Altered Relationships between Cognitive Functions and Narrative Speech in Depressive and Generalized Anxiety Disorder

<title>Abstract</title> <p>Depressive and generalized anxiety disorder are associated with cognitive impairments affecting language and memory. Narrative speech may reflect underlying cognitive disruptions, suggesting that cognitive-linguistic measures could inform future research on intervention targets. This study compared relationships between cognitive functions (autobiographical memory, cognitive flexibility, working memory, problem-solving, attentional control) and narrative production across depressive, anxiety, and healthy groups. A cross-sectional study assessed 321 participants: depressive disorder (n = 146), anxiety disorder (n = 105), and healthy controls (n = 70). Diagnosis was confirmed using SCID-5. Participants completed cognitive tasks and two narrative tasks (picture description, autobiographical memory recall). Narrative responses were transcribed and analyzed across 14 linguistic features. Data were analyzed using multivariate statistics and structural equation modeling. The depressive group showed the greatest impairments in cognition and narrative coherence, followed by the anxiety group. Healthy controls performed best across all domains. Autobiographical memory strongly predicted narrative variables in healthy individuals, but this association was reduced in clinical groups. Narrative coherence, lexical cohesion, and sentence complexity were significantly linked to cognitive flexibility and memory across groups. The relationship between cognition and narrative speech is disrupted in depressive disorder and, to a lesser extent, in anxiety disorder. These findings highlight disrupted cognitive-linguistic integration in clinical groups, suggesting potential targets for cognitive remediation and clarifying cognitive mechanisms underlying language impairments in these disorders.</p>