COGNITIVE DISTORTION AND MIXED ANXIETY-DEPRESSIVE DISORDER Anita Robert Mixed anxiety-depressive disorder
■ Anxiety + Depression symptom – Focusing difficulty – Sleeping disorder – Low self-esteem – Hazard anticipation – …
Impact on everyday life, social and professional life
2 Cognitive distorsion in anxiety and depression disorder
Anxiety Depression ■ Arbitrary focusing ■ Arbitrary focusing ■ Maximization ■ Maximization ■ Minimization ■ Minimization ■ Dichotomous reasoning ■ Dichotomous reasoning ■ Disqualification of one of the poles ■ Disqualification of one of the poles ■ Requalification in the other pole ■ Neutral’s omission
3 Cognitive distortion
■ Filter of information ■ Leads to a misunderstanding of reality ■ Maintenance of dysfunctional cognitive schemas and psychological disorders ■ Use in of cognitive behavioral therapy (CBT)
4 Different kinds of distortion Franceschi (2007)
Dichotomous reasoning Disqualification of one of the poles Arbitrary focusing Neutral’s omission Requalification in the other pole Minimization Maximization
5 Research problem
Are cognitive distortions characteristic of mixed anxiety-depressive disorder?
Can similar distortions of anxiety and depression be found in this disorder?
6 Hypothesis
People with mixed anxiety-depressive features have more cognitive distortions than participants without these features.
Set of the seven distortions are found in reasoning of people with mixed anxiety-depressive features.
7 Method
■ 916 participants
■ Hospital Anxiety and Depression Scale (HADS, Zigmond and Snaith, 1983) ■ Cognitive Distortion Scale for Adult (Echelle de Distorsion Cognitive pour Adulte, EDC-A, Robert et al., pre-print)
8 MADD groups
Control Group (CG) Mixed Anxiety-Depressive Disorder (MADD) 573 343
Ibbotson threshold (Ibbotson et al., 1994) : HADS score > 14
9 Cognitive distortion and mixed anxiety- depressive disorder Negative and Positive cognitive EDC-A mean score distortion mean score 160 *** 85 155 ***
80 150
145 75 **
140 70
135 65 130 60 125 Negative cognitive Positive cognitive ** p<,01 ***p<,001 distortion distortion CG MADD 10 * p<,05 ** p<,01 ***p<,001 Cognitive distortion profile CG MADD
35
** 30 *
25 *** *** *** 20 *** **
15
10
5
0 Dichotomous Disqualification of Arbitrary focusing Neutral’s omission Requalification in Minimization Maximization one of the poles the other pole
11 Negative cognitive distortion ns not significant * p<,05 ** p<,01 18 * CG MADD 16
14 *** ** *** 12 *** *** 10 ** 8
6
4
2
0 Dichotomous Disqualification of Arbitrary focusing Neutral’s omission Requalification in Minimization Maximization one of the poles the other pole Positive cognitive distortion 25 *
20
15 ** ** 10 * ** ns **
5
0 Dichotomous Disqualification of Arbitrary focusing Neutral’s omission Requalification in Minimization Maximization one of the poles the other pole
12 Discussion
■ Cognitive distorsions characteristic feature of mixed anxiety- depressive disorder
■ Seven distortions are in trouble Same five distortions specific to anxiety and all to depression MADD = anxiety disorder complicated by depressive emergence (Mirabel-Sarron, 2009)
13 (Robert et al., pre-print) Anxiety Depression MADD Dichotomous reasoning Negative Positive Disqualification of one of the poles Negative Positive Arbitrary focusing Negative Anxiety Depression MADD Requalification in the other pole PositivePositive Neutral’s omission Negative Positive Minimization Positive RequalificationMaximization in the other pole NegativePositive Positive Minimization Negative Positive Maximization Negative Positive 14 Limits and perspectives
■ Non-clinical population
■ Development of Cognitive Distortion Scale for Adults (Robert et al., pre-print) Distinguish comorbid disorders Cognitive Behavioral Therapy (CBT)
15 THANK YOU FOR YOUR CONSIDERATION