Abstract
Comorbidity among anxiety and depressive disorders is the rule rather than the exception. The Integrative Hierarchical Model
proposes that each of these disorders contains general (common to all), specific (common to some) and unique components. However,
research into this model is limited and hampered by small (clinical) sample sizes. The aim of the present study is to investigate
the incremental validity of the cognitive constructs Anxiety Sensitivity, Pathological Worry and Cognitive Reactivity to sad
mood over and above the personality traits neuroticism and extraversion. Symptomatic (N = 1,111) and remitted (N = 834) patients were selected from the 2,981 participants of the Netherlands Study of Depression and Anxiety (NESDA). Results
revealed both specific and unique cognitive components of anxiety and depression. Across symptomatic and remitted groups,
Anxiety Sensitivity was specific to social anxiety disorder and panic disorder, Aggression Reactivity was a unique component
of dysthymia, and Rumination on Sadness was unique to major depressive disorder. We conclude that cognitive constructs have
additional value in understanding anxiety and depressive disorders. Moreover, they prove to be more than mere epiphenomena
of current disorders.
proposes that each of these disorders contains general (common to all), specific (common to some) and unique components. However,
research into this model is limited and hampered by small (clinical) sample sizes. The aim of the present study is to investigate
the incremental validity of the cognitive constructs Anxiety Sensitivity, Pathological Worry and Cognitive Reactivity to sad
mood over and above the personality traits neuroticism and extraversion. Symptomatic (N = 1,111) and remitted (N = 834) patients were selected from the 2,981 participants of the Netherlands Study of Depression and Anxiety (NESDA). Results
revealed both specific and unique cognitive components of anxiety and depression. Across symptomatic and remitted groups,
Anxiety Sensitivity was specific to social anxiety disorder and panic disorder, Aggression Reactivity was a unique component
of dysthymia, and Rumination on Sadness was unique to major depressive disorder. We conclude that cognitive constructs have
additional value in understanding anxiety and depressive disorders. Moreover, they prove to be more than mere epiphenomena
of current disorders.
- Content Type Journal Article
- Category Original Article
- Pages 1-13
- DOI 10.1007/s10608-011-9401-z
- Authors
- J. Drost, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- A. J. W. Van der Does, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- N. Antypa, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- F. G. Zitman, Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- R. Van Dyck, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Ph. Spinhoven, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Journal Cognitive Therapy and Research
- Online ISSN 1573-2819
- Print ISSN 0147-5916