Disorder-specific automatic self-associations in depression and anxiety: results of The Netherlands Study of Depression and Anxiety
Open accessAbstract
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.
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Previous studies have reported abnormal implicit (and explicit) self-associations in rMDD, but only with small effect size or in response to negative mood.
“Previous studies have reported abnormal implicit (and explicit) self-associations in rMDD, however only showing a small effect size and in a much larger sample showing higher residual depressive symptomatology (Glashouwer and de Jong, 2010), or in response to negative mood (Gemar et al., 2001).”
From Understanding and predicting future relapse in depression from resting state functional connectivity and self-referential processing (2023) · cites this paper as Glashouwer and de Jong, 2010
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“…is in accordance with current and previous observations that comorbid patients also report relatively severe symptoms (see also Hecht et al. 1990 ; Roy-Byrne et al. 2000 ; Bruce et al. 2005) and provides further evidence for the link between the strength of implicit self-associations and the…”
ResultShame and implicit self-concept in women with borderline personality disorder
Rüsch, N., Lieb, K., Göttler, I., Hermann, C., Schramm, E., Richter, H., Jacob, G. A., Corrigan, P. W., & Bohus, M. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.3.500 · Cited by 304 · see citing works
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Automaticity in anxiety disorders and major depressive disorder
Teachman, B. A., Joormann, J., Steinman, S. A., & Gotlib, I. H. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.06.004 · Cited by 130 · see citing works
Ham, K., Chin, S., Suh, Y. J., Rhee, M., Yu, E.-S., Lee, H. J., Kim, J.-H., Kim, S. W., Koh, S.-J., & Chung, K.-M. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01592 · Cited by 61 · see citing works
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Self-citationLow Implicit Self-Esteem and Dysfunctional Automatic Associations in Social Anxiety Disorder
Glashouwer, K. A., Vroling, M. S., de Jong, P. J., Lange, W.-G., & de Keijser, J. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2012.11.005 · Cited by 48 · see citing works
Cognitive reactivity, self-depressed associations, and the recurrence of depression
Elgersma, H. J., de Jong, P. J., van Rijsbergen, G. D., Kok, G. D., Burger, H., van der Does, W., Penninx, B. W. J. H., & Bockting, C. L. H. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.05.018 · Cited by 28 · see citing works
Self-citationVollbehr, N. K., Hoenders, H. J. R., Bartels-Velthuis, A. A., Nauta, M. H., Castelein, S., Schroevers, M. J., Stant, A. D., Albers, C. J., de Jong, P. J., & Ostafin, B. D. (2022) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000777 · Cited by 26 · see citing works
Self-citationGlashouwer, K. A., de Jong, P. J., & Penninx, B. W. J. H. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.05.002 · Cited by 25 · see citing works
Self-citationVollbehr, N. K., Hoenders, H. J. R., Bartels‐Velthuis, A. A., Nauta, M. H., Castelein, S., Schroevers, M. J., Stant, A. D., de Jong, P. J., & Ostafin, B. D. (2020) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1820 · Cited by 16 · see citing works
Self-citationvan Tuijl, L. A., Glashouwer, K. A., Elgersma, H. J., Bockting, C. L. H., Penninx, B. W. J. H., & de Jong, P. J. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.06.001 · Cited by 11 · see citing works
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Rnic, K., LeMoult, J., Torres, I. J., Chakrabarty, T., Foster, J., Frey, B. N., Harkness, K. L., Ho, K., Li, Q. S., Milev, R., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115606 · Cited by 3 · see citing works
- Authors
- Glashouwer, K. A., & de Jong, P. J.
- Affiliations
- University of Groningen (NL)
- Corresponding author
- Glashouwer, K. A.
- ORCID
- Glashouwer, K. A.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-10-08
- Volume
- 40
- Issue
- 7
- Pages
- 1101-1111
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2079708841
- Cited by
- 111
- References
- 2
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 43 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 8 · 2012: 16
- FWCI
- 10.17
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Keywords
- self-schemas, depression, anxiety disorders, implicit associations, comorbidities, remission, symptom severity prediction, cognitive theories of depression
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Automatism, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Surveys and Questionnaires, Self Concept, Severity of Illness Index, Word Association Tests, Cohort Studies, Young Adult
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