The DOI matches its Crossref record; 81 of the 81 references it cites were found in a registry or an index.
Regulatory focus and anxiety: A self-regulatory model of GAD-depression comorbidity
Open accessAbstract
The etiology of generalized anxiety disorder (GAD), including its high degree of comorbidity with major depressive disorder (MDD), remains a conceptual and clinical challenge. In this article, we discuss the relevance of regulatory focus theory, an influential theory of self-regulation, for understanding vulnerability to GAD as well as GAD/MDD comorbidity. The theory postulates two systems for pursuing desired end states: the promotion and prevention systems. Drawing upon studies documenting the affective and motivational consequences of failing to attain promotion versus prevention goals, as well as the literature linking promotion failure with depression, we propose how dysfunction within the prevention system could lead to GAD - with, as well as without, MDD.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“GAD, especially when comorbid with MDD, can be seen as characterized by subjective emotional intensity/distress20, reflecting greater temperamental negative affect25–26 and activation of motivational systems that prize obtaining safety (from perceived threat) over seeking reward27–29 [motivational mechanisms].”
The cited source says what the claim attributes to it.
In the citing paper
“The comorbidity between GAD and depression is more the rule than the exception (Klenk et al., 2011), with studies estimating it at up to 80% of the cases (Judd et al., 1998; Lamers et al., 2011).”
From A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression (2020) · cites this paper as Klenk et al., 2011
The cited source says what the claim attributes to it.
In the citing paper
“emerging evidence that promotion/prevention goals may be supported by differential neural patterns (Eddington et al., 2009; Klenk, Strauman, & Higgins, 2011).”
From Extension of the Transdiagnostic Model to Focus on Intolerance of Uncertainty: A Review of the Literature and Implications for Treatment (2014) · cites this paper as Klenk, Strauman, & Higgins, 2011
In the citing paper
“In accounting for GAD, especially when it co-occurs with MDD, Klenk et al. (2011) postulate primary failure in the prevention system (i.e., hyperactivation) that in turn can lead to failure (e.g., hypoactivation) in the promotion system.”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
In the citing paper
“Individuals with distress disorders frequently experience conflicting pulls from reward/loss and safety/threat systems and lack the means to effectively resolve these motivation conflicts.”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
In the citing paper
“patients with distress disorders, especially GAD and MDD are characterized by intense emotional experiences resulting in an inordinately cautious manner that favors protection over promotion (Woody and Rachman, 1994; Chorpita et al., 1998; Klenk et al., 2011).”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Social Cognitive Theory: An Agentic Perspective
Bandura, A. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.1 · Cited by 15,510
The relation of strength of stimulus to rapidity of habit formation
Yerkes, R. M., & Dodson, J. D. (1908) · Journal of Comparative Neurology and Psychology · doi:10.1002/cne.920180503 · Cited by 6,911
Higgins, E. T. (1997) · American Psychologist · doi:10.1037/0003-066x.52.12.1280 · Cited by 6,775
Self-citationHopelessness depression: A theory-based subtype of depression.
Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989) · Psychological Review · doi:10.1037//0033-295x.96.2.358 · Cited by 3,722
Promotion and Prevention: Regulatory Focus as A Motivational Principle
Higgins, E. T. (1998) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(08)60381-0 · Cited by 3,511
Self-citationOrigins and functions of positive and negative affect: A control-process view.
Carver, C. S., & Scheier, M. F. (1990) · Psychological Review · doi:10.1037/0033-295x.97.1.19 · Cited by 2,726
Watson, D., Wiese, D., Vaidya, J., & Tellegen, A. (1999) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.76.5.820 · Cited by 2,103
Handbook of Motivation and Cognition: Foundations of Social Behavior, Vol. 2.
Wagner, D. G., Higgins, E. T., & Sorrentino, R. M. (1991) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2072281 · Cited by 1,970
Self-citationComorbidity of anxiety and unipolar mood disorders
Mineka, S., Watson, D., & Clark, L. A. (1998) · Annual Review of Psychology · doi:10.1146/annurev.psych.49.1.377 · Cited by 1,573
Developing mechanisms of self-regulation
POSNER, M. I., & ROTHBART, M. K. (2000) · Development and Psychopathology · doi:10.1017/s0954579400003096 · Cited by 1,349
Prefrontal Brain Asymmetry: A Biological Substrate of the Behavioral Approach and Inhibition Systems
Sutton, S. K., & Davidson, R. J. (1997) · Psychological Science · doi:10.1111/j.1467-9280.1997.tb00413.x · Cited by 1,263
Kessler, R. C., Nelson, C. B., McGonagle, K. A., Liu, J., Swartz, M. S., & Blazer, D. G. (1996) · The British Journal of Psychiatry · doi:10.1192/s0007125000298371 · Cited by 1,079
Behavioral activation treatment for depression: returning to contextual roots
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.8.3.255 · Cited by 1,011
Ideal versus ought predilections for approach and avoidance distinct self-regulatory systems.
Higgins, E. T., Roney, C. J. R., Crowe, E., & Hymes, C. (1994) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.66.2.276 · Cited by 970
Self-citationValue from hedonic experience and engagement
Higgins, E. T. (2006) · Psychological Review · doi:10.1037/0033-295x.113.3.439 · Cited by 949
Self-citationPerformance incentives and means: How regulatory focus influences goal attainment.
Shah, J. Y., Higgins, T. E., & Friedman, R. (1998) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.74.2.285 · Cited by 822
Kark, R., & Van Dijk, D. (2007) · Academy of Management Review · doi:10.5465/amr.2007.24351846 · Cited by 818
Higgins, E. T., Klein, R., & Strauman, T. (1985) · Social Cognition · doi:10.1521/soco.1985.3.1.51 · Cited by 721
Self-citationIdeal versus ought predilections for approach and avoidance distinct self-regulatory systems.
Higgins, E. T., Roney, C. J. R., Crowe, E., et al. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.66.2.276 · Cited by 715
Self-citationHiggins, E. T., Bond, R. N., Klein, R., & Strauman, T. J. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.1.5 · Cited by 707
Self-citationBrown, T. A., & Barlow, D. H. (2009) · Psychological Assessment · doi:10.1037/a0016608 · Cited by 639
A Population-Based Twin Study of the Relationship Between Neuroticism and Internalizing Disorders
Hettema, J. M., Neale, M. C., Myers, J., Prescott, C. A., & Kendler, K. S. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.5.857 · Cited by 633
Performance incentives and means: How regulatory focus influences goal attainment.
Shah, J. Y., Higgins, T. E., & Friedman, R. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.74.2.285 · Cited by 616
Behavioral activation and inhibition systems and the severity and course of depression.
Kasch, K. L., Rottenberg, J., Arnow, B. A., & Gotlib, I. H. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.4.589 · Cited by 551
Treatment and prevention of depression
Hollon, S. D., Thase, M. E., & Markowitz, J. C. (2002) · Psychological Science in the Public Interest · doi:10.1111/1529-1006.00008 · Cited by 511
Kessler, R. C., DuPont, R. L., Berglund, P. A., & Wïttchen, H. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.12.1915 · Cited by 486
Evolution, emotions, and emotional disorders.
Nesse, R. M., & Ellsworth, P. C. (2009) · American Psychologist · doi:10.1037/a0013503 · Cited by 426
Akiskal, H. S., & McKinney, W. T. (1973) · Science · doi:10.1126/science.182.4107.20 · Cited by 389
Gailliot, M. T., Schmeichel, B. J., & Baumeister, R. F. (2006) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.91.1.49 · Cited by 361
Carter, R. M., Wïttchen, H., Pfister, H., & Kessler, R. C. (2001) · Depression and Anxiety · doi:10.1002/da.1020 · Cited by 350
Anxiety disorders in major depression.
Fava, M., Rankin, M. A., Wright, E. C., Alpert, J., Nierenberg, A., Pava, J. A., & Rosenbaum, J. (2000) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(00)90140-8 · Cited by 347
Expectancy × value effects: Regulatory focus as determinant of magnitude and direction.
Shah, J. Y., & Higgins, E. T. (1997) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.73.3.447 · Cited by 335
Self-citationAssessment of state and trait anxiety: Conceptual and methodological issues.
Spielberger, C. D. (1985) · Cited by 335
Förster, J., Grant, H., Idson, L. C., & Higgins, E. T. (2001) · Journal of Experimental Social Psychology · doi:10.1006/jesp.2000.1455 · Cited by 321
Self-citationFirst onset versus recurrence of depression: differential processes of psychosocial risk
Lewinsohn, P. M., Allen, N. B., Seeley, J. R., & Gotlib, I. H. (1999) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.108.3.483 · Cited by 301
First onset versus recurrence of depression: Differential processes of psychosocial risk.
Lewinsohn, P. M., Allen, N. B., Seeley, J. R., & Gotlib, I. H. (1999) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.108.3.483 · Cited by 299
Are shame and guilt related to distinct self-discrepancies? A test of Higgins's (1987) hypotheses.
Tangney, J. P., Niedenthal, P. M., Covert, M. V., & Barlow, D. H. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.75.1.256 · Cited by 296
Social psychological foundations of clinical psychology
Maddux, J. E., & Tangney, J. P. (2010) · Cited by 286
Treatment Plans and Interventions for Depression and Anxiety Disorders
Leahy, R. L., Holland, S. J., & Butler, A. C. (2000) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.14.4.409 · Cited by 275
Frontal Brain Asymmetry and Depression: A Self-regulatory Perspective
Tomarkenand, A. J., & Keener, A. D. (1998) · Cognition & Emotion · doi:10.1080/026999398379655 · Cited by 253
Handbook of Personality and Self‐Regulation
Hoyle, R. H. (2010) · Wiley eBooks · doi:10.1002/9781444318111 · Cited by 251
Regulatory concerns and appraisal efficiency: The general impact of promotion and prevention.
Shah, J., & Higgins, E. T. (2001) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.80.5.693 · Cited by 245
Self-citationExpectancy × value effects: Regulatory focus as determinant of magnitude and direction.
Shah, J. Y., & Higgins, E. T. (1997) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.73.3.447 · Cited by 245
Self-citationPsychology of self-regulation: Cognitive, affective, and motivational processes.
Forgas, J. P., Baumeister, R. F., & Tice, D. M. (2011) · Cited by 231
Psychological mechanisms in acute response to trauma
McNally, R. J. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01663-3 · Cited by 211
Shankman, S. A., & Klein, D. N. (2003) · Clinical Psychology Review · doi:10.1016/s0272-7358(03)00038-2 · Cited by 209
Test Anxiety: A Cross-Cultural Perspective
Bodas, J., & Ollendick, T. H. (2005) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-005-2342-x · Cited by 206
Higgins, E. T. (1989) · Journal of Personality · doi:10.1111/j.1467-6494.1989.tb00488.x · Cited by 180
Self-citationA Goal Systems–Self-Regulatory Perspective on Personality, Psychopathology, and Change
Karoly, P. (1999) · Review of General Psychology · doi:10.1037/1089-2680.3.4.264 · Cited by 171
Implicit regulatory focus associated with asymmetrical frontal cortical activity
Amodio, D. M., Shah, J. Y., Sigelman, J. D., Brazy, P. C., & Harmon‐Jones, E. (2003) · Journal of Experimental Social Psychology · doi:10.1016/s0022-1031(03)00100-8 · Cited by 160
Strauman, T. J., Vieth, A. Z., Eddington, K. M., Kolden, G. G., Woods, T. E., Klein, M. H., Papadakis, A. A., Schneider, K. L., & Kwapil, L. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.2.367 · Cited by 151
Self-citationThe Evolution of the Human Self: Tracing the Natural History of Self‐Awareness
Leary, M. R., & Buttermore, N. (2003) · Journal for the Theory of Social Behaviour · doi:10.1046/j.1468-5914.2003.00223.x · Cited by 149
Higgins, E. T. (1999) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.77.6.1313 · Cited by 147
Self-citationKeeley, J. W., Zayac, R. M., & Correia, C. J. (2008) · Statistics Education Research Journal · doi:10.52041/serj.v7i1.477 · Cited by 143
Stressors and job outcomes in sales: a triphasic model versus a linear-quadratic-interactive model
Bhuian, S. N., Mengüç, B., & Borsboom, R. (2003) · Journal of Business Research · doi:10.1016/s0148-2963(03)00132-2 · Cited by 138
Handbook of personality and self-regulation
(2011) · Choice Reviews Online · doi:10.5860/choice.48-5977 · Cited by 138
Strauman, T. J. (1992) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.101.1.87 · Cited by 137
Self-citationSelf-regulation, rumination, and vulnerability to depression in adolescent girls
Papadakis, A. A., PRINCE, R. P., Jones, N. P., & Strauman, T. J. (2006) · Development and Psychopathology · doi:10.1017/s0954579406060408 · Cited by 136
Self-citationA Population-Based Twin Study of the Relationship Between Neuroticism and Internalizing Disorders
Hettema, J. M. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.5.857 · Cited by 128
The Influence of Regulatory Focus on Risky Decision‐Making
Bryant, P., & Dunford, R. (2008) · Applied Psychology · doi:10.1111/j.1464-0597.2007.00319.x · Cited by 118
Generalized Anxiety Disorder in Patients With Major Depression: Is DSM-IV’s Hierarchy Correct?
Zimmerman, M. A., & Chelminski, I. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.3.504 · Cited by 113
Manian, N., Papadakis, A. A., Strauman, T. J., & Essex, M. J. (2006) · Journal of Personality · doi:10.1111/j.1467-6494.2006.00422.x · Cited by 110
Self-citationStandards and the process of self-evaluation: Multiple affects from multiple stages.
Higgins, E. T., Strauman, T. J., & Klein, R. (1986) · Cited by 108
Self-citationBrief Report Anxiety, depression and approach and avoidance goals
Dickson, J. M., & MacLeod, A. K. (2004) · Cognition & Emotion · doi:10.1080/02699930341000013 · Cited by 104
Chambers, R. A., & Conroy, S. K. (2007) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2007.19.1.1 · Cited by 104
Strauman, T. J. (1996) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.71.6.1142 · Cited by 101
Self-citationGroup-based self-regulation: The effects of regulatory focus
Sassenberg, K., & Woltin, K. (2008) · European Review of Social Psychology · doi:10.1080/10463280802201894 · Cited by 98
Sarid, O., Anson, O., Yaari, A., & Margalith, M. (2004) · Research in Nursing & Health · doi:10.1002/nur.20028 · Cited by 92
Strauman, T. J. (1992) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.101.1.87 · Cited by 92
Self-citationEddington, K. M., Dolcos, F., Cabeza, R. E. L., Krishnan, K. R., & Strauman, T. J. (2007) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2007.19.7.1152 · Cited by 91
Self-citationStrauman, T. J. (1996) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.71.6.1142 · Cited by 87
Self-citationvan Lang, N. D. J., Ferdinand, R. F., Ormel, J., & Verhulst, F. C. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.004 · Cited by 79
Self-System Therapy (SST): A Theory-Based Psychotherapy for Depression
Vieth, A. Z., Strauman, T. J., Kolden, G. G., Woods, T. E., Michels, J. L., & Klein, M. H. (2003) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.bpg023 · Cited by 69
Self-citationBruch, M. A., Rivet, K. M., & Laurenti, H. J. (2000) · Personality and Individual Differences · doi:10.1016/s0191-8869(99)00176-2 · Cited by 63
Self-discrepancies and negative affect: A primer on when to look for specificity, and how to find it
Boldero, J., Moretti, M. M., Bell, R., & Francis, J. (2005) · Australian Journal of Psychology · doi:10.1080/00049530500048730 · Cited by 50
Depression, regulatory focus, and motivation
Miller, A. K., & Markman, K. D. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2006.12.006 · Cited by 49
Eddington, K. M., Dolcos, F., McLean, A. N., Krishnan, K. R., Cabeza, R., & Strauman, T. J. (2009) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsp016 · Cited by 41
Self-citationIndividual Differences in Approach and Avoidance
Strauman, T. J., & Wilson, W. A. (2010) · Wiley eBooks · doi:10.1002/9781444318111.ch20 · Cited by 29
Self-citationSelf-Discrepancies in Young Adults and Childhood Violence
Brewin, C. R., & Vallance, H. K. (1997) · Journal of Interpersonal Violence · doi:10.1177/088626097012004008 · Cited by 14
Cited by
Sorted by citations
Petrou, P., Demerouti, E., & Schaufeli, W. B. (2016) · Journal of Management · doi:10.1177/0149206315624961 · Cited by 533
Shanahan, L., Copeland, W., Angold, A. C., Bondy, C. L., & Costello, E. J. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.12.029 · Cited by 306
Zbozinek, T. D., Rose, R. D., Wolitzky-Taylor, K. B., Sherbourne, C. D., Sullivan, G., Stein, M. B., Roy‐Byrne, P., & Craske, M. G. (2012) · Depression and Anxiety · doi:10.1002/da.22026 · Cited by 246
Einstein, D. A. (2014) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12077 · Cited by 223
Motivational Mechanisms Underlying Second Language Achievement: A Regulatory Focus Perspective
Papi, M., & Khajavy, G. H. (2021) · Language Learning · doi:10.1111/lang.12443 · Cited by 191
Metadata
- Authors
- Klenk, M. M., Strauman, T. J., & Higgins, E. T.
- Affiliations
- Duke University (US)
- Columbia University (US)
- Corresponding author
- Strauman, Timothy J.
- Venue
- Personality and Individual Differences
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 50
- Issue
- 7
- Pages
- 935-943
- ISSN
- 0191-8869 (ISSN-L)
- PMC
- PMC3079259
- OpenAlex
- W2036025989
- Cited by
- 105
- References
- 75
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 10 · 2023: 3 · 2022: 6 · 2021: 10 · 2020: 10 · 2019: 7 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 11 · 2013: 5 · 2012: 5
- FWCI
- 9.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Personality and Individual Differences (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Mental Health (R24MH067447, R21MH052281)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- regulatory focus, generalized anxiety disorder, major depressive disorder, self-regulation, promotion focus, prevention focus, anxiety, depression, motivation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
