Psychological Medicine

Original Articles

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

K. A. Glashouwera1 c1 and P. J. de Jonga1

a1 Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands

Abstract

Background Cognitive theory points to the importance of negative self-schemas in the onset and maintenance of depression and anxiety disorders. Hereby, it is important to distinguish between automatic and explicit self-schemas, reflecting different cognitive-motivational systems. This study tested whether patients with a current major depression and/or anxiety disorder are characterized by automatic self-anxious and self-depressive associations and whether these associations are disorder specific.

Method Patients (n=2329) and non-clinical controls (n=652) were tested as part of The Netherlands Study of Depression and Anxiety, a multi-center, longitudinal, cohort study with patients from different health care settings. Patient groups and non-clinical controls (18–65 years of age) were compared with regard to automatic self-anxious and self-depressive associations measured with the Implicit Association Test.

Results Individuals with an anxiety disorder showed enhanced self-anxious associations, whereas individuals with a depression showed enhanced self-depressive associations. Individuals with co-morbid disorders scored high on both automatic self-associations. Although remitted individuals showed weaker automatic self-associations than people with a current disorder, their automatic self-anxious/depressed associations were still significantly stronger than those of the control group. Importantly, automatic self-associations showed predictive validity for the severity of anxious and depressive symptoms over and above explicit self-beliefs.

Conclusions This study represents the first evidence that automatic self-anxious and self-depressive associations are differentially involved in anxiety disorders and depression. This may help to explain the refractoriness of these disorders and points to the potential importance of automatic self-associations in the development of psychopathological symptoms.

(Received October 07 2008)

(Revised August 06 2009)

(Accepted August 13 2009)

(Online publication October 08 2009)

Correspondence

c1 Address for correspondence: K. A. Glashouwer, M.Sc., Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1. 9712 TS Groningen, The Netherlands. (Email: k.a.glashouwer@rug.nl)

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