Anxiety, worry, and difficulty concentrating: Examining concurrent and prospective symptom relationships in the context of the COVID-19 pandemic

Difficulty concentrating is an understudied cognitive phenomenon, despite its status as a diagnostic criterion for generalized anxiety disorder and contributor to clinically significant distress and impairment. Worry may constitute a cognitive mechanism by which anxiety leads to difficulty concentrating. The present study examined concurrent and prospective associations between self-reported anxiety, worry, and subjective difficulty concentrating across three timepoints (T1 April/May, T2 July/August, T3 October/November 2020) in 198 adults (M age = 37.94, SD = 13.42; 81% women, 2% gender minority) drawn from a larger study of trajectories of psychopathology during the COVID-19 pandemic. In multilevel models, anxiety was associated with worry both between (β = 0.65, SE = 0.13) and within participants (β = 0.12, SE = 0.11). Difficulty concentrating was also associated with worry between (β = 0.38, SE = 0.03) and within participants (β = 0.09, SE = 0.02). In a structural equation model, worry partially mediated the longitudinal association between anxiety and difficulty concentrating, though this effect did not survive the addition of covariates including depression. The unadjusted mediation, and these other findings are in line with theoretical accounts of worry as a cognitive mechanism linking anxiety to subjective attentional problems.