Cognitive and Interpersonal Moderators of Daily Co-occurrence of Anxious and Depressed Moods in Generalized Anxiety Disorder
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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.
KeywordsAnxiety Depression Mood co-occurrence Comorbidity Daily diary
- Abela, J. R. Z., Hankin, B. L., Haigh, E. A. P., Adams, P., Vinokuroff, T., & Trayhern, L. (2005). Interpersonal vulnerability to depression in high-risk children: The role of insecure attachment and reassurance seeking. Journal of Clinical Child and Adolescent Psychology, 34(1), 182–192.PubMedCrossRefGoogle Scholar
- Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
- Alloy, L. B., Abramson, L. Y., Hogan, M. E., Whitehouse, W. G., Rose, D. T., Robinson, M. S., et al. (2000). The temple-wisconsin cognitive vulnerability to depression project: Lifetime history of Axis I psychopathology in individuals at high and low cognitive risk for depression. Journal of Abnormal Psychology, 109(3), 403–418.PubMedCrossRefGoogle Scholar
- Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York, NY: Guilford Press.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II (pp. 1–82). San Antonio, TX: Psychological Corporation.Google Scholar
- Cranford, J. A., Shrout, P. E., Iida, M., Rafaeli, E., Yip, T., & Bolger, N. (2006). A procedure for evaluating sensitivity to within-person change: Can mood measures in diary studies detect change reliably? Personality and Social Psychology Bulletin, 32(7), 917–929. doi:10.1177/0146167206287721.PubMedCrossRefGoogle Scholar
- de Graaf, R., Bijl, R. V., Spijker, J., Beekman, A. T. F., & Vollebergh, W. A. M. (2003). Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders: Findings from the Netherlands mental health survey and incidence study. Social Psychiatry and Psychiatric Epidemiology, 38(1), 1–11.PubMedCrossRefGoogle Scholar
- Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the beck anxiety inventory. Journal of Anxiety Disorders, 11, 219–225.Google Scholar
- Garson, G. D. (2009). Linear mixed models: Hierarchical linear, random effects, multilevel, random coefficients, and repeated measures models. Retrieved February 28, 2010, from http://faculty.chass.ncsu.edu/garson/PA765/multilevel.htm.
- Hankin, B. L., Abramson, L. Y., Miller, N., & Haeffel, G. J. (2004). Cognitive vulnerability-stress theories of depression: Examining affective specificity in the prediction of depression versus anxiety in three prospective studies. Cognitive Therapy and Research, 28(3), 309–345.CrossRefGoogle Scholar
- Heck, R., Thomas, S. L., & Tabata, L. (2010). Multilevel and longitudinal modeling with IBM. Routledge: SPSS.Google Scholar
- Joiner, T. E., Jr., & Timmons, K. A. (2009). Depression in its interpersonal context. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (2nd ed., pp. 322–339). New York, NY: Guilford Press.Google Scholar
- Katz, J., Joiner, T. E., Jr., & Kowalski, R. M. (2001). The aversive interpersonal context of depression: Emerging perspectives on depressotypic behavior. In Behaving badly: Aversive behaviors in interpersonal relationships (pp. 117–147). Washington, DC: American Psychological Association.Google Scholar
- Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2004). Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press.Google Scholar
- Overbeek, G., Vollebergh, W., de Graaf, R., Scholte, R., de Kemp, R., & Engels, R. (2006). Longitudinal associations of marital quality and marital dissolution with the incidence of DSM-III-R disorders. Journal of Family Psychology, 20(2), 284–291. doi:10.1037/0893-3220.127.116.114.PubMedCrossRefGoogle Scholar
- Rector, N. A., Antony, M. M., Laposa, J. M., Kocovski, N. L., & Swinson, R. P. (2008). Assessing content domains of repetitive thought in the anxiety spectrum: Rumination and worry in nonclinical and clinically anxious samples. International Journal of Cognitive Therapy, 1(4), 352–377. doi:10.1521/ijct.2008.1.4.352.CrossRefGoogle Scholar
- Renshaw, K. D., Chambless, D., & Steketee, G. (2001). Comorbidity fails to account for the relationship of expressed emotion and perceived criticism to treatment outcome in patients with anxiety disorders. Journal of Behavior Therapy and Experimental Psychiatry, 32(3), 145–158. doi:10.1016/s0005-7916(01)00030-1.PubMedCrossRefGoogle Scholar
- Renshaw, K. D., Chambless, D. L., & Steketee, G. (2003). Perceived criticism predicts severity of anxiety symptoms after behavioral treatment in patients with obsessive-compulsive disorder and panic disorder with agoraphobia. [Comparative Study Research Support, U.S. Gov’t, P.H.S.]. Journal of Clinical Psychology, 59(4), 411–421. doi:10.1002/jclp.10048.
- Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33; quiz 34–57.Google Scholar
- Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. (1995). Structured clinical interview for DSM-IV (SCID-IV). Washington, DC: American Psychiatric Association.Google Scholar
- Starr, L. R., & Davila, J. (in press). Responding to anxiety with rumination and hopelessness: Mechanism of anxiety-depression symptom co-occurrence? Cognitive Therapy and Research. doi:10.1007/s10608-011-9363-1.