Abstract
Previous studies of cognitive specificity indepression and anxiety disorders have establishedreliable profiles of depressive cognitions, and to asomewhat lesser extent, panic-related cognitions. The present study examines cognitive specificity inpure diagnostic groups of patients with panic disorderor major depression and compares cognitive profiles inthese single diagnosis groups to those observed in a group of individuals with comorbid panicand depression. In addition to Beck's CognitionChecklist, we introduce a cognition inventory thatincludes subscales for panic and depression along withsomatic preoccupation, social fears, and worry. Goodspecificity was found for panic and depressioncognitions in the pure diagnostic groups, and thecomorbid group was equivalent to the pure groups onthese measures. However, the comorbid group was alsosignificantly more troubled by less prototypicalcognitions concerning social-evaluative fears andsomatic preoccupation. These results suggest thatindividuals with comorbid depression and panic may holdadditional maladaptive beliefs beyond specificcognitions typically associated with each disorderalone.
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REFERENCES
Alford, B. A., Lester, J. M., Patel, R. J., Buchanan, J. P., & Giunta, L. C. (1995). Hopelessness predicts future depressive symptoms: A prospective analysis of cognitive vulnerability and cognitive content specificity. Journal of Clinical Psychology, 51, 331–339.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Hoeber.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
Beck, A. T., Brown, G., Epstein, N., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.
Beck, A. T., Brown, G., Steer, R. A., Eidelson, J. I., & Riskind, J. H. (1987). Differentiating anxiety and depression: A test of the cognitive content-specificity hypothesis. Journal of Abnormal Psychology, 96, 179–183.
Beck, A. T., Emery, G., & Greenberg, R. I. (1985). Anxiety disorders and phobias. New York: Basic Books.
Beck, A. T., Riskind, J. H., Brown, G., & Steer, R. A. (1988). Levels of hopelessness in DSM-III disorders: A partial test of content specificity in depression. Cognitive Therapy and Research, 12, 459–469.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Beck, A. T., & Steer, R. A. (1987). Manual for the revised Beck Depression Inventory. San Antonio, TX: Psychological Corporation.
Beck, A. T., & Steer, R. A. (1990). Manual for the revised Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Belfer, P. L., & Glass, C. R. (1992). Agoraphobic anxiety and fear of fear: Test of a cognitive-attentional model. Journal of Anxiety Disorders, 6, 133–146.
Borden, J. W., Peterson, D. R., & Jackson, E. A. (1991). The Beck Anxiety Inventory in nonclinical sample s: Initial psychometric properties. Journal of Psychopathology and Behavioral Assessment, 13, 345–356.
Breier, A., Charney, D., & Heninger, G. (1985). The diagnostic validity of anxiety disorders and their relationship to depressive illness. American Journal of Psychiatry, 142, 787–797.
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097.
Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The Mobility Inventory for agoraphobia. Behaviour Research and Therapy, 23, 33–44.
Chambless, D. L., & Gracely, E. J. (1989). Fear of fear and the anxiety disorders. Cognitive Therapy and Research, 13, 9–20.
Clark, D. A., Beck, A. T., & Beck, J. S. (1994). Symptom differences in major depression, dysthymia, panic disorder, and generalize d anxiety disorder. American Journal of Psychiatry, 151, 205–209.
Clark, D. A., Beck, A. T., & Brown, G. (1989). Cognitive me diation in general psychiatry outpatients: A test of the content-specificity hypothesis. Journal of Personality and Social Psychology, 56, 958–964.
Clark, D. A., Beck, A. T., & Stewart, B. (1990). Cognitive specificity and positive-negative affectivity: Complementary or contradictory views on anxiety and depression? Journal of Abnormal Psychology, 99, 148–155.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.
Craske , M. G., Rachman, S. J., & Tallman, K. (1986). Mobility, cognitions, and panic. Journal of Psychopathology and Behavioral Assessment, 8, 199–210.
DiNardo, P., & Barlow, D. (1988). Anxiety Disorders Interview Schedule-Revised (ADIS-R). Albany, NY: Graywind Publications.
DiNardo, P., Moras, K., Barlow, D., Rapee, R., & Brown, T. (1993). Reliability of DSM-III-R anxiety disorder categories: Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Archives of General Psychiatry, 50, 251–256.
Fleiss, J. L. (1981). Statistical methods for rates and proportions. (2nd ed.). New York: Wiley & Sons.
Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders, 6, 55–61.
Glass, C. R., Merluzzi, T. V., Biever, J. L., & Larsen, K. H. (1982). Cognitive assessment of social anxiety: Development and validation of a self-statement questionnaire. Cognitive Therapy and Research, 6, 37–55.
Goldstein, A., & Chambless, D. (1978). A reanalysis of agoraphobia. Behavior Therapy, 9, 47–59.
Grunhaus, L., Pande , A. C., Brown, M. B., & Greden, J. F. (1994). Clinical characteristics of patients with concurrent major depressive disorder and panic disorder. American Journal of Psychiatry, 151, 541–546.
Hoffart, A., Friis, S., & Martinsen, E. W. (1992). Assessment of fear of fear among agoraphobic patients: The Agoraphobic Cognitions Scale. Journal of Psychopathology and Behavioral Assessment, 14, 175–187.
Ingram, R. E., Kendall, P. C., Smith, T. W., Donnell, C., & Ronan, K. (1987). Cognitive specificity in emotional distress. Journal of Personality and Social Psychology, 53, 734–742.
Jolly, J. B., Dyck, M. J., Kramer, T. A., & Wherry, J. N. (1994). Integration of positive and negative affectivity and cognitive content-specificity: Improved discrimination of anxious and depressive symptoms. Journal of Abnormal Psychology, 103,544–552.
Kendall, P. C., & Ingram, R. (1987). The future for cognitive assessment of anxiety. In L. Michelson & L. M. Ascher (Eds.), Anxiety and stress disorders(pp. 89–104). New York: Guilford Press.
Kwon, S., Evans, L., & Oei, T. P. S. (1990). Factor structure of the Mobility Inventory for Agoraphobia: A validational study with Australian samples of agoraphobic patients. Journal of Psychopathology and Behavioral Assessment, 12, 365–374.
Laberge, B., Gauthier, J., Cote, G., Plamondon, J., & Cormier, H. (1992). The treatment of coexisting panic and depression: A review of the literature. Journal of Anxiety Disorders, 6, 169–180.
Livesley, W. J. (1987). A systematic approach to the delineation of personality disorders. American Journal of Psychiatry, 144, 772–777.
Livesley, W. J., Reiffer, L. I., Sheldon, A. E. R., & West, M. (1987). Prototypicality ratings of DSM-III criteria for personality disorders. Journal of Nervous and Mental Disease, 175, 395–401.
Rachman, S., Levitt, K., & Lopatka, C. (1987). Panic: The links between cognitions and bodily symptoms-I. Behaviour Research and Therapy, 25, 411–423.
Raj, B. A., Corvea, M. H., & Dagon, E. M. (1993). The clinical characteristics of panic disorder in the elderly: A retrospective study. Journal of Clinical Psychiatry, 54, 150–155.
Rapee, R. (1987). The psychological treatment of panic attacks: Theoretical conceptualization and review of evidence. Clinical Psychology Review, 7, 427–438.
Rapee, R. M. (1991). Generalize d anxiety disorder: A review of clinical features and theoretical concepts. Clinical Psychology Review, 11, 419–440.
Reiss, S. (1988). Theoretical perspectives on the fear of anxiety. Clinical Psychology Review, 7, 585–596.
Riskind, J. H., Moore, R., Harman, B., Hohmann, A. A., Beck, A. T., & Stewart, B. (1991). The relation of generalized anxiety disorder to depression in general and dysthymic disorder in particular. In R. M. Rapee & D. H. Barlow (Eds.) , Chronic anxiety: Generalized anxiety disorder and mixed anxiety-depression(pp. 44–61). New York: Guilford Press.
Salkovskis, P. M., & Clark, D. M. (1993). Panic disorder and hypochondriasis. Advances in Behaviour Research and Therapy, 15, 23–48.
Somoza, E., Steer, R. A., Beck, A. T., & Clark, D. A. (1994). Differentiating major depression and panic disorders by self-report and clinical rating scales: ROC analysis and information theory. Behaviour Research and Therapy, 32, 771–782.
Steer, R. A., Beck, A. T., Clark, D. A., & Beck, J. S. (1994). Psychometric properties of the Cognition Checklist with psychiatric outpatients and university students. Psychological Assessment, 6, 67–70.
Stopa, L., & Clark, D. M. (1993). Cognitive processes in social phobia. Behaviour Research and Therapy, 31, 255–267.
Welch, G., Hall, A., & Walkey, F. (1990). The replicable dimensions of the Beck Depression Inventory. Journal of Clinical Psychology, 46, 817–827.
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Woody, S.R., Taylor, S., Mclean, P.D. et al. Cognitive Specificity in Panic and Depression: Implications for Comorbidity. Cognitive Therapy and Research 22, 427–443 (1998). https://doi.org/10.1023/A:1018717514803
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DOI: https://doi.org/10.1023/A:1018717514803