Irrational Beliefs in Employees with an Adjustment, a Depressive, or an Anxiety Disorder: a Prospective Cohort Study

Abstract

It remains unclear if patients with different types of common mental disorders, such as adjustment, anxiety and depressive disorders, have the same irrational ideas. The aim of this prospective cohort study (n = 190) is to investigate differences in level and type of irrational beliefs among these groups and to examine whether a change in irrational beliefs is related to symptom recovery. Irrational beliefs (IBI) and symptoms were measured at four points in time: at baseline, after 3, 6 and 12 months. Results showed that diagnostic groups differed in their level of irrational beliefs and this effect remained over time. Highest levels of irrationality were observed in the double diagnosis group, followed by the anxiety disorder group and the depression group. Participants with adjustment disorders showed the lowest levels of irrationality, comparable to a community sample. We did not find differences in the type of irrational beliefs between diagnostic groups. The level of irrationality declined over time for all diagnostic groups. No differences in decrease were observed between diagnostic groups. The magnitude and direction of change in irrational beliefs were related to the magnitude of recovery of depressive, anxiety and stress symptoms over time. These results support the application of general cognitive interventions, especially for patients with a depressive or an anxiety disorder.

Prognostic Factors of Long Term Disability Due to Mental Disorders: A Systematic Review

“…β = 0.13, β = 0.30  Changing work tasks: β = 0.10Engström and Janson [23]Dependency on sickness insurance c.q. full/partial (healthy state) or no work resumption (unhealthy state)(1) Demographics e (2) Labour market data f (3) History of previous sickness absenceLogistic regression to estimate ORs; significant risk factors healthy versus unhealthy state 3 years after initial sickness absence:(1) Healthy:  Male gender: OR 1.637 ( P  < 0.05)(2) Unhealthy:  Age: OR 16.961 (16–29 years, P  < 0.01); OR 4.807 (50–59 years, P  < 0.01)  Unemployment: OR 0.468 ( P  < 0.01)  History of previous sickness absence OR 0.617 ( P  < 0.01)  Multiple diagnosis (stress-related and shoulder/back pain) OR 0.576 ( P  < 0.01)Nieuwenhuijsen et al [24]Time to full/partial return to work (RTW)Performance indicator (PI) g of occupational physician (OP)Kaplan–Meier survival analysis to estimate univariate relations:(1) Longer time to first RTW:  Deviant PI interventions aimed at organization ( P  = 0.02)  Deviant PI continuity of care ( P  < 0.0001)(2) Longer time to full RTW:  Age >50 ( P  = 0.02) Cox proportional hazard ratio (HR, 95% CI) analysis to estimate multivariate associations:(1) Longer time to first RTW:  Deviant PI interventions aimed at organization: HR 0.5 (0.3–0.9)  Deviant PI continuity of care: HR 0.3 (0.2–0.5)(2) Longer time to full RTW: Deviant PI continuity of care: HR 0.3 (0.2–0.5)Nieuwenhuijsen et al [25]Time to full/partial RTW(1) Supervisor behaviour h (2) Conditional factors i Cox regression analysis to estimate hazard ratios (HR, 95% CI) indicating time to RTW:(1) Shorter time to full RTW:  Communication with employee (non-depressed only): HR 3.5 (1.4–8.9)(2) Longer time to full/partial RTW:  Consulting with professionals: HR 0.4 (0.2–0.9)Nieuwenhuijsen et al [26]Time to full RTW(1) Disorder related factors j (2) Personal factors k (3) Environmental factors l Cox regression analysis to estimate hazard ratios (HR, 95% CI) indicating time to full RTW:Longer time:  Age ≥50: HR 0.5 (0.3–0.8)  Expectation of duration >3 months: HR 0.5 (0.3–0.8)  Educational level medium/high : HR 0.5 (0.3–0.8)  Depression/anxiety disorder: HR 0.7 (0.4–0.9)Nieuwenhuijsen et al [27]Symptom recoveryChange in irrational beliefsRepeated measurements MANOVAs to describe relation of change in irrational beliefs and symptom recovery:  Magnitude/direction of change in irrational beliefs are related to magnitude of recovery of depressive, anxiety, stress symptoms over time  Design not suited to assess temporal relationship beliefs/symptomsVaez et al [28](1) Sickness absence(2) Disability pension (DP)(1) Demogra...…”

The Moderating Role of Rational Beliefs in the Relationship between Irrational Beliefs and Posttraumatic Stress Symptomology

“…There is a large body of empirical evidence that demonstrates that irrational beliefs are critical cognitive variables in the emergence of various forms of psychopathology, including mood disorders (Macavei, 2005; Muran, Kassinove, Ross and Muran, 1989; Nelson, 1977; Prud'homme and Barron, 1992; McDermutt, Haaga and Bilek, 1997; Blatt, 1995), major depressive disorder (Szentagotai, David, Lupu and Cosman, 2008), various anxiety disorders (Nieuwenhuijsen, Verbeek, Boer, Blonk and van Dijk, 2010; Lupu and Iftene, 2009; DiLorenzo et al, 2007; Montgomery, David, DiLorenzo and Schnur, 2007; Lorcher, 2003), anger disorders (Jones and Towers, 2004; Martin and Dahlen, 2004; Silverman and DiGiuseppe, 2001; Bernard, 1998), symptoms of various general psychiatric disorders (Alden, Safran and Weideman, 1978), lack of assertiveness (Alden and Safran, 1978), type A coronary prone behaviour pattern (Smith and Brehm, 1981), trait anger, trait depression, and trait anxiety (Bernard, 1998), and state anger, state guilt, and state anxiety (David et al, 2002).…”

Suporte familiar, crenças irracionais e sintomatologia depressiva em estudantes universitários

“…Nesse sentido, estudos mostram que jovens depressivos e dotados de pensamentos disfuncionais podem ter herdado dos pais, por intermédio de processos de aprendizagem, como modelagem e modelação, formas específicas de avaliarem as situações cotidianas e de se autoavaliarem de forma negativa (Ahlstrom, Skarsater, & Danielson, 2010;Meadows, McLanahan, & Brooks-Gunn, 2007). Além disso, níveis altos de crenças irracionais são observados em pessoas diagnosticadas com transtornos de humor, além de pessoas com transtornos de humor em fase controlada demonstrarem baixos níveis de irracionalidade (Nieuwenhuijsen, Verbeek, Boer, Blonk, & Dijk, 2010). Esses dados vão ao encontro dos resultados encontrados no presente estudo, indicando que sintomas depressivos estão associados a pensamentos disfuncionais, e que os pais podem influenciar negativamente ou positivamente em problemas relacionados à depressão, ou mesmo que os sintomas depressivos associados às crenças irracionais podem distorcer a avaliação sobre o grupo familiar.…”

“…Observa-se que o suporte familiar adequado pode inclusive estar relacionado com a prevenção de transtornos mentais, como, por exemplo, a depressão (Ivanova & Israel, 2006;Nieuwenhuijsen, Verbeek, Boer, Blonk, & Dijk, 2010). Santana (2008) verificou que, quanto maior o suporte familiar recebido, menor sintomatologia depressiva e melhores os estilos parentais encontrados.…”