Mind the Mood: Momentary Depression and Anxiety Moderate the Correspondence between Subjective and Objective Cognitive Functioning in FM 2023 Kairys

Abstract

Objective
Subjective cognitive dysfunction (SCD) affects 55-75% of individuals with fibromyalgia (FM) but those reporting cognitive difficulties often lack corresponding objective deficits. Symptoms of depression and anxiety are prevalent in FM and may account for part of this discrepancy. We investigated whether momentary (within-day, across 7 days) changes in mood moderated the relationship between within-the-moment SCD and mental processing speed performance.

Methods
50 individuals with FM (mean age 44.8, mean education 15.7 years, 88% female, 86% White) completed momentary assessments of subjective cognitive functioning, depressive and anxious symptoms, and a test of processing speed. Assessments were completed 5X/day for 8 consecutive days on a study-specific smartphone application.

Results
Momentary ratings of SCD were positively associated with mean reaction time (p<0.001) and variability of processing speed; (p=0.02). Depressive symptoms moderated the relationship between SCD and processing speed, with lower correspondence when depressive symptoms were higher (p = 0.03). A similar moderating effect was shown for both depression (p = 0.02) and anxiety (p = 0.03) on the association between SCD and variability in processing speed performance.

Conclusion
Individuals with FM may be more accurate in their self-perception of momentary changes in mental processing speed during periods of less pronounced mood symptoms based on their corresponding objective processing speed performance. However, during moments of heightened depression and anxiety, we found increasingly less correspondence between SCD and objective performance, suggesting psychological symptoms may play an important role in self-perception of cognitive dysfunction in FM as it relates to mental processing speed.

Paywall, https://onlinelibrary.wiley.com/doi/10.1002/acr.25086

 

Not having access to the full text, here is my take:

Uh, how about cognitive dysfunction during a big flare-up? This study was done during only 8 consecutive days.

PwFM can have a number of consecutive days without a flare-up of symptoms. But this doesn't reflect what happens frequently during a flare:

When I am in a big flare-up, I could not possibly handle filling out any questionnaire, or if i managed to, it would be highly inaccurate due to the obvious cognitive deficits that I experience. If during a flare up (similar to PEM) someone texts me, it is an intrusion, as is email, voices, watching a video--all sensory input is noxious. I cannot respond to normal stimuli. Thinking clearly is impossible, is distorted, as are bodily sensations (very weird, those).

So the methods used in this research cannot accurately capture cognitive dysfunction experienced by PwFM. There seems to be bias in the selection process of subjects. Was it a convenience sample? Recruited how?

Also, importantly, did they parse categories of FM, (mild FM, moderate, or severe). The more severe, the more present and persistent the cognitive dysfunction. Good research into FM always uses these severity categories.

 

So people have a lower opinion of their own abilities when they're in a bad mood? What a waste of money. People with FM need basic and translational biomedical research that will yield new treatments, not psychosocial frittering.