Neurophysiological evidence for goal‐directed attentional control dysfunction in generalized anxiety disorder

Abstract Attentional control theory posits that anxiety disrupts goal‐directed attentional system; however, its neurophysiological mechanisms in generalized anxiety disorder (GAD) remain unclear. This study investigated two core operations of the goal‐directed attentional system in GAD—inhibition and shifting—by characterizing their behavioral and neurophysiological correlates. Twenty‐four patients with GAD and 28 healthy controls completed the Attentional Control Scale (ACS) and performed Go/No‐Go and more‐odd shifting tasks whereas behavioral performance and 64‐channel EEG were recorded. ACS scores indicated significantly lower total and subscale scores in GAD, whereas behavioral performance revealed higher inverse efficiency, reflecting reduced attentional control and processing efficiency. During the Go/No‐Go task, GAD patients showed attenuated NoGo‐N2 and NoGo‐P3 amplitudes, indicating impaired neural subprocesses underlying response inhibition. During the more‐odd shifting task, GAD patients exhibited reduced theta power and weakened theta–gamma coupling (TGC), reflecting disrupted neural coordination supporting cognitive flexibility. Furthermore, anxiety severity was significantly correlated with behavioral performance, NoGo‐N2 and NoGo‐P3 amplitudes, and TGC. These results indicate that greater anxiety severity is associated with impaired inhibitory control, reduced attentional resources, and disrupted neural oscillatory dynamics. Elucidating these deficits may inform the development of targeted interventions aimed at enhancing cognitive control in GAD.