SPOILER ALERT! ~ Childhood anxiety is associated with cognitive deficits, particularly with language, attention and memory ~ The degree of severity of the anxiety disorder determines the level of cognitive deficits. ~ Children with more than one anxiety disorders fare worst in tasks testing memory and language ~ Anxiety disorders, memory & language deficits, and children’s academic performance are all linked together. ~ Children with anxiety disorders do not memorize information accurately and efficiently due to impaired information processing during the first phase of memory formation (i.e., coding phase).
Anxiety disorders are frequently associated with cognitive impairments, and particularly attention deficits. There is now evidence that childhood anxiety is similarly linked to cognitive skills.
Cognitive Impairments with Childhood Anxiety Disorders
Childhood anxiety disorders often follow a chronic course and are characterized by considerable impairments and dysfunction. For example studies found that in children with trait anxiety (i.e., anxiety is a character trait), poor academic performance is related to deficits in verbal working memory (i.e., the component of memory that we use to remember a phone number, a lesson, or to do math, etc…).
Indeed, there is evidence that childhood anxiety is associated with impairments in verbal fluency and attention. For example a study found that compared to non-anxious children, those with an anxiety disorder had higher deficits in verbal fluency (an example of a verbal fluency task is to name as many animals as possible during one minute).
Similarly, poor working memory is consistently reported in pediatric anxiety disorders. Working memory involves the capacity to store and maintain phonological and visuospatial information as well as manipulating temporary information. The current study provides evidence that children with more severe anxiety disorders display more deficits in working memory than those with less severe anxiety.
Cognitive Deficits Associated with Severity of Anxiety Disorders
More importantly, the present findings support the hypothesis that severity of childhood anxiety determines the level of cognitive deficits. For example, the results show that severely anxious children did worst in tests of visuospatial memory (e.g., pointing out squares in the inverse order in which they were presented), semantic memory (e.g., oral recall of 9 words that were listed a few minutes before), and oral and written language.
Performance in those tests was further decreased in children with two or more anxiety disorders, especially in episodic memory (e.g., immediate recall of words presented beforehand), oral language (e.g., identify two words that rhyme), and written language (e.g., reading comprehension). Interestingly, it was suggested that these memory deficits occur during the encoding phase, which is the first step in memory formation, and which indicates that children with anxiety disorder fail to process new information accurately.
It is noteworthy to add that the direction of the association between anxiety disorders and language deficits is still a point of contention. Arguably, children with reading disabilities could potentially develop anxiety disorders, which would make language deficits the primary factor in the child’s poor academic performance instead of the anxiety disorder. Perhaps, the cognitive deficits displayed by those children are not specific to anxiety disorders and thus may be present in other psychopathologies.
Sbicigo, J. B., Toazza, R., Becker, N., Ecker, K., Manfro, G. G., & Salles, J. F. d. (2020). Memory and language impairments are associated with anxiety disorder severity in childhood. Trends in Psychiatry and Psychotherapy, 42(2), 161–170. https://doi.org/10.1590/2237-6089-2019-0051