Co-occurrence of social anxiety and depression symptoms in adolescence: Differential links with implicit and explicit self-esteem?

P. J. de Jong*, B. E. Sportel, E. de Hullu, M. H. Nauta

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

89 Citations (Scopus)


Background. Social anxiety and depression often co-occur. As low self-esteem has been identified as a risk factor for both types of symptoms, it may help to explain their co-morbidity. Current dual process models of psychopathology differentiate between explicit and implicit self-esteem. Explicit self-esteem would reflect deliberate self-evaluative processes whereas implicit self-esteem would reflect simple associations in memory. Previous research suggests that low explicit self-esteem is involved in both social anxiety and depression whereas low implicit self-esteem is only involved in social anxiety. We tested whether the association between symptoms of social phobia and depression can indeed be explained by low explicit self-esteem, whereas low implicit self-esteem is only involved in social anxiety.

Method. Adolescents during the first stage of secondary education (n = 1806) completed the Revised Child Anxiety and Depression Scale (RCADS) to measure symptoms of social anxiety and depression, the Rosenberg Self-Esteem Scale (RSES) to index explicit self-esteem and the Implicit Association Test (IAT) to measure implicit self-esteem.

Results. There was a strong association between symptoms of depression and social anxiety that could be largely explained by participants' explicit self-esteem. Only for girls did implicit self-esteem and the interaction between implicit and explicit self-esteem show small cumulative predictive validity for social anxiety, indicating that the association between low implicit self-esteem and social anxiety was most evident for girls with relatively low explicit self-esteem. Implicit self-esteem showed no significant predictive validity for depressive symptoms.

Conclusions. The findings support the view that both shared and differential self-evaluative processes are involved in depression and social anxiety.

Original languageEnglish
Pages (from-to)475-484
Number of pages10
JournalPsychological Medicine
Issue number3
Publication statusPublished - Mar-2012


  • Adolescence
  • anxiety
  • automatic associations
  • depression
  • implicit association test
  • implicit self-esteem

Cite this