Cognitive Therapy and Research

, Volume 36, Issue 6, pp 655–669 | Cite as

Cognitive and Interpersonal Moderators of Daily Co-occurrence of Anxious and Depressed Moods in Generalized Anxiety Disorder

  • Lisa R. StarrEmail author
  • Joanne Davila
Original Article


Anxiety and depression co-occur, both at the disorder and symptom levels, and within anxiety disorders, fluctuations in daily anxious mood correspond temporally to fluctuations in depressed mood. However, little is known about the factors or conditions under which anxiety and depressive symptoms are most likely to co-occur. The current study investigated the role of cognitive factors (daily rumination and cognitive attributions about anxiety symptoms) and interpersonal functioning (daily perceived rejection, support, criticism, and interpersonal problems) as moderators of the daily association between anxious and depressed moods. Fifty-five individuals with generalized anxiety disorder completed a 21-day diary assessing daily mood and cognitive and interpersonal functioning. Ratings of anxious and depressed mood were more closely associated on days when participants ruminated about their anxiety or viewed anxiety symptoms more negatively. Furthermore, anxious mood predicted later depressed mood on days when participants reported greater interpersonal problems and more perceived rejection. Results suggest that cognitive and interpersonal factors may elevate the likelihood of anxiety-depression co-occurrence.


Anxiety Depression Mood co-occurrence Comorbidity Daily diary 



This research was funded through a grant from the National Institute of Mental Health (F31MH082545) and an American Psychological Association Dissertation Award, both awarded to the first author. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIMH or the APA. The authors would like to thank Joseph Schwartz, Ph.D. for his statistical consultation, and would also like to acknowledge the following people for their project assistance: Rachel Hershenberg, M.A., Athena Yoneda, Ph.D., Jonathan Powers, M.S., Kaitlyn Gorman, and Kayla Whearty.


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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of California, Los AngelesLos AngelesUSA
  2. 2.State University of New York at Stony BrookStony BrookUSA

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