Impaired Cognitive Control and Its
Relationship to Anxiety, Adaptive
Function, and Risk for
Psychopathology in Children with
22q11.2DS
Heather M. Shapiro, Andrea I. Quintero, Elliott A.
Beaton, Kathleen Angkustsiri, Ingrid Leckliter,
Janice Enriquez, & Tony J. Simon
Cognitive Analysis and Brain Imaging Lab
http://cabil.mindinstitute.org
tjsimon@ucdavis.edu
Funding: NIH 2R01HD04269 (Simon), K99MH086616 (Beaton), UC
Davis CEDD, UC Davis T32 MCRTP (Stoddard/Angkustsiri)
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Cognitive Control and Anxiety in 22q
•
Impairments in cognitive control are generally predictive
of schizophrenia.
•
Previous studies indicate that children with 22q are
impaired on tasks that measure cognitive control.
•
Anxiety and negative mood are also elevated in
children with 22q.
•
How might stress/anxiety modulate the etiopathology of
schizophrenia? What might be the relationship /
possible interactions of anxiety and cognitive control?
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2
Methods
Go/No-Go Response Inhibition
45 children with 22q11.2DS (7-14 years old, mean = 11.4) - data from 25 here
36 typical children (7-14 years old, mean = 10.6)
•
•
“Go” trials (75%): press a button as quickly as possible to “whack” the mole
“No-Go” trials (25%): do NOT press button to not “squash” the vegetable
•
Preceded by 1, 3, or 5 “Go” trials
5
3
1
•
Outcome measure: Percent accuracy on No-Go trials
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60
Results: Response Inhibition
Response inhibition:
40
100
80
60
40
Age
p=0.72)
100
80
60
40
TD
22q
20
0
7
8
9
10 11 12 13 14 15
Age
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No-Go Accuracy (%)
0
TD (r=0.35, p=0.04)*
22q-younger
22q (r=-0.05,
22q-older
TD-younger
7 TD-older
8 9 10 11 12 13 14 15
100
No-Go Accuracy (%)
20
22q-younger
22q-older
TD-younger
*TD-older
n/s
80
60
40
100
No-Go Accuracy (%)
80
No-Go Accuracy (%)
No-Go Accuracy (%)
100
3
22q-younger
22q-older
TD-younger
TD-older
80
60
40
4
60
Results: Response Inhibition
Response inhibition:
40
100
80
60
40
Age
p=0.72)
100
80
60
40
TD
22q
20
0
7
8
9
No-Go Accuracy (%)
0
TD (r=0.35, p=0.04)*
22q-younger
22q (r=-0.05,
22q-older
TD-younger
7 TD-older
8 9 10 11 12 13 14 15
100
No-Go Accuracy (%)
20
10 11 12 13 14 15
Age
22q-younger
22q-older
TD-younger
*TD-older
n/s
80
60
40
100
No-Go Accuracy (%)
80
No-Go Accuracy (%)
No-Go Accuracy (%)
100
22q-younger
22q-older
TD-younger
TD-older
80
60
40
Inhibition is impaired in children with 22q11.2DS, and performance is
more variable relative to typical children, especially in teenagers.
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Methods
Clinical/behavioral measures (n=25 in 22q group)
Anxiety
• Spence Children’s Anxiety Scale
• separation anxiety, social phobia, obsessive compulsive,
panic/agoraphobia, physical injury fears, generalized anxiety
Adaptive Function
• Adaptive Behavior Assessment System (ABAS) --
addresses 10 adaptive skills covering 3 domains:
• Conceptual:
• communication skills, functional academics, self-direction
Social:
•
• social skills, leisure skills
• Practical
• self-care, home or school living, community use, work, health and safety
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Results: Anxiety & Adaptive Function
Anxiety in ~60% of children
with 22q are at significant levels.
Adaptive functioning is unrelated
to intelligence but strongly related
to anxiety.
Does Cognitive Control follow
the Adaptive functioning/Anxiety
pattern?
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Results: Anxiety & Adaptive Function
Anxiety in ~60% of children
with 22q are at significant levels.
Adaptive functioning is unrelated
to intelligence but strongly related
to anxiety.
Does Cognitive Control follow
the Adaptive functioning/Anxiety
pattern?
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r -.41 p < 0.05
10
N(24)
r .45 p < 0.05
N(25)
120
8
ABAS: Self-care
Spence:Child (Physical Injury)
Results: Go/No-Go and Anxiety
100
80
60
6
4
2
40
0
20 40 60 80 100
Go No Go: Accuracy
40 60 80 100
Go No Go: Accuracy
(Average)
(Average)
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r -.41 p < 0.05
10
N(24)
r .45 p < 0.05
N(25)
120
8
ABAS: Self-care
Spence:Child (Physical Injury)
Results: Go/No-Go and Anxiety
100
80
60
6
4
2
40
0
20 40 60 80 100
Go No Go: Accuracy
40 60 80 100
Go No Go: Accuracy
(Average)
(Average)
No-Go accuracy correlates negatively with fear anxiety and correlates
positively with Scz prodome-relevant adaptive function measure.
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Conclusions
•
These results suggest that cognitive control and anxiety in
22q11.2DS might be related in a way that is functionally
significant for adaptive outcomes.
•
“Copers” with lower anxiety and higher adaptive scores
perform better on tasks in the schizophrenia endophenotype.
•
As part of a larger study, this investigation might help identify
Allostatic Load risk factors for conversion to schizophrenia
and lead to early diagnosis and preventive intervention.
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Thank You!
Tony Simon
Participants and families
Elliott Beaton
Kathy Angkustsiri
Janice Enriquez
Ingrid Leckliter
Andrea Quintero
Joshua Cruz
Margie Cabaral
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