title: THE IMPACT OF LATE-LIFE ANXIETY AND DEPRESSION ON COGNITIVE FLEXIBILITY AND COGNITIVE RESTRUCTURING SKILL ACQUISITION.
abstract: BACKGROUND
  Studies examining treatment moderators and mediators in late-life anxiety and depression are sparse. Executive functioning skills decrease with age, and are poorer in the context of anxiety and depression. One of the key cognitive behavioral therapy techniques for anxiety and depression is cognitive restructuring (CR), which teaches people to identify and dispute maladaptive thoughts. There is evidence that cognitive flexibility (CF), one aspect of executive functioning, has a negative impact on CR skill acquisition in nonclinical older adults, and this warrants extension in a clinical sample.
  
  
  METHODS
  This study assessed CR skill acquisition in a clinical sample of 47 older adults with anxiety and depression and 53 nonclinical controls during an experimental paradigm, and investigated the influence of CF on this relationship. A battery of neuropsychological tests assessing CF were administered and CR was learned during a brief intervention.
  
  
  RESULTS
  The clinical sample showed poorer CF on some measures, as well as poorer CR quality and efficacy (reduction in subjective distress). CF partially mediated the relationship between clinical status and CR quality, and between clinical status and CR efficacy.
  
  
  CONCLUSIONS
  These results provide preliminary evidence that older adults with anxiety and depression are worse at learning and benefiting from CR with a brief intervention and this is partially due to having poorer CF skills. These findings warrant further examination in a treatment context to assess whether CR skill acquisition improves over treatment.
authors.affiliation: Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.
authors.forename: Carly
authors.initials: C
authors.lastname: Johnco
authors.affiliation: Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.
authors.forename: Viviana M
authors.initials: VM
authors.lastname: Wuthrich
authors.affiliation: Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Rapee
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D013850:Thinking
keywords: aging; cognitive restructuring; cognitive therapy; executive function