Abstract
Background. Cognitive 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.
Method. Patients (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.
Results. Individuals 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.
Conclusions. This 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.
Original language | English |
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Pages (from-to) | 1101-1111 |
Number of pages | 11 |
Journal | Psychological Medicine |
Volume | 40 |
Issue number | 7 |
DOIs | |
Publication status | Published - Jul-2010 |
Keywords
- Anxiety
- automatic associations
- depression
- IAT
- INTERNATIONAL DIAGNOSTIC INTERVIEW
- COGNITIVE VULNERABILITY
- PSYCHOMETRIC PROPERTIES
- INDIVIDUAL-DIFFERENCES
- PERSONALITY-DISORDER
- IMPLICIT COGNITION
- EXPLICIT ATTITUDES
- SOCIAL PHOBIA
- COMORBIDITY
- RELIABILITY