Dysfunctional automatic associations in anxiety and depression

PhD ceremony: Ms. K.A. Glashouwer, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Dysfunctional automatic associations in anxiety and depression

Promotor(s): prof. P.J. de Jong, prof. B.W.J.H. Penninx

Faculty: Behavioural and Social Sciences

Anxiety and depressive disorders are highly prevalent and represent a major problem for public health these days. 1 in 5 individuals suffers from these disorders during their lives and for many patients symptoms keep returning even after successful treatment. Consequently, it is of great importance to gain more insight into why anxiety and depressive disorders are such persistent disorders. Automatic memory processes might play an important underlying role. Automatic associations can become activated involuntarily or even outside someone’s awareness. Often this is functional, because it helps people to act rapidly in various situations. However, sometimes automatic associations might be actually dysfunctional, like in anxiety and depressive disorders. Therefore, we investigated in the context of the Netherlands Study of Depression and Anxiety whether dysfunctional automatic associations are important in anxiety and depressive disorders. Results showed that anxious and depressed patients indeed were characterized by dysfunctional automatic associations. For example, they showed stronger associations between ‘me’ and ‘hopeless’ or ‘me’ and ‘anxious’. Furthermore, dysfunctional automatic associations correlated with suicidal ideation, a common symptom of depression. In addition, stronger dysfunctional automatic associations appeared to be related to a smaller change of remitting from anxiety and depressive disorders and a higher chance of developing an anxiety disorder over time. The results of this dissertation are in line with the idea that dysfunctional automatic associations contribute to the maintenance of anxiety and depressive disorders. Therefore, interventions for anxiety and depression should not only be focused on changing ‘explicit beliefs’, but also on changing dysfunctional automatic associations.