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

Published online by Cambridge University Press:  08 October 2009

K. A. Glashouwer  and
P. J. de Jong
K. A. Glashouwer*
Affiliation:
Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
P. J. de Jong
Affiliation:
Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
*
*Address for correspondence: K. A. Glashouwer, M.Sc., Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1.9712 TSGroningen, The Netherlands. (Email: k.a.glashouwer@rug.nl)
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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.

Keywords

Anxietyautomatic associationsdepressionIAT
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 7 , July 2010 , pp. 1101 - 1111
Copyright
Copyright © Cambridge University Press 2009

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References

APA (2001). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychiatric Association: Washington, DC.Google Scholar
Asendorpf, JB, Banse, R, Mücke, D (2002). Double dissociation between implicit and explicit personality self-concept: the case of shy behavior. Journal of Personality and Social Psychology 83, 380–393.CrossRefGoogle ScholarPubMed
Beck, AT, Epstein, N, Brown, G, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893–897.CrossRefGoogle ScholarPubMed
Beevers, CG (2005). Cognitive vulnerability to depression: a dual process model. Clinical Psychology Review 25, 975–1002.CrossRefGoogle ScholarPubMed
Brauer, M, de Jong, PJ, Huijding, J, Laan, E, Kuile, MM (2009). Automatic and deliberate affective associations with sexual stimuli in women with superficial dyspareunia. Archives of Sexual Behaviour 38, 486–497.CrossRefGoogle ScholarPubMed
Bruce, SE, Yonkers, KA, Otto, MW, Eisen, JL, Weisberg, RB, Pagano, M, Shea, MT, Keller, MB (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. American Journal of Psychiatry 162, 1179–1187.CrossRefGoogle ScholarPubMed
Clark, DA, Beck, AT, Alford, BA (1999). Scientific Foundations of Cognitive Theory and Therapy of Depression. John Wiley & Sons Inc: Hoboken, NJ, USA.Google Scholar
de Houwer, J (2002). The Implicit Association Test as a tool for studying dysfunctional associations in psychopathology: strengths and limitations. Journal of Behavior Therapy and Experimental Psychiatry 33, 115–133.CrossRefGoogle ScholarPubMed
de Houwer, J (2006). What are implicit measures and why are we using them? In Handbook of Implicit Cognition and Addiction (ed. Wiers, R. W. and Stacy, A. W.), pp. 11–28. Sage Publications, Inc: Thousand Oaks, CA, USA.CrossRefGoogle Scholar
de Jong, PJ, van den Hout, MA, Rietbroek, H, Huijding, J (2003). Dissociations between implicit and explicit attitudes toward phobic stimuli. Cognition & Emotion 17, 521–545.CrossRefGoogle ScholarPubMed
de Raedt, R, Schacht, R, Franck, E, De Houwer, J (2006). Self-esteem and depression revisited: implicit positive self-esteem in depressed patients? Behaviour Research and Therapy 44, 1017–1028.CrossRefGoogle ScholarPubMed
Egloff, B, Schmukle, SC (2002). Predictive validity of an implicit association test for assessing anxiety. Journal of Personality and Social Psychology 83, 1441–1455.CrossRefGoogle ScholarPubMed
Fiedler, K, Messner, C, Bluemke, M (2006). Unresolved problems with the ‘I’, the ‘A’, and the ‘T’: a logical and psychometric critique of the Implicit Association Test (IAT). European Review of Social Psychology 17, 74–147.CrossRefGoogle Scholar
Gamer, J, Schmukle, S C, Luka-Krausgrill, U, Egloff, B (2008). Examining the dynamics of the implicit and the explicit self-concept in social anxiety: changes in the Implicit Association Test-Anxiety and the Social Phobia Anxiety Inventory following treatment. Journal of Personality Assessment 90, 476–480.CrossRefGoogle ScholarPubMed
Gawronski, B, Bodenhausen, GV (2006). Associative and propositional processes in evaluation: an integrative review of implicit and explicit attitude change. Psychological Bulletin 132, 692–731.CrossRefGoogle ScholarPubMed
Greenwald, AG, McGhee, DE, Schwartz, JLK (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of Personality and Social Psychology 74, 1464–1480.CrossRefGoogle ScholarPubMed
Greenwald, AG, Nosek, BA, Banaji, MR (2003). Understanding and using the Implicit Association Test: I. An improved scoring algorithm. Journal of Personality and Social Psychology 85, 197–216.CrossRefGoogle ScholarPubMed
Grumm, M, Erbe, C, von Collani, G, Nestler, S (2008). Automatic processing of pain: The change of implicit pain associations after psychotherapy. Behaviour Research and Therapy 46, 701–714.CrossRefGoogle ScholarPubMed
Haeffel, GJ, Abramson, LY, Brazy, PC, Shah, JY, Teachman, BA, Nosek, BA (2007). Explicit and implicit cognition: A preliminary test of a dual-process theory of cognitive vulnerability to depression. Behaviour Research and Therapy 45, 1155–1167.CrossRefGoogle ScholarPubMed
Hecht, H, Von, ZD, Wittchen, HU (1990). Anxiety and depression in a community sample: the influence of comorbidity on social functioning. Journal of Affective Disorders 18, 137–144.CrossRefGoogle Scholar
Hofmann, W, Gawronski, B, Gschwendner, T, Le, H, Schmitt, M (2005). A meta-analysis on the correlation between the Implicit Association Test and explicit self-report measures. Personality and Social Psychology Bulletin 31, 1369–1385.CrossRefGoogle ScholarPubMed
Huijding, J, de Jong, PJ (2006). Specific predictive power of automatic spider-related affective associations for controllable and uncontrollable fear responses toward spiders. Behaviour Research and Therapy 44, 161–176.CrossRefGoogle ScholarPubMed
Huijding, J, de Jong, PJ (2009). Implicit and explicit attitudes toward spiders: sensitivity to treatment and predictive value for generalization of treatment effects. Cognitive Therapy and Research 33, 211–220.CrossRefGoogle ScholarPubMed
Mayer, B, Merckelbach, H, Muris, P (2000). Self-reported automaticity and irrationality in spider phobia. Psychological Reports 87, 395–405.CrossRefGoogle ScholarPubMed
Penninx, BWJH, Beekman, ATF, Smit, JH, Zitman, FG, Nolen, WA, Spinhoven, P, Cuijpers, P, de Jong, PJ, van Marwijck, HWJ, Assendelft, WJJ, van der Meer, K, Verhaak, P, Wensing, M, de Graaf, R, Hoogendijk, WJ, Ormel, J, van Dyck, R (2008). The Netherlands Study of Depression and Anxiety (NESDA): rationale, objectives and methods. International Journal of Methods in Psychiatric Research 17, 121–140.CrossRefGoogle ScholarPubMed
Pinter, B, Greenwald, AG (2005). Clarifying the role of the ‘other’ category in the self-esteem IAT. Experimental Psychology 52, 74–79.CrossRefGoogle ScholarPubMed
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, Farmer, A, Jablensky, A, Pickens, R, Regier, DA, Sartorius, N, Towle, LH (1989). The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle Scholar
Roy-Byrne, PP, Stang, P, Wittchen, HU, Ustun, B, Walters, EE, Kessler, RC (2000). Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and help-seeking. British Journal of Psychiatry 176, 229–235.CrossRefGoogle ScholarPubMed
Rüsch, N, Lieb, K, Göttler, I, Hermann, C, Schramm, E, Richter, H, Jacob, GA, Corrigan, PW, Bohus, M (2007). Shame and implicit self-concept in women with borderline personality disorder. American Journal of Psychiatry 164, 500–508.CrossRefGoogle ScholarPubMed
Rush, AJ, Gullion, CM, Basco, MR, Jarrett, RB, Trivedi, MH (1996). The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychological Medicine 26, 477–486.CrossRefGoogle ScholarPubMed
Schnabel, K, Banse, R, Asendorpf, JB (2006). Assessment of implicit personality self-concept using the Implicit Association Test (IAT): concurrent assessment of anxiousness and angriness. British Journal of Social Psychology 45, 373–396.CrossRefGoogle ScholarPubMed
Spalding, LR, Hardin, CD (1999). Unconscious unease and self-handicapping: Behavioral consequences of individual differences in implicit and explicit self-esteem. Psychological Science 10, 535–539.CrossRefGoogle Scholar
Steffens, MC, König, SS (2006). Predicting spontaneous Big Five behavior with Implicit Association Tests. European Journal of Psychological Assessment 22, 13–20.CrossRefGoogle Scholar
Teachman, BA, Gregg, AP, Woody, SR (2001). Implicit associations for fear-relevant stimuli among individuals with snake and spider fears. Journal of Abnormal Psychology 110, 226–235.CrossRefGoogle ScholarPubMed
Wacker, HR, Battegay, R, Mullejans, R, Schlosser, C (2006). Using the CIDI-C in the general population. In Psychiatry: A World Perspective (ed. Stefanis, C. N., Rabavilas, A. D. and Soldatos, C. R.), pp. 138–143. Elsevier Science Publishers: Amsterdam.Google Scholar
Weertman, A, Arntz, A, de Jong, PJ, Rinck, M (2008). Implicit self- and other-associations in obsessive-compulsive personality disorder traits. Cognition and Emotion 22, 1253–1275.CrossRefGoogle Scholar
Wittchen, HU (1994). Reliability and validity studies of the WHO – Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 57–84.CrossRefGoogle ScholarPubMed
Wittchen, HU, Burke, JD, Semler, G, Pfister, H, Von, CM, Zaudig, M (1989). Recall and dating of psychiatric symptoms. Test-retest reliability of time-related symptom questions in a standardized psychiatric interview. Archives of General Psychiatry 46, 437–443.CrossRefGoogle Scholar
Wittchen, HU, Robins, LN, Cottler, LB, Sartorius, N, Burke, JD, Regier, D (1991). Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field Trials. British Journal of Psychiatry 159, 645–653.CrossRefGoogle ScholarPubMed