Cognitive content specificity in anxiety and depressive disorder symptoms: a twin study of cross-sectional associations with anxiety sensitivity dimensions across development
Cognitive content specificity in anxiety and depressive disorder symptoms: a twin study of cross-sectional associations with anxiety sensitivity dimensions across development
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DOI：
10.1017/s0033291714000828
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发表时间：
2014-12-01
影响因子：
6.9
通讯作者：
Eley, T. C.
中科院分区：
文献类型：
--
作者：
Brown, H. M.;Waszczuk, M. A.;Eley, T. C.
背景资料。焦虑和抑郁障碍的分类长期以来一直存在争议，并具有重要的临床意义。本研究结合遗传敏感设计和多个时间点，通过焦虑敏感维度调查焦虑和抑郁障碍症状的认知内容特异性，这是一种与这两种疾病有关的认知扭曲。在两个具有代表性的双胞胎研究中(n对=300和1372)，在儿童期、青春期和成年期早期的五次数据收集中，研究了焦虑敏感维度与焦虑和抑郁障碍症状之间的表型和遗传相关性。焦虑敏感度的身体问题维度(对身体症状的恐惧)与焦虑显著相关，但不是所有波都与抑郁相关。与抑郁相比，基因对身体问题的影响更多地与焦虑重叠。相反，精神上的担忧(对认知控制的担忧)与抑郁的关联比焦虑更明显。在青春期，社交担忧(对可公开观察到的焦虑症状的恐惧)与焦虑和抑郁有关。遗传因素对精神和社会问题的影响与焦虑和抑郁的程度相似。在所有波中，认知特异性的表型模式以及焦虑敏感维度、焦虑和抑郁障碍症状之间更广泛的遗传关联都是相似的。确定了特定于障碍的和共同的认知担忧，这表明将焦虑和抑郁归类为不同但相关的障碍是合适的，并证实了认知治疗最有可能受益的临床观点，即针对特定与个体在发育过程中出现的症状有关的认知担忧。
Background. The classification of anxiety and depressive disorders has long been debated and has important clinical implications. The present study combined a genetically sensitive design and multiple time points to investigate cognitive content specificity in anxiety and depressive disorder symptoms across anxiety sensitivity dimensions, a cognitive distortion implicated in both disorders.Method. Phenotypic and genetic correlations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were examined at five waves of data collection within childhood, adolescence and early adulthood in two representative twin studies (n pairs=300 and 1372).Results. The physical concerns dimension of anxiety sensitivity (fear of bodily symptoms) was significantly associated with anxiety but not depression at all waves. Genetic influences on physical concerns overlapped substantially more with anxiety than depression. Conversely, mental concerns (worry regarding cognitive control) were phenotypically more strongly associated with depression than anxiety. Social concerns (fear of publicly observable symptoms of anxiety) were associated with both anxiety and depression in adolescence. Genetic influences on mental and social concerns were shared to a similar extent with both anxiety and depression.Conclusions. Phenotypic patterns of cognitive specificity and broader genetic associations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were similar at all waves. Both disorder-specific and shared cognitive concerns were identified, suggesting it is appropriate to classify anxiety and depression as distinct but related disorders and confirming the clinical perspective that cognitive therapy is most likely to benefit by targeting cognitive concerns relating specifically to the individual's presenting symptoms across development.