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Poulter MML, Balsom AA, Gordon JL. Pilot trial of a new self-directed psychological intervention for infertility-related distress. Pilot Feasibility Stud 2024; 10:111. [PMID: 39152484 PMCID: PMC11328509 DOI: 10.1186/s40814-024-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 08/05/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. METHODS In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. RESULTS The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p < .001; Cohen's ds = 0.9-1.3). CONCLUSIONS This self-directed intervention was well received and has the potential to be highly effective in reducing infertility-related distress, informing future development and optimization. TRIAL REGISTRATION ClinicalTrials.gov, NCT05103982.
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Affiliation(s)
| | - Ashley A Balsom
- Department of Psychology, University of Regina, Regina, SK, Canada
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2
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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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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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7
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Shin SH, Ksinan Jiskrova G, Yoon SH, Kobulsky JM. Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:438-446. [PMID: 32101477 DOI: 10.1080/00952990.2020.1722684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Childhood maltreatment (CM) has been repeatedly linked to future problem drinking. Depression has been identified as a potential factor contributing to problematic alcohol use in maltreated individuals. However, depression has been operationalized as the presence or number of depression symptoms in the majority of previous studies. The role of other relevant measures of depression, such as depressive implicit associations, is not well understood. OBJECTIVES The present study addresses this gap in the literature by examining the mediating role of both depression symptoms and depressive implicit associations. METHODS A community sample of young adults (N = 208, mean age = 19.7, 78.4% females) completed self-report measures of CM, depression symptoms, and problem drinking. Depressive implicit associations were assessed by a computer-based implicit association test (IAT). Structural equation modeling (SEM) was used to examine the direct link between CM and problem drinking as well as indirect links through depression symptoms and depressive implicit associations. RESULTS CM was significantly associated with both depression symptoms (β = 0.35, p < .001) and depressive implicit associations (β = 0.36, p < .001). Additionally, CM was associated with problem drinking indirectly via depression symptoms during young adulthood (β = .06, p = .019). CONCLUSION Our study provides evidence for the role of depression symptoms, but not for depressive implicit associations, in linking CM and problem drinking. Treating depression in individuals with a history of CM may help to prevent problem drinking in this vulnerable population.
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Affiliation(s)
- Sunny H Shin
- School of Social Work, Virginia Commonwealth University , Richmond, VA, USA.,School of Medicine, Department of Psychiatry, Virginia Commonwealth University , Richmond, VA, USA
| | | | - Susan H Yoon
- College of Social Work, Ohio State University , Columbus, OH, USA
| | - Julia M Kobulsky
- School of Social Work, Temple University , Philadelphia, PA, USA
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Vollbehr NK, Hoenders HR, Bartels‐Velthuis AA, Nauta MH, Castelein S, Schroevers MJ, Stant AD, de Jong PJ, Ostafin BD. A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial. Int J Methods Psychiatr Res 2020; 29:e1820. [PMID: 32067293 PMCID: PMC7301287 DOI: 10.1002/mpr.1820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/09/2019] [Accepted: 01/31/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Despite the gains made by current first-line interventions for major depressive disorder (MDD), modest rates of treatment response and high relapse indicate the need to augment existing interventions. Following theory and initial research indicating the promise of mindful yoga interventions (MYIs), this study examines mindful yoga as a treatment of MDD. METHODS/DESIGN This randomized controlled trial uses a sample of young females (18-34 years) to examine the efficacy and cost-effectiveness of a 9-week manualized MYI added to treatment as usual (TAU) versus TAU alone. Primary outcome measures consist of clinician-administered (Hamilton Depression Rating Scale) and self-report (Depression-Anxiety-Stress Scales) measures of depression. Underlying mechanisms will be examined, including rumination, negative self-evaluation, intolerance of uncertainty, interoceptive awareness, and dispositional mindfulness. Assessments were conducted at preintervention and will be conducted at postintervention, 6-, and 12-month follow up. RESULTS The baseline sample consists of 171 females (88 were randomized into the MYI), reporting a baseline Mage = 25.08 years (SDage = 4.64), MHamilton-depression = 18.39 (SDHamilton = 6.00), and a MDASS-depression = 21.02 (SDDASS = 9.36). CONCLUSION This trial will provide important information regarding the benefits of adding yoga-based interventions to TAU for young women with MDD and the mechanisms through which such benefits may occur.
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Affiliation(s)
- Nina K. Vollbehr
- Lentis Psychiatric InstituteCenter for Integrative PsychiatryGroningenNetherlands
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenNetherlands
| | - H.J. Rogier Hoenders
- Lentis Psychiatric InstituteCenter for Integrative PsychiatryGroningenNetherlands
| | - Agna A. Bartels‐Velthuis
- Lentis Psychiatric InstituteCenter for Integrative PsychiatryGroningenNetherlands
- University Center for Psychiatry, Rob Giel Research centerUniversity of Groningen, University Medical Center GroningenGroningenNetherlands
| | - Maaike H. Nauta
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenNetherlands
| | - Stynke Castelein
- Lentis Psychiatric InstituteCenter for Integrative PsychiatryGroningenNetherlands
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenNetherlands
- Lentis Psychiatric InstituteLentis ResearchGroningenNetherlands
| | - Maya J. Schroevers
- Faculty of Medical SciencesUniversity of Groningen, University Medical Center GroningenGroningenNetherlands
| | | | - Peter J. de Jong
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenNetherlands
| | - Brian D. Ostafin
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenNetherlands
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Ham K, Chin S, Suh YJ, Rhee M, Yu ES, Lee HJ, Kim JH, Kim SW, Koh SJ, Chung KM. Preliminary Results From a Randomized Controlled Study for an App-Based Cognitive Behavioral Therapy Program for Depression and Anxiety in Cancer Patients. Front Psychol 2019; 10:1592. [PMID: 31402881 PMCID: PMC6669916 DOI: 10.3389/fpsyg.2019.01592] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/25/2019] [Indexed: 01/02/2023] Open
Abstract
Cancer patients experience various psychological and social difficulties, the most common being depression and anxiety. The purpose of this study was to develop and evaluate the effectiveness of an app-based cognitive behavioral therapy program for depression and anxiety in cancer patients. For this purpose, 63 participants who met the inclusion criteria were randomly assigned to either a mobile-application-based cognitive behavioral therapy program (HARUToday), a simple information-provision mobile-application-based program (HARUCard), or a waitlist control group. Self-report questionnaires including the Beck Depression Inventory, State-Trait Anxiety Inventory, Health-Related Quality of Life Scale, Dysfunctional Attitude Scale, and two computer tasks including the dot-probe task and the Implicit Association Test, were administered before and after 66 days of intervention. The results showed that the Beck Depression Inventory and State-Trait Anxiety Inventory scores of the cognitive behavioral therapy program (HARUToday) group decreased significantly after the intervention compared to the attention control (HARUCard) and waitlist control groups. However, there were no significant changes in scores of the Health-Related Quality of Life Scale and Dysfunctional Attitude Scale, and the two computer tasks. Such results suggest that a mobile-application-based cognitive behavioral therapy program may be an effective intervention for alleviating depression and anxiety, but not the general quality of life of cancer patients. Taking into consideration that psychosocial problems may not the topmost priority for cancer patients who are facing a chronic and possibly mortal disease, a mobile-application cognitive behavioral therapy program may be a possible solution for the alleviation of depression and anxiety in cancer patients who have many restraints in terms of time and space.
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Affiliation(s)
- Kyunghee Ham
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Siyung Chin
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Yung Jae Suh
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Myungah Rhee
- Department of Psychology, Yonsei University, Seoul, South Korea
| | - Eun-Seung Yu
- Department of Psychiatry, National Cancer Center, Goyang-si, South Korea
| | - Hyun Jeong Lee
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang-si, South Korea
| | - Jong-Heun Kim
- Department of Psychiatry, National Cancer Center, Goyang-si, South Korea
| | - Sang Wun Kim
- Department of Obstetrics and Gynecology, Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, South Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Kyong-Mee Chung
- Department of Psychology, Yonsei University, Seoul, South Korea
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Swinkels LMJ, Gramser H, Becker ES, Rinck M. Self-Approach Tendencies: Relations With Explicit and Implicit Self-Evaluations. Front Psychol 2019; 10:309. [PMID: 30846951 PMCID: PMC6394373 DOI: 10.3389/fpsyg.2019.00309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/31/2019] [Indexed: 11/15/2022] Open
Abstract
We used a newly developed Self-Approach-Avoidance Task (Self-AAT) to measure self-approach tendencies in female students. In this task, participants use a joystick to pull portraits of themselves and of others closer or to push them away. In the three studies, we found a significant self-approach tendency: participants were faster to pull mirror-imaged portraits of themselves closer than to push them away. This approach tendency was reduced for non-mirrored self-portraits, and absent for control pictures showing unknown males, unknown females, or empty backgrounds. Moreover, in two out of the three studies, the self-approach tendency was weakly related to explicit self-valuations measured with the Rosenberg Self-Esteem Scale (RSES), and in one out of two studies, it was related to implicit self-evaluations measured with the Implicit Association Task (IAT). Implications and potential applications of the findings are discussed.
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Affiliation(s)
- Lieke M J Swinkels
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Hidde Gramser
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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Elgersma HJ, Koster EHW, Vugteveen J, Hoekzema A, Penninx BWJH, Bockting CLH, de Jong PJ. Predictive value of attentional bias for the recurrence of depression: A 4-year prospective study in remitted depressed individuals. Behav Res Ther 2019; 114:25-34. [PMID: 30665123 DOI: 10.1016/j.brat.2019.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 12/07/2018] [Accepted: 01/03/2019] [Indexed: 01/04/2023]
Abstract
Previous research showed that individuals who were remitted from a depressive disorder displayed heightened attention towards negative adjectives (e.g., worthless). We tested if this attentional bias (AB) is predictive of future recurrence of depressive episodes and/or having depressive symptoms at 2- and 4-year follow-up. We used a longitudinal approach within the Netherlands Study of Depression and Anxiety (NESDA) and selected participants who were remitted from Major Depressive Disorder (MDD) (n = 918). AB was measured with a verbal Exogenous Cueing Task; using 2 presentation times (500 and 1250 ms) and 3 stimulus types (negative, positive, neutral). Over 4 years, we prospectively assessed recurrence of depressive episodes and depressive symptomatology after participants completed the ECT. Diagnosis of depressive disorder was measured with clinical rating-scales and self-report questionnaires. A heightened probability of recurrence was neither associated with (heightened) AB for negative nor with (lowered) AB for positive adjectives. Thus, the findings do not support the view that an AB toward negative stimuli or away from positive stimuli plays a critical role in the recurrence of depression.
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Affiliation(s)
- Hermien J Elgersma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.
| | - Ernst H W Koster
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jorien Vugteveen
- Department of Psychometrics and Statistics, University of Groningen, Groningen, the Netherlands
| | - Albert Hoekzema
- Department of Research Support, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Claudi L H Bockting
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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Elgersma HJ, Koster EHW, van Tuijl LA, Hoekzema A, Penninx BWJH, Bockting CLH, de Jong PJ. Attentional bias for negative, positive, and threat words in current and remitted depression. PLoS One 2018; 13:e0205154. [PMID: 30379840 PMCID: PMC6209165 DOI: 10.1371/journal.pone.0205154] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 09/20/2018] [Indexed: 12/17/2022] Open
Abstract
Background The aim of this study was to improve our understanding of the underlying mechanisms in the maintenance of depression. We examined attentional bias (AB) for negative and positive adjectives and general threat words in strictly-defined clinical groups of participants with pure Major Depressive Disorder (MDD) without a history of anxiety disorders (AD), mixed MDD and AD, and remitted participants. Method We investigated both stimulus specificity and time course of AB in these groups, adopting a cross-sectional design. Data were drawn from the large scale Netherlands Study of Depression and Anxiety (NESDA), from which we selected all participants with pure current MDD without a history of AD (n = 29), all participants with current MDD and co-morbid AD(s) (n = 86), all remitted MDD participants (n = 294), and a comparison group without (a history of) MDD or ADs (n = 474). AB was measured with an Exogenous Cueing Task covering short and long presentation times (500 and 1250 ms) and 4 stimulus types (negative, positive, threat, neutral). Results Both traditional and trial level (dynamic) AB scores failed to show an AB for negative adjectives in participants with MDD or mixed MDD/AD. Specifically for long duration trials (1250 ms), remitted participants showed a larger AB traditional score (albeit the actual score still being negative) than the comparison group. The mixed MDD/AD group showed a higher trial-level AB score away from positive adjectives (1250 ms) than the comparisons. In addition, the mixed MDD/AD group showed higher and more variable trial-level AB scores away from short and towards longer presented general threat words together with a non-significant tendency to show less negative traditional AB scores for threat trials (500 ms) than the comparison group. Conclusions All in all, the findings do not corroborate the view that an AB towards negative or away from positive adjectives is critically involved in currently depressed individuals. Yet, the relatively high (less negative) AB score for negative adjectives in remitted individuals points to the possibility that an AB for negative information may be involved as a risk factor in the recurrence of MDD.
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Affiliation(s)
- Hermien J Elgersma
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Ernst H W Koster
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lonneke A van Tuijl
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - A Hoekzema
- Department of Research Support, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Claudi L H Bockting
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.,Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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13
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van Tuijl LA, Glashouwer KA, Elgersma HJ, Bockting CL, Penninx BW, de Jong PJ. Depression recurrence after recovery: Prognostic value of implicit and explicit self-depressed associations. Behav Res Ther 2018; 107:76-82. [DOI: 10.1016/j.brat.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/22/2018] [Accepted: 06/04/2018] [Indexed: 11/29/2022]
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De Cuyper K, Hermans D, Pieters G, Claes L, Vansteelandt K. Indirect and direct measures of striving for perfection moderate body mass index curves in the intensive treatment of anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2018; 27:86-96. [PMID: 30009415 DOI: 10.1002/erv.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/11/2018] [Accepted: 06/17/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Kathleen De Cuyper
- University Psychiatric Center KU Leuven, Leuven, Belgium.,KU Leuven Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Dirk Hermans
- KU Leuven Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Guido Pieters
- KU Leuven Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Laurence Claes
- KU Leuven Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
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15
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Vaillancourt K, Pawlby S, Fearon RMP. HISTORY OF CHILDHOOD ABUSE AND MOTHER-INFANT INTERACTION: A SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES. Infant Ment Health J 2017; 38:226-248. [PMID: 28236319 DOI: 10.1002/imhj.21634] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Literature that has examined maternal self-reported history of abuse and an observational assessment of infant-mother interaction were reviewed. Electronic databases were searched, and studies that met predefined criteria were included. Fourteen (12 independent samples) studies were included and assessed for quality using the Effective Public Health Practice Project tool (National Collaborating Centre for Methods and Tools, 2008). Ten of the 14 studies found a direct or an indirect relationship between self-reported abuse and observed caregiving. The small number of studies and variation in sample characteristics and measurement limit conclusions. Of the studies that were rated of the highest quality, there is some consistency showing that the effect of maternal abuse history on caregiving may be via a third variable (i.e., stress reactivity or depressive symptoms). The current review discusses strengths and limitations of the existing literature and offers suggestions for future research.
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Affiliation(s)
- Kyla Vaillancourt
- Institute of Psychiatry, Psychology & Neuroscience, King's College London
| | - Susan Pawlby
- Institute of Psychiatry, Psychology & Neuroscience, King's College London
| | - R M Pasco Fearon
- Department of Clinical, Educational and Health Psychology, University College London
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16
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Werntz AJ, Steinman SA, Glenn JJ, Nock MK, Teachman BA. Characterizing implicit mental health associations across clinical domains. J Behav Ther Exp Psychiatry 2016; 52:17-28. [PMID: 26962979 PMCID: PMC4871740 DOI: 10.1016/j.jbtep.2016.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 01/19/2016] [Accepted: 02/24/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Implicit associations are relatively uncontrollable associations between concepts in memory. The current investigation focuses on implicit associations in four mental health domains (alcohol use, anxiety, depression, and eating disorders) and how these implicit associations: a) relate to explicit associations and b) self-reported clinical symptoms within the same domains, and c) vary based on demographic characteristics (age, gender, race, ethnicity, and education). METHODS Participants (volunteers over age 18 to a research website) completed implicit association (Implicit Association Tests), explicit association (self + psychopathology or attitudes toward food, using semantic differential items), and symptom measures at the Project Implicit Mental Health website tied to: alcohol use (N = 12,387), anxiety (N = 21,304), depression (N = 24,126), or eating disorders (N = 10,115). RESULTS Within each domain, implicit associations showed small to moderate associations with explicit associations and symptoms, and predicted self-reported symptoms beyond explicit associations. In general, implicit association strength varied little by race and ethnicity, but showed small ties to age, gender, and education. LIMITATIONS This research was conducted on a public research and education website, where participants could take more than one of the studies. CONCLUSIONS Among a large and diverse sample, implicit associations in the four domains are congruent with explicit associations and self-reported symptoms, and also add to our prediction of self-reported symptoms over and above explicit associations, pointing to the potential future clinical utility and validity of using implicit association measures with diverse populations.
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Affiliation(s)
- Alexandra J Werntz
- Department of Psychology, University of Virginia, PO Box 400400, Charlottesville, VA, 22904, United States.
| | - Shari A Steinman
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY, 10032, United States.
| | - Jeffrey J Glenn
- Department of Psychology, University of Virginia, PO Box 400400, Charlottesville, VA, 22904, United States.
| | - Matthew K Nock
- Psychology Department, Harvard University, William James Hall, 33 Kirkland St., Cambridge, MA, 02138, United States.
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, PO Box 400400, Charlottesville, VA, 22904, United States.
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Dentale F, Grano C, Muzi M, Pompili M, Erbuto D, Violani C. Measuring the automatic negative self-schema: New evidence for the construct and criterion validity of the Depression Implicit Association. SELF AND IDENTITY 2016. [DOI: 10.1080/15298868.2016.1179218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Abstract
Implicit cognition, or our unconscious thoughts and beliefs, is an important predictor of our behaviors and decisions. It also predicts outcomes related to physical and mental health at the level of the individual and influences the dynamics of the patient-physician relationship. This article outlines specific ways in which implicit measures of cognition predict vulnerabilities to adverse health and contribute to social disparities in health and discusses important future directions for this body of research.
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Affiliation(s)
- Neha A John-Henderson
- Department of Psychology, University of Pittsburgh, 4405 Sennott Square, 201 South Bouquet Street, Pittsburgh, PA 15213, USA.
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19
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Elgersma HJ, de Jong PJ, van Rijsbergen GD, Kok GD, Burger H, van der Does W, Penninx BWJH, Bockting CLH. Cognitive reactivity, self-depressed associations, and the recurrence of depression. J Affect Disord 2015; 183:300-9. [PMID: 26047308 DOI: 10.1016/j.jad.2015.05.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mixed evidence exists regarding the role of cognitive reactivity (CR; cognitive responsivity to a negative mood) as a risk factor for recurrences of depression. One explanation for the mixed evidence may lie in the number of previous depressive episodes. Heightened CR may be especially relevant as a risk factor for the development of multiple depressive episodes and less so for a single depressive episode. In addition, it is theoretically plausible but not yet tested that the relationship between CR and number of episodes is moderated by the strength of automatic depression-related self-associations. AIM To investigate (i) the strength of CR in remitted depressed individuals with a history of a single vs. multiple episodes, and (ii) the potentially moderating role of automatic negative self-associations in the relationship between the number of episodes and CR. METHOD Cross-sectional analysis of data obtained in a cohort study (Study 1) and during baseline assessments in two clinical trials (Study 2). Study 1 used data from the Netherlands Study of Depression and Anxiety (NESDA) and compared never-depressed participants (n=901) with remitted participants with either a single (n=336) or at least 2 previous episodes (n=273). Study 2 included only remitted participants with at least two previous episodes (n=273). The Leiden Index of Depression Sensitivity Revised (LEIDS-R) was used to index CR and an Implicit Association Test (IAT) to measure implicit self-associations. RESULTS In Study 1, remitted depressed participants with multiple episodes had significantly higher CR than those with a single or no previous episode. The remitted individuals with multiple episodes of Study 2 had even higher CR scores than those of Study 1. Within the group of individuals with multiple episodes, CR was not heightened as a function of the number of episodes, even if individual differences in automatic negative self-associations were taken into account. LIMITATIONS The study employed a cross-sectional design, which precludes a firm conclusion with regard to the direction of this relationship. CONCLUSIONS The findings are consistent with the view that high CR puts people at risk for recurrent depression and is less relevant for the development of an incidental depressive episode. This suggests that CR is an important target for interventions that aim to prevent the recurrence of depression.
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Affiliation(s)
- Hermien J Elgersma
- Department of Clinical Psychology, University of Groningen, The Netherlands.
| | - Peter J de Jong
- Department of Clinical Psychology, University of Groningen, The Netherlands
| | | | - Gemma D Kok
- Department of Clinical Psychology, University of Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Willem van der Does
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Claudi L H Bockting
- Department of Clinical Psychology, University of Groningen, The Netherlands; Utrecht University, Department of Clinical and Health Psychology, Utrecht, The Netherlands
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20
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Button KS, Kounali D, Stapinski L, Rapee RM, Lewis G, Munafò MR. Fear of negative evaluation biases social evaluation inference: evidence from a probabilistic learning task. PLoS One 2015; 10:e0119456. [PMID: 25853835 PMCID: PMC4390305 DOI: 10.1371/journal.pone.0119456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 01/29/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Fear of negative evaluation (FNE) defines social anxiety yet the process of inferring social evaluation, and its potential role in maintaining social anxiety, is poorly understood. We developed an instrumental learning task to model social evaluation learning, predicting that FNE would specifically bias learning about the self but not others. METHODS During six test blocks (3 self-referential, 3 other-referential), participants (n = 100) met six personas and selected a word from a positive/negative pair to finish their social evaluation sentences "I think [you are / George is]…". Feedback contingencies corresponded to 3 rules, liked, neutral and disliked, with P[positive word correct] = 0.8, 0.5 and 0.2, respectively. RESULTS As FNE increased participants selected fewer positive words (β = -0.4, 95% CI -0.7, -0.2, p = 0.001), which was strongest in the self-referential condition (FNE × condition 0.28, 95% CI 0.01, 0.54, p = 0.04), and the neutral and dislike rules (FNE × condition × rule, p = 0.07). At low FNE the proportion of positive words selected for self-neutral and self-disliked greatly exceeded the feedback contingency, indicating poor learning, which improved as FNE increased. CONCLUSIONS FNE is associated with differences in processing social-evaluative information specifically about the self. At low FNE this manifests as insensitivity to learning negative self-referential evaluation. High FNE individuals are equally sensitive to learning positive or negative evaluation, which although objectively more accurate, may have detrimental effects on mental health.
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Affiliation(s)
- Katherine S. Button
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Daphne Kounali
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Lexine Stapinski
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ronald M. Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Glyn Lewis
- Mental Health Sciences Unit, University College London, London, United Kingdom
| | - Marcus R. Munafò
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
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21
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Manthey L, van Loenen-Frösch F, Giltay EJ, van Veen T, Glashouwer K, Penninx BWJH, Zitman FG. High dose benzodiazepines prolong reaction times in chronic users who have major depressive and/or anxiety disorders. Br J Clin Pharmacol 2014; 77:571-7. [PMID: 23962205 DOI: 10.1111/bcp.12224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 08/02/2013] [Indexed: 01/14/2023] Open
Abstract
AIM Short term administration of benzodiazepines (BZD) was found to prolong reaction time (RT) in experimental studies. However, studies on long term BZD use did not always adjust for important confounders and showed inconsistent results. We aimed to identify a possible relationship between long term BZD use and RT in BZD users in this large cross-sectional, observational study. METHODS The RTs of non-users (n = 2404) were compared with low (n = 288), intermediate (n = 74), and high dose BZD users (n = 57) in the Netherlands Study of Depression and Anxiety (NESDA). RTs were obtained from the Implicit Association Test. Analyses were adjusted for sociodemographic characteristics, health indicators, severity of psychopathology and antidepressant use. RESULTS Of the NESDA participants, 419 subjects (14.8%) used BZDs. A higher dose of BZDs was associated with prolonged RTs (P = 0.01). When comparing the different dose groups, the high dose group, but not the low and medium dose groups, had significantly longer RTs than the non-users. CONCLUSIONS Tolerance for the RT prolonging effect of relatively high doses of BZDs does not seem to develop. As prolonged RTs can have adverse consequences in daily life, BZDs should be prescribed conservatively at the lowest possible dose.
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Affiliation(s)
- Leonie Manthey
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
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22
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Cognitive vulnerability and implicit emotional processing: imbalance in frontolimbic brain areas? COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2014; 15:69-79. [DOI: 10.3758/s13415-014-0316-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wong J, Morrison AS, Heimberg RG, Goldin PR, Gross JJ. Implicit associations in social anxiety disorder: the effects of comorbid depression. J Anxiety Disord 2014; 28:537-46. [PMID: 24983794 PMCID: PMC4134987 DOI: 10.1016/j.janxdis.2014.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 04/13/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
Abstract
Implicit associations of the self to concepts like "calm" have been shown to be weaker in persons with social anxiety than in non-anxious healthy controls. However, other implicit self associations, such as those to acceptance or rejection, have been less studied in social anxiety, and none of this work has been conducted with clinical samples. Furthermore, the importance of depression in these relationships has not been well investigated. We addressed these issues by administering two Implicit Association Tests (IATs; Greenwald, McGhee, & Schwartz, 1998), one examining the implicit association of self/other to anxiety/calmness and the other examining the association of self/other to rejection/acceptance, to individuals with generalized social anxiety disorder (SAD, n=85), individuals with generalized SAD and a current or past diagnosis of major depressive disorder or current dysthymic disorder (n=47), and non-anxious, non-depressed healthy controls (n=44). The SAD and SAD-depression groups showed weaker implicit self-calmness associations than healthy controls, with the comorbid group showing the weakest self-calmness associations. The SAD-depression group showed the weakest implicit self-acceptance associations; no difference was found between non-depressed individuals with SAD and healthy controls. Post hoc analyses revealed that differences appeared to be driven by those with current depression. The SAD-only and SAD-depression groups did not differ in self-reported (explicit) social anxiety. The implications of these findings for the understanding of SAD-depression comorbidity and for the treatment of SAD are considered.
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Affiliation(s)
- Judy Wong
- Adult Anxiety Clinic of Temple University
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24
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Verkuil B, Brosschot JF, Thayer JF. Cardiac reactivity to and recovery from acute stress: Temporal associations with implicit anxiety. Int J Psychophysiol 2014; 92:85-91. [DOI: 10.1016/j.ijpsycho.2014.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/05/2014] [Accepted: 03/08/2014] [Indexed: 11/26/2022]
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25
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Lemmens LHJM, Roefs A, Arntz A, van Teeseling HC, Peeters F, Huibers MJH. The value of an implicit self-associative measure specific to core beliefs of depression. J Behav Ther Exp Psychiatry 2014; 45:196-202. [PMID: 24211849 DOI: 10.1016/j.jbtep.2013.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/04/2013] [Accepted: 10/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The present study examined differences in explicit and implicit measures of self-esteem between depressed patients and healthy controls using an indirect measurement procedure especially adapted to measure self-esteem aspects of core beliefs of depression. Furthermore, we examined whether our implicit and explicit self-associative measures were associated with each other and with depressive symptoms, and investigated the effect of a discrepancy between the implicit and explicit measure on depression. METHODS Participants were 87 depressed patients and 30 healthy controls. The Self-Liking and Self-Competence Scale was administered as a measure of explicit self-esteem. A depression-specific variant of the Single Category Implicit Association Test served as a measure of implicit self-esteem. RESULTS Patients showed significantly lower levels of explicit self-esteem as compared to healthy controls. In spite of our adaptations, no differences were found on the implicit measure. The implicit measure of self-esteem was neither related to the explicit measure nor to depressive symptoms. Furthermore, although both the explicit measure of self-esteem and the difference score of the explicit and implicit measure were related to symptoms of depression, the relation between the explicit measure and depression was found to be significantly stronger. LIMITATIONS Results should be interpreted with caution because it is not clear yet to what extent these implicit measures really reflect self-esteem. CONCLUSIONS This study suggests that only the explicit measure of self-esteem - and not the implicit - is related to depression. Future research using well-designed measurement procedures for obtaining implicit and explicit measures could contribute to a better insight in the nature of these constructs.
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Affiliation(s)
- Lotte H J M Lemmens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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26
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Jabben N, de Jong PJ, Kupka RW, Glashouwer KA, Nolen WA, Penninx BWJH. Implicit and explicit self-associations in bipolar disorder: a comparison with healthy controls and unipolar depressive disorder. Psychiatry Res 2014; 215:329-34. [PMID: 24365387 DOI: 10.1016/j.psychres.2013.11.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 11/27/2013] [Accepted: 11/30/2013] [Indexed: 11/27/2022]
Abstract
According to cognitive theory, negative self-schemas are involved in the occurrence of depression. Whereas implicit depressive self-associations have been found in unipolar depression, it is unknown whether impaired associations with regard to the self are also involved in Bipolar Disorder (BD). This study investigated whether a bias in self-associations is a characteristic of bipolar disorder and whether discrepancies between implicit and explicit self-evaluations may be relevant for understanding bipolar psychopathology. Implicit and explicit self-associations were assessed in patients with BD (n=99), in patients with depressive disorder (n=1236), and healthy controls (n=387). Analyses of variance and correlation analyses were used to compare bipolar patients to controls and unipolar patients on implicit self-associations and the discrepancy between implicit and explicit self-associations. Similar to unipolar patients, patients with BD showed stronger implicit depressive self-associations than controls. Specifically for bipolar patients there was no significant correlation between implicit and explicit depressive self-associations. In a similar vein, discrepancies between implicit and explicit self-associations were relatively pronounced in symptomatic bipolar patients as compared to both healthy controls and unipolar depressed patients. Thus automatic depressive self-associations were characteristic for all mood disorders whereas a lack of concordance between implicit and explicit self-associations was specific for BD.
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Affiliation(s)
- Nienke Jabben
- Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Peter J de Jong
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Ralph W Kupka
- Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Klaske A Glashouwer
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Willem A Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Kruijt AW, Antypa N, Booij L, de Jong PJ, Glashouwer K, Penninx BWJH, Van der Does W. Cognitive reactivity, implicit associations, and the incidence of depression: a two-year prospective study. PLoS One 2013; 8:e70245. [PMID: 23922962 PMCID: PMC3724814 DOI: 10.1371/journal.pone.0070245] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/18/2013] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Cognitive reactivity to sad mood is a vulnerability marker of depression. Implicit self-depressed associations are related to depression status and reduced remission probability. It is unknown whether these cognitive vulnerabilities precede the first onset of depression. AIM To test the predictive value of cognitive reactivity and implicit self-depressed associations for the incidence of depressive disorders. METHODS Prospective cohort study of 834 never-depressed individuals, followed over a two-year period. The predictive value of cognitive reactivity and implicit self-depressed associations for the onset of depressive disorders was assessed using binomial logistic regression. The multivariate model corrected for baseline levels of subclinical depressive symptoms, neuroticism, for the presence of a history of anxiety disorders, for family history of depressive or anxiety disorders, and for the incidence of negative life events. RESULTS As single predictors, both cognitive reactivity and implicit self-depressed associations were significantly associated with depression incidence. In the multivariate model, cognitive reactivity was significantly associated with depression incidence, together with baseline depressive symptoms and the number of negative life events, whereas implicit self-depressed associations were not. CONCLUSION Cognitive reactivity to sad mood is associated with the incidence of depressive disorders, also when various other depression-related variables are controlled for. Implicit self-depressed associations predicted depression incidence in a bivariate test, but not when controlling for other predictors.
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Affiliation(s)
- Anne-Wil Kruijt
- Institute of Psychology, Leiden University, Leiden, The Netherlands.
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Glashouwer KA, Vroling MS, de Jong PJ, Lange WG, de Keijser J. Low implicit self-esteem and dysfunctional automatic associations in social anxiety disorder. J Behav Ther Exp Psychiatry 2013; 44:262-70. [PMID: 23298819 DOI: 10.1016/j.jbtep.2012.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 11/09/2012] [Accepted: 11/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Negative automatic associations towards the self and social cues are assumed to play an important role in social anxiety disorder. We tested whether social anxiety disorder patients (n = 45) showed stronger dysfunctional automatic associations than non-clinical controls (n = 45) and panic disorder patients (n = 24) and whether there existed gender differences in this respect. METHODS We used a single-target Implicit Association Test and an Implicit Association Test to measure dysfunctional automatic associations with social cues and implicit self-esteem, respectively. RESULTS Results showed that automatic associations with social cues were more dysfunctional in socially anxious patients than in both control groups, suggesting this might be a specific characteristic of social anxiety disorder. Socially anxious patients showed relatively low implicit self-esteem compared to non-clinical controls, whereas panic disorder patients scored in between both groups. Unexpectedly, we found that lower implicit self-esteem was related to higher severity of social anxiety symptoms in men, whereas no such relationship was found in women. CONCLUSIONS These findings support the view that automatic negative associations with social cues and lowered implicit self-esteem may both help to enhance our understanding of the cognitive processes that underlie social anxiety disorder.
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Affiliation(s)
- Klaske A Glashouwer
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands.
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Tracking the implicit self using event-related potentials. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2013; 13:885-99. [DOI: 10.3758/s13415-013-0169-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Glashouwer KA, Smulders FTY, de Jong PJ, Roefs A, Wiers RWHJ. Measuring automatic associations: validation of algorithms for the Implicit Association Test (IAT) in a laboratory setting. J Behav Ther Exp Psychiatry 2013; 44:105-13. [PMID: 22940788 DOI: 10.1016/j.jbtep.2012.07.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 07/06/2012] [Accepted: 07/30/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES In their paper, "Understanding and using the Implicit Association Test: I. An improved scoring algorithm", Greenwald, Nosek, and Banaji (2003) investigated different ways to calculate the IAT-effect. However, up to now, it remained unclear whether these findings - based on internet data - also generalize to laboratory settings. Therefore, the main goal of the present study was to cross-validate scoring algorithms for the IAT in a laboratory setting, specifically in the domain of psychopathology. METHODS Four known IAT algorithms and seven alternative IAT algorithms were evaluated on several performance criteria in the large-scale laboratory sample of the Netherlands Study of Depression and Anxiety (N = 2981) in which two IATs were included to obtain measurements of automatic self-anxious and automatic self-depressed associations. RESULTS AND CONCLUSIONS Results clearly demonstrated that the D(2SD)-measure and the D(600)-measure as well as an alternative algorithm based on the correct trials only (D(noEP)-measure) are suitable to be used in a laboratory setting for IATs with a fixed order of category combinations. It remains important to further replicate these findings, especially in studies that include outcome measures of more spontaneous kinds of behaviors.
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Affiliation(s)
- Klaske A Glashouwer
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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Button KS, Browning M, Munafò MR, Lewis G. Social inference and social anxiety: evidence of a fear-congruent self-referential learning bias. J Behav Ther Exp Psychiatry 2012; 43:1082-7. [PMID: 22699043 DOI: 10.1016/j.jbtep.2012.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 05/15/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Fears of negative evaluation characterise social anxiety, and preferential processing of fear-relevant information is implicated in maintaining symptoms. Little is known, however, about the relationship between social anxiety and the process of inferring negative evaluation. The ability to use social information to learn what others think about one, referred to here as self-referential learning, is fundamental for effective social interaction. The aim of this research was to examine whether social anxiety is associated with self-referential learning. METHODS 102 Females with either high (n = 52) or low (n = 50) self-reported social anxiety completed a novel probabilistic social learning task. Using trial and error, the task required participants to learn two self-referential rules, 'I am liked' and 'I am disliked'. RESULTS Participants across the sample were better at learning the positive rule 'I am liked' than the negative rule 'I am disliked', β = -6.4, 95% CI [-8.0, -4.7], p < 0.001. This preference for learning positive self-referential information was strongest in the lowest socially anxious and was abolished in the most symptomatic participants. Relative to the low group, the high anxiety group were better at learning they were disliked and worse at learning they were liked, social anxiety by rule interaction β = 3.6; 95% CI [+0.3, +7.0], p = 0.03. LIMITATIONS The specificity of the results to self-referential processing requires further research. CONCLUSIONS Healthy individuals show a robust preference for learning that they are liked relative to disliked. This positive self-referential bias is reduced in social anxiety in a way that would be expected to exacerbate anxiety symptoms.
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Affiliation(s)
- Katherine S Button
- School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, UK.
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Omori A, Tateno A, Ideno T, Takahashi H, Kawashima Y, Takemura K, Okubo Y. Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents. BMC Psychiatry 2012; 12:205. [PMID: 23173747 PMCID: PMC3539926 DOI: 10.1186/1471-244x-12-205] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 10/25/2012] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia. METHODS We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT) as well as Link's devaluation-discrimination scale. RESULTS The old term for schizophrenia, "Seishin-Bunretsu-Byo", was more congruent with criminal than the new term for schizophrenia, "Togo-Shitcho-Sho", before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect. CONCLUSIONS Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents' attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.
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Affiliation(s)
- Ataru Omori
- Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Takashi Ideno
- Department of Psychology, Waseda University, 1-24-1 Toyama, Shinjyuku-ku, Tokyo, 162-8644, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan,Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama, 332-0012, Japan
| | - Yoshitaka Kawashima
- Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Kazuhisa Takemura
- Department of Psychology, Waseda University, 1-24-1 Toyama, Shinjyuku-ku, Tokyo, 162-8644, Japan
| | - Yoshiro Okubo
- Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
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Hussey I, Barnes-Holmes D. The Implicit Relational Assessment Procedure as a Measure of Implicit Depression and the Role of Psychological Flexibility. COGNITIVE AND BEHAVIORAL PRACTICE 2012. [DOI: 10.1016/j.cbpra.2012.03.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Teachman BA, Joormann J, Steinman SA, Gotlib IH. Automaticity in anxiety disorders and major depressive disorder. Clin Psychol Rev 2012; 32:575-603. [PMID: 22858684 PMCID: PMC3419810 DOI: 10.1016/j.cpr.2012.06.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 05/21/2012] [Accepted: 06/25/2012] [Indexed: 01/23/2023]
Abstract
In this paper we examine the nature of automatic cognitive processing in anxiety disorders and Major Depressive Disorder (MDD). Rather than viewing automaticity as a unitary construct, we follow a social cognition perspective (Bargh, 1994) that argues for four theoretically independent features of automaticity: unconscious (processing of emotional stimuli occurs outside awareness), efficient (processing emotional meaning uses minimal attentional resources), unintentional (no goal is needed to engage in processing emotional meaning), and uncontrollable (limited ability to avoid, alter or terminate processing emotional stimuli). Our review of the literature suggests that most anxiety disorders are characterized by uncontrollable, and likely also unconscious and unintentional, biased processing of threat-relevant information. In contrast, MDD is most clearly typified by uncontrollable, but not unconscious or unintentional, processing of negative information. For the anxiety disorders and for MDD, there is no sufficient evidence to draw firm conclusions about efficiency of processing, though early indications are that neither anxiety disorders nor MDD are characterized by this feature. Clinical and theoretical implications of these findings are discussed and directions for future research are offered. In particular, it is clear that paradigms that more directly delineate the different features of automaticity are required to gain a more comprehensive and systematic understanding of the importance of automatic processing in emotion dysregulation.
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Affiliation(s)
- Bethany A Teachman
- Department of Psychology, University of Virginia, University of Virginia, Charlottesville, VA 22904‐4400, USA.
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Glashouwer KA, de Jong PJ, Penninx BWJH. Prognostic value of implicit and explicit self-associations for the course of depressive and anxiety disorders. Behav Res Ther 2012; 50:479-86. [PMID: 22659157 DOI: 10.1016/j.brat.2012.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/25/2012] [Accepted: 05/06/2012] [Indexed: 02/05/2023]
Abstract
Dysfunctional self-beliefs are assumed to play an important role in maintaining depression and anxiety. Current dual-process models emphasize the relevance of differentiating between implicit and explicit self-beliefs. Therefore, this study tested the prognostic value of automatic and explicit self-associations for the naturalistic course of depressive and anxiety disorders over two years follow-up. Both self-depressed and self-anxious associations were measured in unipolar depressed patients (n = 313), anxious patients (n = 566), and patients with comorbid depressive and anxiety disorders (n = 577) as part of the Netherlands Study of Depression and Anxiety. Outcomes showed that in single predictor models specifically automatic self-anxious associations were related to a reduced chance of remission from anxiety, whereas automatic self-depressed associations were related to a reduced chance of remission from depression. Explicit self-anxious associations and fearful avoidance behaviour showed independent predictive validity for remission from anxiety, whereas explicit self-depressed associations and having both major depressive disorder and dysthymia showed independent predictive validity for remission from depression. These findings are not only consistent with the view that both implicit and explicit dysfunctional self-associations are related to the course of anxiety and unipolar depressive disorders, but also suggest that both types of self-beliefs are proper targets for therapeutic interventions.
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Affiliation(s)
- Klaske A Glashouwer
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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de Jong PJ, Sportel BE, de Hullu E, Nauta MH. Co-occurrence of social anxiety and depression symptoms in adolescence: differential links with implicit and explicit self-esteem? Psychol Med 2012; 42:475-484. [PMID: 21798114 DOI: 10.1017/s0033291711001358] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- P J de Jong
- Department of Clinical Psychology, University of Groningen, The Netherlands.
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Lane KA, Goh JX, Driver-Linn E. Implicit Science Stereotypes Mediate the Relationship between Gender and Academic Participation. SEX ROLES 2011. [DOI: 10.1007/s11199-011-0036-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Corvin A, Donohoe G, Hargreaves A, Gallagher L, Gill M. The cognitive genetics of neuropsychiatric disorders. Curr Top Behav Neurosci 2011; 12:579-613. [PMID: 22367920 DOI: 10.1007/7854_2011_188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Classification in psychiatry is heavily dependent on clinical symptoms and illness course. This ignores the critical role that cognitive problems play in neuropsychiatric disorders affecting different domains across the lifespan, from ADHD and autism to schizophrenia and Alzheimers disease. At this point, it is unclear whether cognitive mechanisms are specific to disorders, whether multiple processes can contribute to the same disorder, or whether aberrant neural processing can result in many different phenotypic outcomes. Understanding this would allow us to better grasp normal as well as pathological brain function. This could inform diagnostics based on understanding of neurophysiological processes and the consequent development of new therapeutics. Genetics, and the development of genomic research, offers real opportunities to understand the molecular mechanisms relevant to cognition. This chapter defines and describes the main cognitive phenotypes, which are investigated in psychiatric disorders. We review evidence for their heritability and early progress in the field using cytogenetic, linkage and candidate gene-based research methodologies. With high-throughput genomics it is now possible to explore novel common and rare risk variants for psychiatric disorders and their role in cognitive function at a genome-wide level. We review the results of early genomic studies and discuss the novel insights that they are starting to provide. Finally, we review the analysis of whole-genome DNA sequence data and the challenges that this will bring for cognitive genomics research.
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Affiliation(s)
- A Corvin
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland,
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Restrained eaters show enhanced automatic approach tendencies towards food. Appetite 2010; 55:30-6. [DOI: 10.1016/j.appet.2010.03.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 02/16/2010] [Accepted: 03/09/2010] [Indexed: 11/21/2022]
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Child abuse and negative explicit and automatic self-associations: The cognitive scars of emotional maltreatment. Behav Res Ther 2010; 48:486-94. [DOI: 10.1016/j.brat.2010.02.003] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 01/26/2010] [Accepted: 02/19/2010] [Indexed: 11/17/2022]
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Do Automatic Self-Associations Relate to Suicidal Ideation? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2009; 32:428-437. [PMID: 20700378 PMCID: PMC2914256 DOI: 10.1007/s10862-009-9156-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Accepted: 08/07/2009] [Indexed: 11/21/2022]
Abstract
Dysfunctional self-schemas are assumed to play an important role in suicidal ideation. According to recent information-processing models, it is important to differentiate between ‘explicit’ beliefs and automatic associations. Explicit beliefs stem from the weighting of propositions and their corresponding ‘truth’ values, while automatic associations reflect more simple associations in memory. Both types of associations are assumed to have different functional properties and both may be involved in suicidal ideation. Thus far, studies into self-schemas and suicidal ideation focused on the more explicit, consciously accessible traces of self-schemas and predominantly relied on self-report questionnaires or interviews. To complement these ‘explicit’ findings and more directly tap into self-schemas, this study investigated automatic self-associations in a large scale community sample that was part of the Netherlands Study of Depression and Anxiety (NESDA). The results showed that automatic self-associations of depression and anxiety were indeed significantly related to suicidal ideation and past suicide attempt. Moreover, the interactions between automatic self-depressive (anxious) associations and explicit self-depressive (anxious) beliefs explained additional variance over and above explicit self-beliefs. Together these results provide an initial insight into one explanation of why suicidal patients might report difficulties in preventing and managing suicidal thoughts.
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