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Jahan-Mihan A, Stevens P, Medero-Alfonso S, Brace G, Overby LK, Berg K, Labyak C. The Role of Water-Soluble Vitamins and Vitamin D in Prevention and Treatment of Depression and Seasonal Affective Disorder in Adults. Nutrients 2024; 16:1902. [PMID: 38931257 PMCID: PMC11206829 DOI: 10.3390/nu16121902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Depression is a major global health concern expected to worsen by 2030. In 2019, 28 million individuals were affected by depressive disorders. Dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression. B vitamins are crucial for neurological function and mood regulation. Deficiencies in these vitamins are linked to depression. Studies on individual B vitamins show promise in improving depressive symptoms, particularly thiamin, riboflavin, niacin, and folate. Vitamin C deficiency may heighten depressive symptoms, but its exact role is not fully understood. Seasonal Affective Disorder (SAD) is associated with insufficient sunlight exposure and vitamin D deficiency. Vitamin D supplementation for SAD shows inconsistent results due to methodological variations. Further investigation is needed to understand the mechanisms of vitamins in depression treatment. Moreover, more research on SAD and light therapy's efficacy and underlying mechanisms involving photoreceptors, enzymes, and immune markers is needed. Although dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression, dietitians treating psychiatric disorders face challenges due to diverse study designs, making direct comparisons difficult. Therefore, this article reviews the current literature to assess the role of dietary and supplemental vitamins in the prevention and treatment of depression. This review found that, although evidence supports the role of B vitamins and vitamins C and D in preventing and treating depression, further research is needed to clarify their mechanisms of action and determine the most effective intervention strategies.
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Affiliation(s)
- Alireza Jahan-Mihan
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Dr., Jacksonville, FL 32224, USA; (P.S.); (S.M.-A.); (G.B.); (L.K.O.); (K.B.); (C.L.)
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Falkenstein MJ, Kelley KN, Martin HS, Kuckertz JM, Coppersmith D, Bezahler A, Narine K, Beard C, Webb CA. Multi-method assessment of suicidal thoughts and behaviors among patients in treatment for OCD and related disorders. Psychiatry Res 2024; 333:115740. [PMID: 38237537 PMCID: PMC10922745 DOI: 10.1016/j.psychres.2024.115740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/17/2024]
Abstract
Obsessive-compulsive and related disorders (OCRDs) are associated with increased risk of suicidal thoughts and behaviors (STBs), yet research characterizing suicidality in OCRDs remains limited. A major challenge in assessing STBs is the reliance on explicit self-report. This study utilized multi-method assessment to examine changes in both implicit and explicit STBs in 31 adults receiving partial/residential treatment for OCRDs. Assessments were administered at admission and weekly during treatment. Approximately three-quarters of participants reported lifetime suicidal thoughts, with 16 % reporting a prior suicide attempt. OCD severity was significantly correlated with lifetime suicidal thoughts, and was significantly higher for those with lifetime suicidal thoughts and prior attempts compared to those without. Implicit biases towards death were not associated with OCD severity, and did not predict explicitly endorsed STBs. This is the first study to measure both explicit and implicit STBs in adults with OCRDs. Limitations included small sample size and lack of racial/ethnic diversity. Given the majority had recent suicidal thoughts and one in six had a prior attempt, we emphasize the importance of STB assessment in OCD treatment settings.
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Affiliation(s)
- Martha J Falkenstein
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States.
| | - Kara N Kelley
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States
| | - Heather S Martin
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States
| | - Jennie M Kuckertz
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | | | - Andreas Bezahler
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States
| | - Kevin Narine
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States
| | - Courtney Beard
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | - Christian A Webb
- Obsessive Compulsive Disorder Institute, McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
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Rnic K, LeMoult J, Torres IJ, Chakrabarty T, Foster J, Frey BN, Harkness KL, Ho K, Li QS, Milev R, Quilty LC, Rotzinger S, Soares CN, Uher R, Kennedy SH, Lam RW. Predicting recurrence of major depressive episodes using the Depression Implicit Association Test: A Canadian biomarker integration network in depression (CAN-BIND) report. Psychiatry Res 2023; 330:115606. [PMID: 37979318 DOI: 10.1016/j.psychres.2023.115606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 11/20/2023]
Abstract
Identifying clinically relevant predictors of depressive recurrence following treatment for Major Depressive Disorder (MDD) is critical for relapse prevention. Implicit self-depressed associations (SDAs), defined as implicit cognitive associations between elements of depression (e.g., sad, miserable) and oneself, often persist following depressive episodes and may represent a cognitive biomarker for future recurrences. Thus, we examined whether SDAs, and changes in SDAs over time, prospectively predict depressive recurrence among treatment responders in the CAN-BIND Wellness Monitoring for MDD Study, a prospective cohort study conducted across 5 clinical centres. A total of 96 patients with MDD responding to various treatments were followed an average of 1.01 years. Participants completed the Depression Implicit Association Test (DIAT) - a computer-based measure of SDAs - every 8 weeks on a tablet device. Survival analyses indicated that greater SDAs at baseline and increases in SDAs over time predicted shorter time to MDD recurrence, even after accounting for depressive symptom severity. The findings show that SDAs are a robust prognostic indicator of risk for MDD recurrence, and that the DIAT may be a feasible and low-cost clinical screening tool. SDAs also represent a potential mechanism underlying the course of recurrent depression and are a promising target for relapse prevention interventions.
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Affiliation(s)
- Katerina Rnic
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; British Columbia Mental Health and Substance Use Services, Vancouver, BC, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jane Foster
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada; Department of Psychiatry, Queen's University, Providence Care, Kingston, ON, Canada
| | - Keith Ho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Qingqin S Li
- Neuroscience, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Roumen Milev
- Department of Psychology, Queen's University, Kingston, ON, Canada; Department of Psychiatry, Queen's University, Providence Care, Kingston, ON, Canada
| | - Lena C Quilty
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Susan Rotzinger
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Claudio N Soares
- Department of Psychiatry, Queen's University, Providence Care, Kingston, ON, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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van Kleef RS, Kaushik P, Besten M, Marsman JBC, Bockting CLH, van Vugt M, Aleman A, van Tol MJ. Understanding and predicting future relapse in depression from resting state functional connectivity and self-referential processing. J Psychiatr Res 2023; 165:305-314. [PMID: 37556963 DOI: 10.1016/j.jpsychires.2023.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The recurrent nature of Major Depressive Disorder (MDD) asks for a better understanding of mechanisms underlying relapse. Previously, self-referential processing abnormalities have been linked to vulnerability for relapse. We investigated whether abnormalities in self-referential cognitions and functioning of associated brain-networks persist upon remission and predict relapse. METHODS Remitted recurrent MDD patients (n = 48) and never-depressed controls (n = 23) underwent resting-state fMRI scanning at baseline and were additionally assessed for their implicit depressed self-associations and ruminative behaviour. A template-based dual regression approach was used to investigate between-group differences in default mode, cingulo-opercular and frontoparietal network resting-state functional connectivity (RSFC). Additional prediction of relapse status at 18-month follow-up was investigated within patients using both regression analyses and machine learning classifiers. RESULTS Remitted patients showed higher rumination, but no implicit depressed self-associations or RSFC abnormalities were observed between patients and controls. Nevertheless, relapse was related to i) baseline RSFC between the ventral default mode network and the precuneus, dorsomedial frontal gyrus, and inferior occipital lobe, ii) implicit self-associations, and iii) uncontrollability of ruminative thinking, when controlled for depressive symptomatology. Moreover, preliminary machine learning classifiers demonstrated that RSFC within the investigated networks predicted relapse on an individual basis. CONCLUSIONS Remitted MDD patients seem to be commonly characterized by abnormal rumination, but not by implicit self-associations or abnormalities in relevant brain networks. Nevertheless, relapse was predicted by self-related cognitions and default mode RSFC during remission, suggesting that variations in self-relevant processing play a role in the complex dynamics associated with the vulnerability to developing recurrent depressive episodes. CLINICAL TRIAL REGISTRATION Netherlands Trial Register, August 18, 2015, trial number NL53205.042.15.
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Affiliation(s)
- Rozemarijn S van Kleef
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands.
| | - Pallavi Kaushik
- Bernoulli Institute of Mathematics, Computer Science and Artificial Intelligence, University of Groningen, the Netherlands; Department of Computer Science and Engineering, Indian Institute of Technology, Roorkee, India
| | - Marlijn Besten
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands; Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Jan-Bernard C Marsman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| | - Claudi L H Bockting
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Marieke van Vugt
- Bernoulli Institute of Mathematics, Computer Science and Artificial Intelligence, University of Groningen, the Netherlands
| | - André Aleman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands; Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Marie-José van Tol
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
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Song S, DeMeo NN, Almeida DM, Majd M, Engeland CG, Graham-Engeland JE. The longitudinal connection between depressive symptoms and inflammation: Mediation by sleep quality. PLoS One 2022; 17:e0269033. [PMID: 35617264 PMCID: PMC9135207 DOI: 10.1371/journal.pone.0269033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
Although there is a strong association between depressive symptoms and markers of inflammation, it remains unclear whether depressive symptoms at one point in life may predict inflammation later in life. Moreover, despite extant literature linking sleep with both depressive symptoms and inflammation, there is little research investigating poor sleep as a mechanism linking depressive symptoms with later inflammation. The links between depression and physical health can also vary by gender. In longitudinal analyses with data from the Midlife in the United States (MIDUS) study, we examined whether depressive symptoms were associated with inflammatory markers 11 years later and whether these associations were mediated by sleep disturbances or moderated by gender. Participants reported depressive symptoms and demographic information at baseline. At 11-year follow-up, the same participants (n = 968) reported depressive symptoms, sleep quality and duration using validated scale items, and provided a blood sample from which inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) were quantified. Actigraphy assessment of sleep was obtained in a subsample (n = 276). After adjusting for concurrent depressive symptoms and other relevant covariates, baseline depressive symptoms were associated with CRP 11 years later in the full sample, and with IL-6 among women. Subjective sleep quality mediated the association between depressive symptoms and CRP. Results suggest that depressive symptoms may be longitudinally associated with inflammation; however, directionality issues cannot be determined from the present work, particularly as inflammation markers (which might have been associated with baseline depressive symptoms) were not available at baseline. Findings further suggest that longitudinal associations between depressive symptoms and inflammation may potentially be explained by sleep and may reflect gender specific patterns.
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Affiliation(s)
- Sunmi Song
- Department of Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
| | - Natasha N. DeMeo
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States of America
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States of America
| | - Christopher G. Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
- The College of Nursing, The Pennsylvania State University, University Park, PA, United States of America
| | - Jennifer E. Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States of America
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Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. J Affect Disord 2021; 295:1347-1359. [PMID: 34706448 DOI: 10.1016/j.jad.2021.08.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders. METHODS A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders. RESULTS All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders. CONCLUSION NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.
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von Hippel C, Brener L, Rose G, Kjelsaas K, von Hippel W. No evidence that implicit identification with mental illness predicts recovery. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:530-545. [PMID: 34096627 DOI: 10.1111/bjc.12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/07/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Recovery from mental illness is multiply-determined, but one factor that has been proposed to influence recovery is the degree to which the person identifies as someone with a mental illness. This study examines the relationship between implicit identification with being mentally unwell and recovery among clients of a community mental health service. A multi-faceted view of recovery was adopted. METHODS A longitudinal design was used to assess implicit identification with mental illness and its relationship to recovery, including symptom severity, well-being, life satisfaction, and optimism, which were supplemented with ratings by both support workers and the research assistants who conducted the study. Participants were 216 community mental health care clients, with 150 retested at Time 2, and 100 retested at Time 3. RESULTS Implicit identification with mental illness was correlated with recovery at Time 1 and Time 3, though this relationship did not emerge at Time 2. Cross-lag regression analyses failed to reveal evidence that implicit identification with mental illness predicts subsequent recovery. CONCLUSIONS The current research suggests that implicit identification with mental illness can be considered a marker of ongoing recovery, but is not predictive of subsequent recovery. Hence, these data suggest that implicit identification with mental illness is unlikely to play an independent role in the recovery process. PRACTITIONER POINTS Research regarding the mental health consequences of implicit identification focuses on symptomatology. Recovery is more than a reduction in symptoms, however, and thus, a broader conceptualization of recovery was examined. Implicit identification with being mentally unwell was associated with poorer recovery broadly operationalized, but did not predict subsequent recovery.
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Affiliation(s)
| | - Loren Brener
- University of New South Wales, Sydney, New South Wales, Australia
| | - Grenville Rose
- University of New South Wales, Sydney, New South Wales, Australia
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Gómez Penedo JM, Krieger T, Koditek MC, Grosse Holtforth M. Discrepant negative self-associations as a risk factor for depressive deterioration after outpatient psychotherapy. J Behav Ther Exp Psychiatry 2020; 69:101576. [PMID: 32470685 DOI: 10.1016/j.jbtep.2020.101576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES This paper examines the discrepancy between implicit and explicit negative self-associations (NSA) after cognitive psychotherapy for depression as a predictor of long-term outcome. METHODS One hundred and twenty patients completed an Implicit-Association Test relating the self with depressive attributes and a self-report questionnaire with identical item content, at the end of time-limited outpatient depression psychotherapy. At post-treatment and at 3-, 6-, and 12-month follow-up, patients completed the BDI-II. We used different strategies to operationalized implicit and explicit NSA discrepancies and three-level Hierarchical linear models to analyze the effects. RESULTS We found significant interactive effects of discrepancy between implicit and explicit NSA and the direction of the discrepancy on long-term outcome. In patients with a greater explicit than implicit NSA (a damaged self-esteem pattern) a greater absolute discrepancy was associated with worse long-term outcome in terms of BDI scores at the end of follow-up and rate of change during follow-up. Consistently, with an alternative method, we found that damaged self-esteem discrepancies were associated with worse estimated BDI-II scores at the end of follow-up. LIMITATIONS The inclusion in the sample of only treatment completers limits the generalizability of the results. Furthermore, the follow-up period captured only the first 12 months after treatment. CONCLUSIONS Our results support the notion that a discrepancy between implicit and explicit negative self-associations may pose a risk factor for deterioration after psychotherapy for depression.
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Affiliation(s)
- Juan Martín Gómez Penedo
- Universidad de Buenos Aires (CONICET), Buenos Aires, Argentina & Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Marie Christine Koditek
- Department of Clinical Psychology and Psychotherapy, University of Bern & Psychosomatic Competence Center, Department of Neurology, University Hospital, Inselspital, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Martin Grosse Holtforth
- Department of Clinical Psychology and Psychotherapy, University of Bern & Psychosomatic Competence Center, Department of Neurology, University Hospital, Inselspital, Fabrikstrasse 8, 3012, Bern, Switzerland
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Teachman BA, Clerkin EM, Cunningham WA, Dreyer-Oren S, Werntz A. Implicit Cognition and Psychopathology: Looking Back and Looking Forward. Annu Rev Clin Psychol 2019; 15:123-148. [DOI: 10.1146/annurev-clinpsy-050718-095718] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Implicit cognitive processing is theorized to have a central role in many forms of psychopathology. In the current review, we focus on implicit associations, by which we mean evaluative representations in memory that are difficult to control and do not require conscious reflection to influence affect, cognition, or behavior. We consider definitional and measurement challenges before examining recent empirical evidence for these associations in anxiety, obsessive–compulsive, posttraumatic stress, depressive, and alcohol use disorders. This examination is framed by a brief review of the ways that prominent models of psychopathology represent biased implicit processing of disorder-relevant information. We consider to what extent models reflect more traditional automatic/implicit versus strategic/explicit dual-process perspectives or reflect more recent dynamical systems perspectives in which mental representations are iteratively reprocessed, evolving continuously. Finally, we consider the future research needed to better understand the interactive and temporal dynamics of implicit cognition in psychopathology.
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Affiliation(s)
- Bethany A. Teachman
- Department of Psychology, University of Virginia, Charlottesville, Virginia 22904, USA
| | - Elise M. Clerkin
- Department of Psychology, Miami University, Oxford, Ohio 45056, USA
| | | | | | - Alexandra Werntz
- Department of Psychology, University of Virginia, Charlottesville, Virginia 22904, USA
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