Executive functioning in Huntington’s Disease and Major Depressive Disorder: Moderators and associations with emotion regulation

Abstract

Elucidating disorder- and domain-specific deficits within psychiatric and medically ill populations is a primary focus in the field of neuropsychology. Comparing overlapping and distinct patterns of cognitive functioning across psychiatric disorders may improve our understanding of brain–behavior relationships and either support or challenge existing diagnostic boundaries. Executive functioning (EF) has been proposed as a transdiagnostic factor underlying risk for psychopathology, and EF is important for dealing with stress and negative emotions that accompany many psychiatric disorders. The present study compared EF impairments using a common methodology and shared metrics in two samples affected by psychiatric disorders: adults with Huntington’s disease (HD; n = 82; 58.5% female, M age = 42.17 ± 12.43 years; 97.6% White) and adults with a history of major depressive disorder (MDD; n = 105; 89.3% female, M age = 42.77 ± 6.33 years; 70.5% White, 9.5% Black/African American, 10.5% Multiracial). Results indicated that individuals with HD are at risk for impairments equal to or greater than one standard deviation below the normative mean across core domains of EF (inhibitory control, working memory, shifting). Individuals with a history of MDD evidenced much lower risk for EF impairments compared to normative data and outperformed individuals with HD on all three domains of EF. Between-group differences remained after accounting for current depression symptom, and relatively low inhibitory control scores drove within-group differences. Results did not provide support for EF domains and processing speed entered simultaneously as predictors of secondary control coping. Findings suggest that individuals with HD may benefit from interventions targeting all core EFs, but that EFs may not be a primary target of intervention for individuals remitted from depression.