title: Positive and negative affect, depression, and cognitive processes in the Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR) Trial.
abstract: OBJECTIVE
  This study examined the relationship between positive and negative affect, depressive symptoms, and cognitive performance.
  
  
  METHODS
  The sample consisted of 1479 non-demented, postmenopausal women (mean age = 67 years) at increased risk of breast cancer enrolled in the National Surgical Adjuvant Breast and Bowel Project's Study of Tamoxifen and Raloxifene. At each annual visit, women completed a standardized neuropsychological battery and self-report measures of affect and depression. Data from three visits were used in linear mixed models for repeated measures using likelihood ratio tests. Separate analyses were performed to relate positive/negative affect and depression to each cognitive measure.
  
  
  RESULTS
  Higher positive affect was associated with better letter fluency (p = .006) and category fluency (p < .0001). Higher negative affect was associated with worse global cognitive function (p < .0001), verbal memory (CVLT List B; p = .002), and spatial ability (p < .0001). Depressive symptoms were negatively associated with verbal knowledge (p = .004), figural memory (p < .0001), and verbal memory (p's ≤ .0001).
  
  
  CONCLUSIONS
  Findings are consistent with some prior research demonstrating a link between positive affect and increased verbal fluency and between depressive symptoms and decreased memory. The most novel finding shows that negative affect is related to decreased global cognition and visuospatial ability. Overall, this research in a large, longitudinal sample supports the notion that positive affect is related to increases and negative affect to decreases in performance on distinct cognitive measures.
authors.affiliation: Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA. danhauer@wakehealth.edu
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Danhauer
authors.forename: Claudine
authors.initials: C
authors.lastname: Legault
authors.forename: Hanna
authors.initials: H
authors.lastname: Bandos
authors.forename: Kelley
authors.initials: K
authors.lastname: Kidwell
authors.forename: Joseph
authors.initials: J
authors.lastname: Costantino
authors.forename: Leslie
authors.initials: L
authors.lastname: Vaughan
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Avis
authors.forename: Steve
authors.initials: S
authors.lastname: Rapp
authors.forename: Laura H
authors.initials: LH
authors.lastname: Coker
authors.forename: Michelle
authors.initials: M
authors.lastname: Naughton
authors.forename: Cecile
authors.initials: C
authors.lastname: Naylor
authors.forename: Antonio
authors.initials: A
authors.lastname: Terracciano
authors.forename: Sally
authors.initials: S
authors.lastname: Shumaker
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D003071:Cognition; D003863:Depression; D005260:Female; D006801:Humans; D017698:Postmenopause; D020849:Raloxifene Hydrochloride / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D013629:Tamoxifen; D020849:Raloxifene Hydrochloride