examined whether self-reported EF prospectively predicted worsening of depression symptoms. Time 1 (T1) shifting, inhibition, and working memory (WM) were assessed in relation to T1 and time 2 (T2) depressive symptoms in participants pre-selected to range in risk for depression. Analyses indicated that poorer EF at T1 predicted increases in depressive symptoms and furthermore that this relationship was specific to WM. In contrast, a bidirectional relationship was not evident, as depressive symptoms did not prospectively predict changes in EF. Finally, T1 EF accounted for T2 depressive symptoms beyond two well established predictors of depression: depressive symptoms at T1 and rumination at T2. These findings suggest that EF deficits play an active role in depression onset, maintenance, and/or recurrence.

Relationships among cognition, emotion, and motivation: implications for intervention and neuroplasticity in psychopathology.

Emotion-cognition and motivation-cognition relationships and related brain mechanisms are receiving increasing attention in the clinical research literature as a means of understanding diverse types of psychopathology and improving biological and psychological treatments. This paper reviews and integrates some of the growing evidence for cognitive biases and deficits in depression and anxiety, how these disruptions interact with emotional and motivational processes, and what brain mechanisms appear to be involved. This integration sets the stage for understanding the role of neuroplasticity in implementing change in cognitive, emotional, and motivational processes in psychopathology as a function of intervention.