Investigating the Interplay of Working Memory, Affective Symptoms, and Coping With Stress in Offspring of Parents With Huntington's Disease

Objective: The offspring of parents with Huntington's disease (HD) are faced with substantial levels of chronic uncontrollable and unpredictable stress. These stressors may place them at heightened risk of psychological distress and negative effects on executive functioning. This study investigated working memory, secondary control coping strategies (e.g., cognitive reappraisal, acceptance, distraction), and symptoms of anxiety/depression in offspring at risk for HD. Method: Adolescent (ages 10-19) and young adult (ages 20-29) offspring (n = 33; mean [M] age = 19.12 years, standard deviation [SD] = 6.01 years; 61% female) of parents with HD were recruited in a Huntington Disease Society of America Level 1 Center of Excellence. Participants completed self-report measures of coping and neuropsychiatric symptoms (i.e., anxiety, depression) and a standardized working memory assessment. Pearson correlations and path analyses were used to test associations. Results: Participant scores on the working memory assessment were significantly lower compared with normative data, and scores on a mixed anxiety/depression scale revealed a significant elevation compared with normative data. Working memory, secondary control coping, and symptoms of anxiety/depression were significantly correlated. Analyses of the full model revealed that the total indirect effect of working memory on anxiety/depression through secondary control coping was significant (β = −0.20). Conclusion: Secondary control coping skills are an important factor in understanding the relationship between working memory and symptoms of anxiety/depression in the offspring of parents with HD. Future longitudinal research is needed to establish the direction of these associations. Working memory and coping skills represent potential targets for intervention to reduce the risk of anxiety/depression in this population. Key Points Question: How are working memory and coping with stress related to symptoms of anxiety and depression in adolescent and young adult offspring of parents with Huntington's disease (HD)? Findings: Support was found for the indirect association of working memory with symptoms of anxiety and depression through secondary control coping (e.g., acceptance, cognitive reappraisal) in the offspring of parents with HD. Importance: Secondary control coping skills are an important factor in understanding the relationship between working memory and symptoms of anxiety and depression in the offspring of