The Structure of Cognitive Vulnerabilities to Depression and Anxiety

Abstract

Cognitive theories of psychopathology posit that maladaptive patterns of cognitions confer elevated risks to individuals in the development of psychological disorders. This meta-analysis examined the extent to which six cognitive vulnerabilities associated with depression (i.e., pessimistic inferential style, dysfunctional attitudes, and ruminative style) and anxiety (i.e., anxiety sensitivity, intolerance of uncertainty, and fear of negative evaluation) were related with one another. A total of 159 effect sizes from 73 articles were obtained to estimate the mean correlations among the vulnerabilities. Results indicated that they were moderately to strongly correlated. Meta-analytic structural equation modeling was applied to evaluate two alternative factor analytic models underlying the associations among the vulnerabilities. A one-factor model provided the best fit to the meta-analytic data, suggesting a common etiologic factor shared among the vulnerabilities. This suggests that the vulnerabilities are not distinct at a broad level and their common core presents an avenue for transdiagnostic interventions.

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

“…Hong and Cheung (2015) suggested that several cognitive vulnerabilities may share a common core of IU and, therein, fearing the unknown. Indeed, IU mediates the relationship between neuroticism and WHAT UNCERTAINTIES REMAIN?…”

“…Models of psychopathology posit that uncertainty is a central feature in anxiety-related experience (Carleton, 2016) and the incapacity to endure unknowns appears to be a robust vulnerability factor associated with a range of psychological disorders (Grupe & Nitschke, 2013;Hong & Cheung, 2015). IU was originally defined as a broad construct that reflects "cognitive, emotional, and behavioral reactions to uncertainty in everyday life situations" (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994, p. 792).…”

“…Recent measurement research sheds light on the conceptual nature of IU, postulating that that IU comprises two dimensions; prospective IU (e.g., "I always want to know what the future has in store for me") and inhibitory IU (e.g., "When its time to act, uncertainty paralyzes me"; Carleton, 2012;Carleton, Sharpe, & Asmundson, 2007;Hong & Cheung, 2015;McEvoy & Mahoney, 2011), sometimes referred to as desire for predictability and uncertainty paralysis, respectively (Berenbaum, Bredemeier, & Thompson, 2008;Birrell, Meares, Wilkinson, & Freeston, 2011). Both prospective and inhibitory IU are conceptualized as responses to uncertainty such that prospective IU represents cognitive appraisals of threat related to future uncertainty while inhibitory IU represents behavioral inhibition related to uncertainty (Carleton, 2012;Carleton, Norton, & Asmundson, 2007;Einstein, 2014).…”

“…Norton and Paulus (2015) assert that hierarchical conceptualizations can aid in identifying transdiagnostic processes with incremental explanatory power beyond higher-order factors like neuroticism or negative affect. Using a meta-analytic approach, Hong and Cheung (2015) examined the overlap among a range of vulnerabilities and found a lack of support for symptom specificity. In line with this and to address limitations of prior studies, future research should include multiple vulnerabilities simultaneously to examine the unique and shared magnitude of associations with different disorder symptoms (Brown & Naragon-Gainey, 2013;Hong & Cheung, 2015;Norton & Mehta, 2007).…”

“…Using a meta-analytic approach, Hong and Cheung (2015) examined the overlap among a range of vulnerabilities and found a lack of support for symptom specificity. In line with this and to address limitations of prior studies, future research should include multiple vulnerabilities simultaneously to examine the unique and shared magnitude of associations with different disorder symptoms (Brown & Naragon-Gainey, 2013;Hong & Cheung, 2015;Norton & Mehta, 2007). Furthermore, researchers should investigate how IU relates to, interacts with, and predicts other potential maintaining vulnerabilities such as WHAT UNCERTAINTIES REMAIN?…”