Disorder-specific automatic self-associations in depression and anxiety: results of The Netherlands Study of Depression and Anxiety

2009 ◽  
Vol 40 (7) ◽  
pp. 1101-1111 ◽  
Author(s):  
K. A. Glashouwer ◽  
P. J. de Jong

BackgroundCognitive theory points to the importance of negative self-schemas in the onset and maintenance of depression and anxiety disorders. Hereby, it is important to distinguish between automatic and explicit self-schemas, reflecting different cognitive-motivational systems. This study tested whether patients with a current major depression and/or anxiety disorder are characterized by automatic self-anxious and self-depressive associations and whether these associations are disorder specific.MethodPatients (n=2329) and non-clinical controls (n=652) were tested as part of The Netherlands Study of Depression and Anxiety, a multi-center, longitudinal, cohort study with patients from different health care settings. Patient groups and non-clinical controls (18–65 years of age) were compared with regard to automatic self-anxious and self-depressive associations measured with the Implicit Association Test.ResultsIndividuals with an anxiety disorder showed enhanced self-anxious associations, whereas individuals with a depression showed enhanced self-depressive associations. Individuals with co-morbid disorders scored high on both automatic self-associations. Although remitted individuals showed weaker automatic self-associations than people with a current disorder, their automatic self-anxious/depressed associations were still significantly stronger than those of the control group. Importantly, automatic self-associations showed predictive validity for the severity of anxious and depressive symptoms over and above explicit self-beliefs.ConclusionsThis study represents the first evidence that automatic self-anxious and self-depressive associations are differentially involved in anxiety disorders and depression. This may help to explain the refractoriness of these disorders and points to the potential importance of automatic self-associations in the development of psychopathological symptoms.

2020 ◽  
pp. 1-10 ◽  
Author(s):  
R. A. Schoevers ◽  
C. D. van Borkulo ◽  
F. Lamers ◽  
M.N. Servaas ◽  
J. A. Bastiaansen ◽  
...  

Abstract Background There is increasing interest in day-to-day affect fluctuations of patients with depressive and anxiety disorders. Few studies have compared repeated assessments of positive affect (PA) and negative affect (NA) across diagnostic groups, and fluctuation patterns were not uniformly defined. The aim of this study is to compare affect fluctuations in patients with a current episode of depressive or anxiety disorder, in remitted patients and in controls, using affect instability as a core concept but also describing other measures of variability and adjusting for possible confounders. Methods Ecological momentary assessment (EMA) data were obtained from 365 participants of the Netherlands Study of Depression and Anxiety with current (n = 95), remitted (n = 178) or no (n = 92) DSM-IV defined depression/anxiety disorder. For 2 weeks, five times per day, participants filled-out items on PA and NA. Affect instability was calculated as the root mean square of successive differences (RMSSD). Tests on group differences in RMSSD, within-person variance, and autocorrelation were performed, controlling for mean affect levels. Results Current depression/anxiety patients had the highest affect instability in both PA and NA, followed by remitters and then controls. Instability differences between groups remained significant when controlling for mean affect levels, but differences between current and remitted were no longer significant. Conclusions Patients with a current disorder have higher instability of NA and PA than remitted patients and controls. Especially with regard to NA, this could be interpreted as patients with a current disorder being more sensitive to internal and external stressors and having suboptimal affect regulation.


2007 ◽  
Vol 41 (10) ◽  
pp. 836-842 ◽  
Author(s):  
Jane Phillips ◽  
Louise Sharpe ◽  
Stephen Matthey

Objective: Depression and anxiety are known to be common among women presenting to residential mother–infant programmes for unsettled infant behaviour but most studies have used self-report measures of psychological symptomatology rather than diagnostic interviews to determine psychiatric diagnoses. The aim of the present study was to determine rates of depressive and anxiety disorders and rates of comorbidity among clients of the Karitane residential mother–infant programme for unsettled infant behaviour. Method: One hundred and sixty women with infants aged 2 weeks–12 months completed the Edinburgh Postnatal Depression Scale and were interviewed for current and lifetime history of depressive and anxiety disorders using the Structured Clinical Interview for DSM-IV diagnosis (Research version). Results: A total of 25.1% of the sample met criteria for a current diagnosis of major depression, 31.7% had met criteria for major depression since the start of the pregnancy, and 30.5% of clients met criteria for a current anxiety disorder. Of note were the 21.6% who met criteria for generalized anxiety disorder or anxiety disorder not otherwise specified (worry confined to the topics of the baby or being a mother). High levels of comorbidity were confirmed in the finding that 60.8% of those with an anxiety disorder had experienced major or minor depression since the start of their pregnancy and 46.3% of those who had experienced depression since the start of their pregnancy also met criteria for a current anxiety disorder. Conclusions: There are high levels of psychiatric morbidity among clients attending residential mother–infant units for unsettled infant behaviour, highlighting the importance of providing multifaceted interventions in order to address both infant and maternal psychological issues.


2009 ◽  
Vol 71 (5) ◽  
pp. 508-518 ◽  
Author(s):  
Carmilla M. M. Licht ◽  
Eco J. C. de Geus ◽  
Richard van Dyck ◽  
Brenda W. J. H. Penninx

2015 ◽  
Vol 27 (4) ◽  
pp. 383-389 ◽  
Author(s):  
Nazan Kaymaz ◽  
Emel Sarı Gökten ◽  
Mehmet Erdem Uzun ◽  
Şule Yıldırım ◽  
Mustafa Tekin ◽  
...  

Abstract Objective: This study aims to investigate whether anxiety disorders in adolescents have a link with the separation time of bed/bedroom sharing with parents. It also aims to raise awareness in society about the issue of minimizing anxiety disorders in childhood. Methods: A case-control study was conducted in Şevket Yılmaz Training and Research Hospital between June 2013 and May 2014. The participants included 51 adolescents who were diagnosed as generalized anxiety disorder (GAD) with no-comorbidity and 71 healthy adolescents as the control group, who were chosen randomly. Diagnosis of GAD was based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed) by child and adolescent psychiatry doctors. The Turkish version of the State-Trait Anxiety Inventory (STAI) was used for the control group. A special survey about demographics and bed-sharing statements was constructed for the purpose of the study. The groups were analyzed in terms of duration of co-sleeping (bed-sharing) and rooming-in (keeping the mother and the baby in same room) with parents during infancy and the development of anxiety disorders in later period. Results: Mean duration of rooming-in was significantly longer in the case group than in the control group (p=0.009). Similarly, mean duration of co-sleeping in the case group was longer than that of the control group. However, this difference was not statistically significant (p=0.529). Conclusion: Sleeping in the same room with children for a long time may result in anxiety disorders in later period due to possible difficulties in bonding and/or less self-confidence.


Author(s):  
Tetiana Tolstaia

In recent years, reports from international organizations have focused on the mental health of internally displaced persons and the provision of timely medical care. Involuntary resettlement is accompanied by transformation of the entire system of socio- psychological relations, including interpersonal, family, parental, labor and leads to a significant strain on pathopsychological mechanisms, which ultimately contributes to the formation of anxiety disorders. In examined patients from main group, along with mood depression and anxiety, there were various fears and anxieties, asthenic manifestations and autonomic paroxysms, as well as against the background of anxious symptoms, they noted presence of isolated obsessive fears, closely related to anxious thinking about assessments in the eyes of others, short-term violent reactions to minor emotional events, mismatch of the strength of emotional reactions to the situation. At the same time, patients of the control group showed sensitization to external stimuls, especially during sleep and in the process of falling asleep.


2013 ◽  
Vol 43 (5) ◽  
pp. 562-577 ◽  
Author(s):  
Donna L. Ewing ◽  
Jeremy J. Monsen ◽  
Ellen J. Thompson ◽  
Sam Cartwright-Hatton ◽  
Andy Field

Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efficacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efficacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety disorder. An electronic search was conducted using the following databases: ASSIA, Cochrane Controlled Trials Register, Current Controlled Trials, Medline, PsycArticles, PsychInfo, and Web of Knowledge. The search terms included “anxiety disorder(s)”, “anxi*”, “cognitive behavio*, “CBT”, “child*”, “children”, “paediatric”, “adolescent(s)”, “adolescence”, “youth” and “young pe*”. The studies identified from this search were screened against the inclusion and exclusion criteria, and 20 studies were identified as appropriate for inclusion in the current meta-analysis. Pre- and posttreatment (or control period) data were used for analysis. Results: Findings indicated significantly greater odds of anxiety remission from pre- to posttreatment for those engaged in the transdiagnostic CBT intervention compared with those in the control group, with children in the treatment condition 9.15 times more likely to recover from their anxiety diagnosis than children in the control group. Risk of bias was not correlated with study effect sizes. Conclusions: Transdiagnostic CBT seems effective in reducing symptoms of anxiety in children and young people. Further research is required to investigate the efficacy of CBT for children under the age of 6.


Author(s):  
Sævar M. Gústavsson ◽  
Paul M. Salkovskis ◽  
Jón F. Sigurðsson

Abstract Background: Generalised anxiety disorder (GAD) has been an uneasy member of the anxiety disorders group since its inclusion in the third edition of the DSM. Multiple theories and treatment protocols for GAD and its defining symptom, excessive worry, have comparable efficacy in treating GAD symptoms. Crucially, these theories of GAD and excessive worry fail to explain when and why worry is excessive and when it is adaptive. Aims: In this paper we propose a cognitive behavioural account of the difference between excessive and adaptive states of worry and explore the theme of threat and the function of safety-seeking behaviours as seen in GAD. Specifically, we incorporate the concept of inflated responsibility in a cognitive behavioural analysis of threat appraisal and safety-seeking behaviours in excessive worry and GAD. Conclusion: It is proposed that when worry is used as a strategy intended to increase safety from perceived social or physical threat then it should be conceptualised as a safety-seeking behaviour. However, when worry is used as a strategy to solve a problem which the person realistically can resolve or to deal explicitly with the feeling of anxiety then it functions as an adaptive coping behaviour. We also propose that the theme of threat in GAD centres on an inflated sense of responsibility for external everyday situations, and the function of safety-seeking behaviours is to attain certainty that responsibility has been fulfilled. The clinical implications of this cognitive behavioural analysis of excessive worry are discussed, as well as future research directions.


2011 ◽  
Vol 26 (S2) ◽  
pp. 138-138
Author(s):  
A. Bener

AimTo determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.DesignA cross sectional.SettingPrimary health care center, QatarSubjectsA total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.MethodsThe study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.ResultsThe overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 1834 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).ConclusionThe depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.


2016 ◽  
Vol 33 (S1) ◽  
pp. s219-s219
Author(s):  
C. Black ◽  
M. Bot ◽  
P. Scheffer ◽  
B. Penninx

IntroductionOxidative stress has been implicated in the pathophysiology of depression and anxiety disorders and may be influenced by antidepressant use.ObjectivesThis study investigated the association of oxidative stress, measured by plasma levels of F2-isoprostanes and 8-hydroxy-2′-deoxyguanosine (8-OHdG), reflecting oxidative lipid and DNA damage respectively, with major depressive disorder (MDD), generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressant use in a large cohort.MethodsData was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1641) or remitted (n = 610) MDD and/or anxiety disorder(s) (of which n = 709 antidepressant users) and 633 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Plasma 8-OHdG and F2-isoprostanes were measured using UHPLC-MS/MS. ANCOVA was performed adjusting for sampling, sociodemographic, health and lifestyle variables.ResultsF2-isoprostanes did not differ between controls and patients, or by antidepressant use. Patients (current or remitted) using antidepressants had lower 8-OHdG (adjusted mean 38.3 pmol/L) compared to patients (current or remitted) without antidepressants (44.7 pmol/L) and controls (44.9 pmol/L, P < 0.001; Cohen's d 0.26). Findings for 8-OHdG were similar over all disorders and all antidepressant types (SSRIs, TCAs, SNRIs; P < 0.001).ConclusionContrary to previous findings this large-scale study did not find increased oxidative stress measured by F2-isoprostanes or 8-OHdG in MDD or anxiety disorders. 8-OHdG levels were lower in antidepressant users, which suggests antidepressants may have antioxidant properties.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2010 ◽  
Vol 41 (1) ◽  
pp. 129-139 ◽  
Author(s):  
A. Taylor-Clift ◽  
B. H. Morris ◽  
J. Rottenberg ◽  
M. Kovacs

BackgroundWhile anxiety has been associated with exaggerated emotional reactivity, depression has been associated with blunted, or context insensitive, emotional responding. Although anxiety and depressive disorders are frequently co-morbid, surprisingly little is known about emotional reactivity when the two disorders co-occur.MethodWe utilized the emotion-modulated startle (EMS) paradigm to examine the effects of a concurrent depressive episode on emotional reactivity in young adults with anxiety disorders. Using an archival dataset from a multi-disciplinary project on risk factors in childhood-onset depression, we examined eye-blink startle reactions to late-onset auditory startle probes while participants viewed pictures with affectively pleasant, unpleasant and neutral content. EMS response patterns were analyzed in 33 individuals with a current anxiety (but no depressive) disorder, 24 individuals with a current anxiety disorder and co-morbid depressive episode and 96 healthy controls.ResultsControl participants and those with a current anxiety disorder (but no depression) displayed normative linearity in startle responses, including potentiation by unpleasant pictures. By contrast, individuals with concurrent anxiety and depression displayed blunted EMS.ConclusionsAn anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).


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