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

• Published in: Psychological medicine Vol. 40; no. 7; pp. 1101 - 1111
• Main Authors: Glashouwer, K. A., de Jong, P. J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.07.2010
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Anxiety; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Anxiety disorders. Neuroses; Anxiety-Depression; automatic associations; Automatism; Biological and medical sciences; Cognition & reasoning; Cognitive theories; Cohort Studies; Comorbidity; Depression; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Female; Follow-Up Studies; Humans; IAT; Implicit beliefs; Male; Medical sciences; Mental depression; Middle Aged; Miscellaneous; Mood disorders; Netherlands; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Concept; Self image; Selfschemata; Severity of Illness Index; Surveys and Questionnaires; Theory; Word Association Tests; Young Adult; Netherlands; Europe; Anxiety; depression; automatic associations; IAT; Mood disorder; Social environment; Human; Multicenter study; Implicit Association Test Greenwald et al; Mental health; Anxiety disorder; Cognitive schema; Associative relation; Psychometrics; Depression; Cognition; Self association; Follow up study; Cohort study; Public health
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291709991371

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. 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. 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. 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.