Skip to main content
SpringerLink
Log in

Is the relationship between anxious and depressive cognitions and symptoms linear or curvilinear?

  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

Two studies are reported that investigated the relationship between anxious and depressive cognitions and symptoms in clinical and nonclinical adult samples. In the first study, the Cognitions Checklist (CCL), Beck Depression Inventory, Beck Anxiety Inventory, and revised Hamilton Rating Scales of Anxiety and Depression were administered to 1,553 psychiatric outpatients. Hierarchical polynomial regression analyses found only a linear component underlying most of the relationships among cognition and symptom scales. In the second study, the CCL and measures of anxious and depressive symptoms were administered to 50 depressed psychiatric inpatients, 78 chronic medically ill patients, and 25 normal controls. The relationships of cognitions and symptoms differed across samples for both the clinical rating and self-report measures of symptoms. However, the results supported a linear relationship between frequency of negative cognitions and severity of anxious or depressive symptoms in the depressed inpatient, and to a lesser extent, medical samples.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahrens, A., & Haaga, D. A. F. (1993). The specificity of attributional style and expectations to positive and negative affectivity, depression, and anxiety.Cognitive Therapy and Research, 17, 83–101.

    Google Scholar 

  • Alloy, L. B., Kelly, K. A., Mineka, S., & Clements, C. M. (1990). Comorbidity of anxiety and depressive disorders: A helplessness-hopelessness perspective. In J. Maser & R. L. Cloninger (Eds.),Comorbidity of mood and anxiety disorders (pp. 499–543). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Ambrose, B., & Rholes, W. S. (1993). Automatic cognitions and the symptoms of depression and anxiety in children and adolescents: An examination of the content-specificity hypothesis.Cognitive Therapy and Research, 17, 153–171.

    Google Scholar 

  • American Psychiatric Association. (1987).Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.) (DSM-III-R). Washington, DC: Author.

    Google Scholar 

  • Barczak, P., Hodgkinson, P., Kane, N., Andrews, S., Congdon, A. M., Clay, J. C., & Betts, T. (1988). Patterns of psychiatric morbidity in a genito-urinary clinic: A validation of the Hospital Anxiety Depression Scale (HAD).British Journal of Psychiatry, 152, 698–700.

    PubMed  Google Scholar 

  • Beck, A. T. (1967).Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  • Beck, A. T. (1976).Cognitive therapy of the emotional disorders. New York: New American Library.

    Google Scholar 

  • Beck, A. T. (1987). Cognitive models of depression.Journal of Cognitive Psychotherapy, 1, 2–27.

    Google Scholar 

  • Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective.American Psychologist, 46, 368–375.

    PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties.Journal of Consulting and Clinical Psychology, 56, 893–897.

    PubMed  Google Scholar 

  • Beck, A. T., & Steer, R. A. (1987).Manual for the Revised Beck Depression Inventory. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., & Steer, R. A. (1990).Manual for the Beck Anxiety Inventory. San Antonio: Psychological Corporation.

    Google Scholar 

  • 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, 42, 861–865.

    Google Scholar 

  • Borden, J. W., Peterson, D. R., & Jackson, E. A. (1991). The Beck Anxiety Inventory in nonclinical samples: Initial psychometric properties.Journal of Psychopathology and Behavioral Assessment, 13, 345–356.

    Google Scholar 

  • Bramley, P. N., Easton, A. M. E., Morley, S., & Snaith, R. P. (1988). The differentiation of anxiety and depression by rating scales.Acta Psychiatrica Scandinavica, 77, 133–138.

    PubMed  Google Scholar 

  • Clark, D. A. (1986). Cognitive-affective interaction: A test of the “specificity” and “generality” hypotheses.Cognitive Therapy and Research, 10, 607–623.

    Google Scholar 

  • Clark, D. A. (1988). The validity of measures of cognition: A review of the literature.Cognitive Therapy and Research, 12, 1–20.

    Google Scholar 

  • Clark, D. A., Beck, A. T., & Beck, J. (1994). Symptom differences in major depression, dysthymia, panic disorder, and generalized anxiety disorder.American Journal of Psychiatry, 151, 205–209.

    PubMed  Google Scholar 

  • Clark, D. A., Beck, A. T., & Brown, G. (1989). Cognitive mediation in general psychiatric outpatients: A test of the content-specificity hypothesis.Journal of Personality and Social Psychology, 56, 958–964.

    PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Clark, D. A., Steer, R. E., & Beck, A. T. (1994).Common and specific dimensions of self-reported anxiety and depression: Implications for the cognitive and tripartite models.Journal of Abnormal Psychology, 103, 645–654.

    PubMed  Google Scholar 

  • Clark, L. A., & Watson, D. (1991). A tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications.Journal of Abnormal Psychology, 100, 316–336.

    PubMed  Google Scholar 

  • Dent, H. R., & Salkovskis, P. M. (1986). Clinical measures of depression, anxiety and obsessionality in non-clinical populations.Behavior Research and Therapy, 24, 689–691.

    Google Scholar 

  • Fydrich, T., Dowdall, D., & Chambless, D. L. (1991). Reliability and validity of the Beck Anxiety Inventory.Journal of Anxiety Disorders, 6, 55–61.

    Google Scholar 

  • Garber, J., Weiss, B., & Shanley, N. (1993). Cognitions, depressive symptoms, and development in adolescents.Journal of Abnormal Psychology, 102, 47–57.

    PubMed  Google Scholar 

  • Gotlib, I. H., & Cane, D. B. (1989). Self-report assessment of depression and anxiety. In P. C. Kendall & D. Watson (Eds.),Anxiety and depression: Distinctive and overlapping features (pp. 131–169). San Diego: Academic Press.

    Google Scholar 

  • Guy, W. (1976).NCDEU assessment manual for psychopharmacology (DHHS Publication No. ADM 91-338). Washington, DC: U.S. Department of Health, Education, and Welfare.

    Google Scholar 

  • Hamilton, M. (1959). The assessment of anxeity states by rating.British Journal of Medical Psychology, 32, 50–55.

    PubMed  Google Scholar 

  • Hamilton, M. (1960). A rating scale for depression.Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–61.

    Google Scholar 

  • Harrell, T., Chambless, D., & Calhoun, J. (1981). Correlational relationships between self-statements and affective states.Cognitive Therapy and Research, 5, 159–173.

    Google Scholar 

  • Ingram, R. E. (1989). Unique and shared cognitive factors in social anxiety and depression: Automatic thinking and self-appraisal.Journal of Social and Clinical Psychology, 8, 198–208.

    Google Scholar 

  • Kovacs, M. (1979).Children's Depression Inventory. Pittsburgh: University of Pittsburgh.

    Google Scholar 

  • LaPointe, K., & Harrell, T. (1978). Thoughts and feelings: Correlational relationships and cross-situational consistency.Cognitive Therapy and Research, 2, 311–322.

    Google Scholar 

  • Laurent, J., & Stark, K. D. (1993). Testing the cognitive content-specificity hypothesis with anxious and depressed youngsters.Journal of Abnormal Psychology, 102, 226–237.

    PubMed  Google Scholar 

  • Moras, K., Di Nardo, P. A., & Barlow, D. H. (1992). Distinguishing anxiety and depression: Reexamination of the reconstructed Hamilton Scales.Psychological Assessment, 4, 224–227.

    Google Scholar 

  • Rholes, W. S., Riskind, J. H., & Neville, B. (1985). The relationship of cognitions and hopelessness to depression and anxiety.Cognitive Therapy and Research, 3, 36–50.

    Google Scholar 

  • Riskind, J. H., Beck, A. T., Berchick, R. J., Brown, G., & Steer, R. A. (1987). Reliability of DSM-III diagnosis for major depression and generalized anxiety disorder using the Structured Clinical Interview for DSM-III.Archives of General Psychiatry, 44, 817–820.

    PubMed  Google Scholar 

  • Snaith, R. P., & Taylor, C. M. (1985). Rating scales of depression and anxeity: A current perspective.British Journal of Clinical Pharmacology, 19, 17S-20S.

    PubMed  Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1988).Instruction manual for the Structured Clinical Interview for DSM-III-R (SCID, 6/1/88 Revision). New York: Biometrics Research Department, New York State Psychiatric Institute.

    Google Scholar 

  • Spielberger, C. D., Edwards, C. D., Lushene, R. E., Montuori, J., & Platzek, D. (1973).Manual for the State-Trait Anxiety Inventory for Children (STAIC). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1990).User's guide for the Structured Clinical Interview for DSM-III-R. Washington, DC: American Psychiatric Association Press.

    Google Scholar 

  • Steer, R. A., Beck, A. T., Clark, D. A., & Beck, J. S. (1994). Psychometric properties of the Cognitions Checklist with psychiatric outpatients and university students.Psychological Assessment, 6, 67–70.

    Google Scholar 

  • Thorpe, G. L., Barnes, G. S., Hunter, J. E., & Hines, D. (1983). Thoughts and feelings: Correlations in two clinical and two nonclinical samples.Congnitive Therapy and Research, 7, 565–574.

    Google Scholar 

  • Watson, D., & Clark, L. A. (1990, November).The affective bases of anxiety and depression. Paper presented at the Annual Conference of the Association for the Advancement of Behavior Therapy, San Francisco.

  • Wickless, C., & Kirsch, I. (1988). Cognitive correlates of anger, anxiety, and sadness.Cognitive Therapy and Research, 12, 367–377.

    Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale.Acta Psychiatrica Scandinavica, 67, 361–370.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of New Brunswick, Bag Service #45444, E3B 6E4, Fredericton, New Brunswick, Canada

    David A. Clark

  2. University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, USA

    Robert A. Steer

  3. University of Pennsylvania Medical School, USA

    Aaron T. Beck

  4. University of New Brunswick, Canada

    Dean Snow

Authors
  1. David A. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert A. Steer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aaron T. Beck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dean Snow
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

The second study was supported by a grant from the New Brunswick Medical Research Fund and the Centracare Foundation awarded to the first author. We would like to thank the patients and staff of the Dr. Everett Chalmers Hospital for their cooperation with this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Clark, D.A., Steer, R.A., Beck, A.T. et al. Is the relationship between anxious and depressive cognitions and symptoms linear or curvilinear?. Cogn Ther Res 20, 135–154 (1996). https://doi.org/10.1007/BF02228031

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02228031

Key words

Search

Navigation