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The latest research is showing that mental health problems of all kinds exact a cognitive price.  In a comprehensive meta-analysis of 97 studies across all of the mental health conditions defined in the Diagnostic and Statistical Manual of Mental Disorders (29 disorders), the association with cognitive dysfunction, a previously underappreciated effect, extended from simple conditions like “worry” to more severe conditions such as major depression. The study was published in Clinical Psychology Review in June 2021 and is based on data from over 200,000 individuals. The research team coined the term “C Factor” to refer to the negative cognitive impact of a wide range of mental health issues.

The C Factor appeared in the studies as poorer performance on cognitive tests or as a reduction in cognitive skills like attention and memory.

As Amital Abramovitch, the lead researcher on the study, explains, “We found that both diagnosable mental disorders, as well as some common symptoms such as anxiety and worry, carry a so-called ‘cognitive price.’ We termed this phenomenon ‘The C Factor’ – short for cognitive dysfunction. Our analysis suggests that it can be found across disorders and that it constitutes an integral part of poorer mental health.”

The effect of the C-Factor appears to be present even when an individual’s mental condition is not severe enough to lead to a diagnosis. For example, many people have depressive symptoms without meeting the criteria for major depressive disorder. Diminished cognitive functioning often accompanies these symptoms. One of the reasons this is so important is that while only about 20% of Americans will meet the criteria for major depression, almost two thirds will experience meaningful symptoms of depression, and therefore the C-Factor, at some point in their lives.

This does not mean that deficits in cognitive skills cause these diseases and disorders. But what it does suggest is that these diseases often result in or are accompanied by lowered cognitive functioning. The study did not clarify why so many different diseases and conditions entail cognitive dysfunction. That will likely be a subject for further research.

While the study did not address the potential for interventions to improve cognitive functioning, the potential for cognitive training to improve a variety of cognitive skills, whether associated with another mental health condition or not is getting increased attention.  For example, many children diagnosed with ADHD have experienced improvement in attention, working memory and other cognitive skills from cognitive training programs. While cognitive training doesn’t cure or treat ADHD, it often helps strengthen cognitive function leading to improvements in academic performance as well as greater success in everyday life.

Indeed, while strengthening cognitive skills may not, by itself, cure a mental illness, developing stronger skills typically reduces stress for children and adults. This is because it gives them more confidence in their ability to learn and engage in new learning situations successfully and more resilience in bouncing back from challenges.

In an issue brief presented by the Kennedy Forum entitled Fixing Behavioral Health Care in America: Promoting Brain Health and Brain Fitness: A National Call for Action, researchers said,

“Today we know that without interventions that directly address a child’s ability to learn and function in society, our current academic paradigm and process will continue to be less than effective. Neuroscience shows that brain fitness interventions can build higher-order processing skills, promote emotional resilience, and mitigate stress. These interventions interrupt and ameliorate many of the underlying neuro-developmental lags in children caused by the environmental stressors that thwart learning. In fact, many of the current adverse and economic conditions that almost half of our children are exposed to are likely due, in part, to the limitations our education system had in preparing their parents to succeed. Brain health and fitness interventions implemented across American education will benefit our nation’s children now and into the future and help close the academic achievement gap.

“Research over the past two decades illuminates the powerful opportunities that simple, targeted, effective brain fitness interventions offer. On the neuro-cognitive level, these interventions can shift the intrinsic dispositions, abilities, and capacities of children to help them cultivate the cognitive capacity, attention, and self-regulation needed to succeed both academically and in life.”

As the connection between mental health issues and lessened cognitive functioning becomes clearer, and as the incidence of mental health issues from minor stress to major disorders increases, the need for cognitive interventions is like to increase.


Read The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology

Read Fixing Behavioral Health Care in America: Promoting Brain Health and Brain Fitness: A National Call for Action

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