COGNITIVE DISTORTION AND MIXED -DEPRESSIVE DISORDER Anita Robert Mixed anxiety-depressive disorder

■ Anxiety + symptom – Focusing difficulty – Sleeping disorder – Low self-esteem – Hazard – …

 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

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