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Neuropsychological test performance in anxious youth: an examination of the impact of environmental factors and anxiety on assessment

The relationship between anxiety and neuropsychological functioning has attracted much attention in the literature over the past two decades. Though significant progress has been made in understanding the cognitive correlates of anxiety disorders, many questions still remain, particularly in child and adolescent populations. The following chapters examine the relationship between youth anxiety and neuropsychological functioning in three ways:

Paper 1 examines the relationship between anxiety and executive functioning difficulties in a sample of youth seeking treatment for anxiety. Specifically, the study sought to clarify which executive functioning domains were most strongly associated with anxiety, and which anxiety subtypes were most linked to executive dysfunction. Self-reported anxiety and executive functioning data from 102 youth (ages 8-18) and/or their parents were examined via bivariate Pearson correlation and stepwise regression modeling. Consistent with hypotheses, results indicated that youth with elevated anxiety experience specific difficulties with daily tasks involving the capacity to “shift,” or flexibly adapt thoughts and behaviors to meet changing task demands, compared to other executive functions.

Paper 2 explores the effects of state anxiety on neuropsychological test performance, relative to a youth’s performance when not in acutely anxiety provoking circumstances. In this pilot study, we investigated the relationship between youth state anxiety, trait anxiety, and neuropsychological test performance in youth before and after an anxiety manipulation. Fourteen youth were recruited from an outpatient anxiety treatment center and from the surrounding community. After baseline neuropsychological screening, youth were randomly assigned to either an anxiety induction or a matched control condition, and then re-tested on similar neuropsychological measures. Contrary to our hypotheses, we found a positive relationship between state/trait anxiety and neuropsychological test performance in youth. Results are limited by a small sample size and little variability in state anxiety.

Paper 3 is a clinically oriented commentary on how clinicians can identify and respond to test anxiety in youth undergoing neuropsychological testing using evidence-based techniques. This paper describes factors that contribute to test anxiety in children and adolescents, the signs and symptoms of elevated anxiety in testing contexts, and offers brief strategies practitioners may use to address youth anxiety during neuropsychological tests.

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/43937
Date24 February 2022
CreatorsKeller, Alex Eve
ContributorsPincus, Donna
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation

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