title: Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis.
abstract: BACKGROUND
  Anxiety is an aversive emotional state characterized by perceived uncontrollability and hypervigilance to threat that can frequently cause disruptions in higher-order cognitive processes like working memory. The attentional control theory (ACT) predicts that anxiety negatively affects the working memory system.
  
  
  METHODS
  This study tested the association between anxiety and working memory after the addition of stress and measured the glucocorticoid, cortisol. To better understand this relationship, we utilized a moderated mediation model.
  
  
  METHODS
  Undergraduate students from a public university (N = 103) self-reported their anxiety levels. Participants first completed a short-term memory test. During and after a forehead cold pressor task (stress vs. control procedure) participants completed a working memory test. Salivary cortisol was taken at baseline and after the last working memory test.
  
  
  RESULTS
  Overall, acute stress had no effect on working memory. However, we found that anxiety levels mediated the influence of condition (stressed vs. control) on working memory, but only among those individuals who had high cortisol levels after exposure to acute stress, supporting a moderated mediation model.
  
  
  CONCLUSIONS
  These results imply that activation of the hypothalamic-pituitary-adrenal axis was necessary for working memory impairment in anxious individuals. These results provide support for the ACT.
authors.affiliation: a Department of Psychology , California State University San Marcos , San Marcos , CA , 92096 , USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Hood
authors.forename: Kim
authors.initials: K
authors.lastname: Pulvers
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spady
authors.forename: Alexa
authors.initials: A
authors.lastname: Kliebenstein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bachand
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000378:metabolism* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism; D057566:Self Report; D013315:Stress, Psychological / Q000378:metabolism* / Q000503:physiopathology* / Q000523:psychology; D013334:Students / Q000523:psychology; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: ACT; BAI; bootstrapping; glucocorticoids; mediation; stress