Comps - Psychopathology (Subdomain 2) Flashcards
What explains the comorbidity of anxiety and depression? (Seligman & Ollendick, 1998; Garber & Weering, 2010)
- Overlap in definitions (symptoms, screening scales, assessment methods)
- Anxiety and depression may represent two factors of the same model
- Overlap in risk/etiology factors
- Cognitive biases
- Neural circuitry dysfunction can affect emotional modulation
Overlap in symptoms of anxiety and depression
Fatigue, concentration problems, insomnia, irritability, rumination
Overlap in screening scales of anxiety and depression
Since there is a lot of symptom overlap, the screening scales measure similar things
Overlap in assessment methods of anxiety and depression
-Assessments that use dimensional models show a significant correlation between anxiety and depression
-Overlap in broadband scales (i.e., MMPI)
Tripartite Model (Clark & Watson, 1991)
-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
What is the common component between anxiety and depression from the Tripartite Model?
Negative affectivity
What are the factors that overlap in risk/etiology?
-Temperamental factors (behavioral inhibition)
-Parental factors
Behavioral Inhibition
The tendency to be shy and cautious when exposed to unfamiliar or stressful stimuli (the tendency to withdraw from the source of stimuli)
Genetic Parental Factors
-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
Environmental Parental Factors
Parental behavior:
-Too controlling can lead to anxiety
-Too rejecting can lead to depression
-Insecure attachment can lead to either or both
Cognitive biases of anxiety and depression
-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
Neural circuitry dysfunction in anxiety and depression
Depending on overactivation in certain parts to the brain lends itself to emotion regulation issues
Can anxiety lead to depression? (Seligman & Ollendick, 1998)
-The consequences of anxiety could lead to depression
-Pathways
-Anxiety-prone may mean depression-prone (and bidirectional)
-Shared stress (diathesis-stress model)
What are the implications of high comorbidity of depression and anxiety? (Seligman & Ollendick, 1998; Garber & Weering, 2010)
- Treatment targeting negative affectivity (common component) will likely help both anxiety and depression
- Preventative (treating anxiety may prevent depression)
- Psychopharmacological therapeutic treatment is the same (SSRIs)
- CBT for anxiety and mild depression
- Intervention may spill over and benefit other problems
Does avoidance predict anxiety and depression? (Grant et al., 2013)
-Avoidance appears to predict anxiety and depression
-Avoidance coping (manage consequences of stress and disengage from problems resulting from stress)
-Cognitive avoidance
-Behavioral avoidance
Cognitive Avoidance (don’t think)
-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)
Cognitive Avoidance Example
Engage in activities to distract from thoughts, but when those distractions came back, you sleep all day
Behavioral Avoidance (don’t do)
Any actions people use to escape or distract themselves from difficult thoughts, feelings, and situations
Behavioral Avoidance Example
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
What is the transdiagnostic model for treating anxiety and depression? (Barlow & Kennedy, 2016)
-The transdiagnostic idea for comorbidity of depression and anxiety is that it may be overlapping constructs
-There are 5 constructs
What are the 5 constructs of the transdiagnostic model for treating anxiety and depression? (Barlow & Kennedy, 2016)
- Experiential Avoidance
- Rumination
- Anxiety Sensitivity
- Mindfulness Deficits
- Negative Appraisals
Experiential Avoidance
The tendency to escape or avoid uncomfortable internal experiences such as thoughts, memories, or emotions
Rumination
The cognitive strategy where individuals repetitively fixate on negative moods and their possible causes, meanings, and consequences with an emphasis on past events
Anxiety Sensitivity
The tendency to believe that symptoms of anxiety, particularly somatic symptoms, will have negative consequences (e.g., panic disorders)
Mindfulness Deficits
-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
Negative Appraisals
Intensive negative affectivity is associated with pessimism, negativistic, and very rigid negative appraisals of experiences and events (Beck, 1976)
Transdiagnostic Treatment Focus
-Recognize emotions and respond adaptively
-Aiming to change the idea of life as uncontrollable and narrowing to a negative focus
Transdiagnostic Treatment Targets
-MI (make sure they are ready and motivated to change behavior)
-Psychoeducation
-Emotional Mindfulness
-Cognitive reappraisal
-Exposure
-Relapse prevention
Does rumination relate to the connection between anxiety and depression? (Olantunji et al., 2013)
There is a strong link between rumination and depression, and a moderate correlation between rumination and anxiety and depression
Emotionally Driven Rumination
Rumination that occurs when in a certain emotional state
Ruminative Brooding
Passive comparison of current state to unachieved standard
