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Worry and cognitive control predict course trajectories of anxiety in older adults with late-life depression

Published online by Cambridge University Press:  23 March 2020

P. Spinhoven ,
D.C. van der Veen ,
R.C. Oude Voshaar  and
H.C. Comijs
P. Spinhoven*
Affiliation:
Leiden University, Institute of Psychology, Leiden, The Netherlands Leiden University Medical Centre, Department of Psychiatry, Leiden, The Netherlands
D.C. van der Veen
Affiliation:
University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center of Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
R.C. Oude Voshaar
Affiliation:
University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center of Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
H.C. Comijs
Affiliation:
GGZ inGeest/VU University Medical Centre, Department of Psychiatry/Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
*
* Corresponding author. Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands. Fax: +3171 5274678. E-mail address:[email protected] (P. Spinhoven).
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Abstract

Background:

Many older adults with depressive disorder manifest anxious distress. This longitudinal study examines the predictive value of worry as a maladaptive cognitive emotion regulation strategy, and resources necessary for successful emotion regulation (i.e., cognitive control and resting heart rate variability [HRV]) for the course of anxiety symptoms in depressed older adults. Moreover, it examines whether these emotion regulation variables moderate the impact of negative life events on severity of anxiety symptoms.

Methods:

Data of 378 depressed older adults (CIDI) between 60 and 93 years (of whom 144 [41%] had a comorbid anxiety disorder) from the Netherlands Study of Depression in Older Adults (NESDO) were used. Latent Growth Mixture Modeling was used to identify different course trajectories of six-months BAI scores. Univariable and multivariable longitudinal associations of worry, cognitive control and HRV with symptom course trajectories were assessed.

Results:

We identified a course trajectory with low and improving symptoms (57.9%), a course trajectory with moderate and persistent symptoms (33.5%), and a course trajectory with severe and persistent anxiety symptoms (8.6%). Higher levels of worry and lower levels of cognitive control predicted persistent and severe levels of anxiety symptoms independent of presence of anxiety disorder. However, worry, cognitive control and HRV did not moderate the impact of negative life events on anxiety severity.

Conclusions:

Worry may be an important and malleable risk factor for persistence of anxiety symptoms in depressed older adults. Given the high prevalence of anxious depression in older adults, modifying worry may constitute a viable venue for alleviating anxiety levels.

Keywords

Late-life depressionLate-life anxietyWorryCognitive controlHeart rate variabilityNegative life events
Type
Original article
Information
European Psychiatry , Volume 44 , July 2017 , pp. 134 - 140
Copyright
Copyright © European Psychiatric Association 2017

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References

Bryant, CJackson, HAmes, DThe prevalence of anxiety in older adults: methodological issues and a review of the literature. J Affect Disord 2008; 109: 233–250.CrossRefGoogle Scholar
Lenze, EJMulsant, BHShear, MKAlexopoulos, GSFrank, EReynolds, CFComorbidity of depression and anxiety disorders in later life. Depress Anxiety 2001; 14: 86–93.CrossRefGoogle ScholarPubMed
de Beurs, EBeekman, ATDeeg, DJVan Dyck, Rvan Tilburg, WPredictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam. Psychol Med 2000; 30: 515–527.CrossRefGoogle ScholarPubMed
Schuurmans, JComijs, HEmmelkamp, PMWeijnen, IJvan den Hout, Mvan Dyck, RLong-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders. Int Psychogeriatr 2009; 21: 1148–1159.CrossRefGoogle ScholarPubMed
Thompson, RAEmotion regulation: a theme in search of definition. Monogr Soc Res Child Dev 1994; 59: 25–52.CrossRefGoogle ScholarPubMed
Aldao, ANolen-Hoeksema, SSchweizer, SEmotion-regulation strategies across psychopathology: a meta-analytic review. Clin Psychol Rev 2010; 30: 217–237.CrossRefGoogle ScholarPubMed
Olatunji, BWolitzky-Taylor, KBSawchuk, CNCiesielski, BGWorry and the anxiety disorders: a meta-analytic synthesis of specificity to GAD. Appl Prev Psychol 2010; 14: 1–24.CrossRefGoogle Scholar
Braver, TSBarch, DMA theory of cognitive control, aging cognition, and neuromodulation. Neurosci Biobehav Rev 2002; 26: 809–817.CrossRefGoogle ScholarPubMed
Beaudreau Sa, MacKay-Brandt, AReynolds, JApplication of a cognitive neuroscience perspective of cognitive control to late-life anxiety. J Anxiety Disord 2013; 27: 559–566.CrossRefGoogle ScholarPubMed
Levy, WCCerqueira, MDHarp, GDJohannessen, KAAbrass, IBSchwartz, RS, et al.Effect of endurance exercise training on heart rate variability at rest in healthy young and older men. Am J Cardiol 1998; 82: 1236–1241.CrossRefGoogle Scholar
Thayer, JFLane, RDA model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord 2000; 61: 201–216.CrossRefGoogle Scholar
Appelhans, BMLuecken, LJHeart rate variability as an index of regulated emotional responding. Rev Gen Psychol 2006; 10: 229–240.CrossRefGoogle Scholar
Wrzus, CMüller, VWagner, GGLindenberger, URiediger, MAffective and cardiovascular responding to unpleasant events from adolescence to old age: complexity of events matters. Dev Psychol 2013; 49: 384–397.CrossRefGoogle ScholarPubMed
Comijs, HCvan Marwijk, HWvan der Mast, RCNaarding, POude Voshaar, RCBeekman, AT, et al.The Netherlands Study of Depression in Older Persons (NESDO): a prospective cohort study. BMC Res Notes 2011;4:524.CrossRefGoogle Scholar
Comijs, HCNieuwesteeg, JKok, Rvan Marwijk, HWvan der Mast, RCNaarding, P, et al.The two-year course of late-life depression; results from the Netherlands Study of Depression in Older Persons. BMC Psychiatry 2015;15:20.CrossRefGoogle ScholarPubMed
Wittchen, HUReliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. J Psychiat Res 1994; 28: 57–84.CrossRefGoogle Scholar
Beck, ATBrown, GEpstein, NSteer, RAAn inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56: 893–897.CrossRefGoogle ScholarPubMed
Rush, AJGiles, DESchlesser, MAFulton, CLWeissenburger, JBurns, CThe Inventory for Depressive Symptomatology (IDS): preliminary findings. Psychiat Res 1986; 18: 65–87.CrossRefGoogle ScholarPubMed
Brugha, TBebbington, PTennant, CHurry, JThe list of threatening experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med 1985; 15: 189–194.CrossRefGoogle ScholarPubMed
Brugha, TCragg, DThe list of threatening experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatr Scand 1990; 82: 77–81.CrossRefGoogle ScholarPubMed
Wisocki, PAHanden, BMorse, CKThe Worry Scale as a measure of anxiety among homebound and community active elderly. Behav Ther 1986; 5: 91–95.Google Scholar
van der Veen, DCComijs, HCvan Zelst, WHSchoevers, RAOude Voshaar, RCDefining anxious depression in later life: a scaring heterogeneity in results. Am J Ger Psychiatr 2014; 22: 1375–1378.CrossRefGoogle ScholarPubMed
Stroop, JRStudies of interference in serial verbal reactions. J Exp Psychol 1935; 18: 643–662.CrossRefGoogle Scholar
Klein, MPonds, RWHoux, PJJolles, JEffect of test duration on age-related differences in Stroop interference. J Clin Exp Neuropsychol 1997; 19: 77–82.CrossRefGoogle ScholarPubMed
de Geus, EJWillemsen, GHKlaver, CHvan Doornen, LJAmbulatory measurement of respiratory sinus arrhythmia and respiration rate. Biol Psychol 1995; 41: 205–227.CrossRefGoogle ScholarPubMed
Licht, CMNaarding, PPenninx, BWvan der Mast, RCde Geus, EJComijs, HThe association between depressive disorder and cardiac autonomic control in adults 60 years and older. Psychosom Med 2015; 77: 279–291.CrossRefGoogle ScholarPubMed
Berntson, GGCacioppo, JTBinkley, PFUchino, BNQuigley, KSFieldstone, AAutonomic cardiac control. III. Psychological stress and cardiac response in autonomic space as revealed by pharmacological blockades. Psychophysiology 1994; 31: 599–608.CrossRefGoogle ScholarPubMed
Grossman, PKaremaker, JWieling, WPrediction of tonic parasympathetic cardiac control using respiratory sinus arrhythmia: the need for respiratory control. Psychophysiology 1991; 28: 201–216.CrossRefGoogle ScholarPubMed
Jung, TWickrama, KAn introduction to LCGA and GMM. Soc Pers Psychol Compass 2008; 2: 302–317.CrossRefGoogle Scholar
Nylund, KLAsparoutiov, TMuthen, BODeciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Struct Equ Modeling 2007; 14: 535–569.CrossRefGoogle Scholar
Licht, CMde Geus, EJvan Dyck, RPenninx, BWAssociation between anxiety disorders and heart rate variability in The Netherlands Study of Depression and Anxiety (NESDA). Psychosom Med 2009; 71: 508–518.CrossRefGoogle Scholar
IBM Corp IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp; 2013Google Scholar
Muthén, LKMuthén, BOMplus User's Guide, 7th ed., Los Angeles, CA: Muthen & Muthen; 1998–2012.Google Scholar
Schuurmans, JComijs, HCBeekman, ATde Beurs, EDeeg, DJEmmelkamp, PM, et al.The outcome of anxiety disorders in older people at 6-year follow-up: results from the Longitudinal Aging Study Amsterdam. Acta Psychiatr Scand 2005; 111: 420–428.CrossRefGoogle ScholarPubMed
Batelaan, NMRhebergen, DSpinhoven, Pvan Balkom, AJPenninx, BTwo-year course trajectories of anxiety disorders: do DSM classifications matter?. J Clin Psychiatr 2014; 75: 985–993.CrossRefGoogle ScholarPubMed
Spinhoven, PBatelaan, NRhebergen, Dvan Balkom, ASchoevers, RPenninx, BWPrediction of 6-year symptom course trajectories of anxiety disorders by diagnostic, clinical and psychological variables. J Anxiety Disord 2016; 44: 92–101.CrossRefGoogle ScholarPubMed
Borkovec, TDThe nature, functions, and origins of worry. In: Tallis, GCLDF editors. Worrying: perspectives on theory, assessment, and treatment New York: Wiley; 1994. p. 5–34.Google Scholar
Olatunji, BONaragon-Gainey, KWolitzky-Taylor, KBSpecificity of rumination in anxiety and depression: a multimodal meta-analysis. Clin Psychol 2013; 20: 225–257.Google Scholar
Ehring, TWatkins, ERRepetitive negative thinking as a transdiagnostic process. Int J Cogn Ther 2008; 1: 192–205.CrossRefGoogle Scholar
Brosschot, JFGerin, WThayer, JFThe perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and health. J Psychosom Res 2006; 60: 113–124.CrossRefGoogle ScholarPubMed
Spinhoven, PDrost, Jvan Hemert, BPenninx, BWCommon rather than unique aspects of repetitive negative thinking are related to depressive and anxiety disorders and symptoms. J Anxiety Disord 2015; 33: 45–52.CrossRefGoogle Scholar
Ionescu, DFNiciu, MJMathews, DCRichards, EMZarate, CA Jr.Neurobiology of anxious depression: a review. Depress Anxiety 2013; 30: 374–385.CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 5th ed., Washington, DC: APA; 2013.Google Scholar
Williams, JMMathews, AMacLeod, CThe emotional Stroop task and psychopathology. Psychol Bull 1996; 120: 3–24.CrossRefGoogle Scholar
Urry, HLGross, JJEmotion regulation in older age. Curr Dir Psychol Sci 2010; 19: 352–357.CrossRefGoogle Scholar
Charles, STStrength and vulnerability integration: a model of emotional well-being across adulthood. Psychol Bull 2010; 136: 1068–1091.CrossRefGoogle Scholar
Carstensen, LLIsaacowitz, DMCharles, STaking time seriously: a theory of socioemotional selectivity. Am Psychol 1999; 54: 165–181.CrossRefGoogle ScholarPubMed
aan het Rot, MHogenelst, KSchoevers, RAMood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies. Clin Psychol Rev 2012; 32: 510–523.CrossRefGoogle ScholarPubMed
Cain, AEDepp, CAJeste, DVEcological momentary assessment in aging research: a critical review. J Psychiat Res 2009; 43: 987–996.CrossRefGoogle Scholar
Kroeze, Rvan der Veen, DCServaas, MNBastiaansen, JAOude Voshaar, RRuhe, E, et al. Personalized feedback on symptom dynamics of psychopathology: a proof-of-principle study. J Person-Orient Res 2016 [in press].CrossRefGoogle Scholar
Hoge, EABui, EMarques, LMetcalf, CAMorris, LKRobinaugh, DJ, et al.Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatr 2013; 74: 786–792.CrossRefGoogle ScholarPubMed
Topper, MEmmelkamp, PMWatkins, EEhring, TPrevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: a randomized controlled trial. Behav Res Ther 2017; 90: 123–136.CrossRefGoogle Scholar
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