Comps - Psychopathology (Subdomain 2)

Question 1

What explains the comorbidity of anxiety and depression? (Seligman & Ollendick, 1998; Garber & Weering, 2010)

Answer 1

1. Overlap in definitions (symptoms, screening scales, assessment methods)
2. Anxiety and depression may represent two factors of the same model
3. Overlap in risk/etiology factors
4. Cognitive biases
5. Neural circuitry dysfunction can affect emotional modulation

Question 2

Overlap in symptoms of anxiety and depression

Answer 2

Fatigue, concentration problems, insomnia, irritability, rumination

Question 3

Overlap in screening scales of anxiety and depression

Answer 3

Since there is a lot of symptom overlap, the screening scales measure similar things

Question 4

Overlap in assessment methods of anxiety and depression

Answer 4

-Assessments that use dimensional models show a significant correlation between anxiety and depression
-Overlap in broadband scales (i.e., MMPI)

Question 5

Tripartite Model (Clark & Watson, 1991)

Answer 5

-Depression and anxiety represent a common component with 2 different aspects
-Symptoms of anxiety and depression fall into 3 groups (low positive affect, physiological arousal, nonspecific distress (negative affect is the core component))
-Low positive affect is specific to depression
-Physiological arousal is specific to anixety
-High negative affect is where anxiety and depression overlap

Question 6

What is the common component between anxiety and depression from the Tripartite Model?

Answer 6

Negative affectivity

Question 7

What are the factors that overlap in risk/etiology?

Answer 7

-Temperamental factors (behavioral inhibition)
-Parental factors

Question 8

Behavioral Inhibition

Answer 8

The tendency to be shy and cautious when exposed to unfamiliar or stressful stimuli (the tendency to withdraw from the source of stimuli)

Question 9

Genetic Parental Factors

Answer 9

-Parental psychopathology predicts childhood anxiety/depression (e.g., higher rates of depression in children of parents with MDD than parents without MDD)
-Twin studies suggest there is a shared genetic component

Question 10

Environmental Parental Factors

Answer 10

Parental behavior:
-Too controlling can lead to anxiety
-Too rejecting can lead to depression
-Insecure attachment can lead to either or both

Question 11

Cognitive biases of anxiety and depression

Answer 11

-This part is not well researched
-Biases around themes of loss and threat have a complicated/nonlinear relationship to predicting anxiety and depression
-The problem is that many disorders share these risk factors

Question 12

Neural circuitry dysfunction in anxiety and depression

Answer 12

Depending on overactivation in certain parts to the brain lends itself to emotion regulation issues

Question 13

Can anxiety lead to depression? (Seligman & Ollendick, 1998)

Answer 13

-The consequences of anxiety could lead to depression
-Pathways
-Anxiety-prone may mean depression-prone (and bidirectional)
-Shared stress (diathesis-stress model)

Question 14

What are the implications of high comorbidity of depression and anxiety? (Seligman & Ollendick, 1998; Garber & Weering, 2010)

Answer 14

1. Treatment targeting negative affectivity (common component) will likely help both anxiety and depression
2. Preventative (treating anxiety may prevent depression)
3. Psychopharmacological therapeutic treatment is the same (SSRIs)
4. CBT for anxiety and mild depression
5. Intervention may spill over and benefit other problems

Question 14

Does avoidance predict anxiety and depression? (Grant et al., 2013)

Answer 14

-Avoidance appears to predict anxiety and depression
-Avoidance coping (manage consequences of stress and disengage from problems resulting from stress)
-Cognitive avoidance
-Behavioral avoidance

Question 15

Cognitive Avoidance (don’t think)

Answer 15

-A coping mechanism that involves avoiding threats, stress-related emotions, and negative thought patterns
-Perpetuates rumination with avoidance
-Strategy that people use to avoid anxiety (provides short-term relief, but comes back harder long-term)

Question 16

Cognitive Avoidance Example

Answer 16

Engage in activities to distract from thoughts, but when those distractions came back, you sleep all day

Question 17

Behavioral Avoidance (don’t do)

Answer 17

Any actions people use to escape or distract themselves from difficult thoughts, feelings, and situations

Question 18

Behavioral Avoidance Example

Answer 18

Someone afraid of public speaking might drop a class in which they have to give a speech, even though they need that class to graduate

Question 19

What is the transdiagnostic model for treating anxiety and depression? (Barlow & Kennedy, 2016)

Answer 19

-The transdiagnostic idea for comorbidity of depression and anxiety is that it may be overlapping constructs
-There are 5 constructs

Question 20

What are the 5 constructs of the transdiagnostic model for treating anxiety and depression? (Barlow & Kennedy, 2016)

Answer 20

1. Experiential Avoidance
2. Rumination
3. Anxiety Sensitivity
4. Mindfulness Deficits
5. Negative Appraisals

Question 21

Experiential Avoidance

Answer 21

The tendency to escape or avoid uncomfortable internal experiences such as thoughts, memories, or emotions

Question 22

Rumination

Answer 22

The cognitive strategy where individuals repetitively fixate on negative moods and their possible causes, meanings, and consequences with an emphasis on past events

Question 23

Anxiety Sensitivity

Answer 23

The tendency to believe that symptoms of anxiety, particularly somatic symptoms, will have negative consequences (e.g., panic disorders)

Question 24

Mindfulness Deficits

Answer 24

-Mindfulness: being aware and accepting of one’s experience, including emotions in the present moment no matter how unpleasant the experience
-Higher levels of mindfulness reported lower feelings of anxiety and cortisol

Question 25

Negative Appraisals

Answer 25

Intensive negative affectivity is associated with pessimism, negativistic, and very rigid negative appraisals of experiences and events (Beck, 1976)

Question 26

Transdiagnostic Treatment Focus

Answer 26

-Recognize emotions and respond adaptively
-Aiming to change the idea of life as uncontrollable and narrowing to a negative focus

Question 27

Transdiagnostic Treatment Targets

Answer 27

-MI (make sure they are ready and motivated to change behavior)
-Psychoeducation
-Emotional Mindfulness
-Cognitive reappraisal
-Exposure
-Relapse prevention

Question 28

Does rumination relate to the connection between anxiety and depression? (Olantunji et al., 2013)

Answer 28

There is a strong link between rumination and depression, and a moderate correlation between rumination and anxiety and depression

Question 29

Emotionally Driven Rumination

Answer 29

Rumination that occurs when in a certain emotional state

Question 30

Ruminative Brooding

Answer 30

Passive comparison of current state to unachieved standard