a1 Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
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)
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: email@example.com)