The relationship between trait vulnerability and anxiety and depressive diagnoses at long-term follow-up of Generalized Anxiety Disorder.

The current study examined the relationship between measures of trait vulnerability and long-term outcome in 83 patients diagnosed and treated for Generalized Anxiety Disorder (GAD) 8-14 years previously. Diagnostic status was assessed by structured interview, and trait affect, trait anxiety and trait depression were measured by the Positive and Negative Affect Scale (PANAS), the State-Trait Anxiety Inventory (STAI-T) and the Personal Style Inventory (PSI), respectively. Trait measures were all highly inter-correlated, and patients with diagnoses of GAD, social phobia and depressive disorders at long-term follow-up recorded very poor scores on all three scales. Trait anxiety recorded pre-treatment was also related to both anxiety and depression at long-term follow-up. However, trait depression showed no significant association with panic disorder. Increased numbers of comorbid diagnoses were strongly related to high levels of both trait anxiety and negative affect (NA). The findings suggest that patients reporting high trait anxiety or NA may suffer from a chronic course of disorder and higher levels of comorbidity over the longer term.

[1]  R. Kessler,et al.  Generalized anxiety disorder in women. A population-based twin study. , 1992, Archives of general psychiatry.

[2]  G. Andrews,et al.  Evidence for a General Neurotic Syndrome , 1990, British Journal of Psychiatry.

[3]  D. Watson,et al.  Positive and negative affectivity and their relation to anxiety and depressive disorders. , 1988, Journal of abnormal psychology.

[4]  N. Martin,et al.  Genetic covariation between neuroticism and the symptoms of anxiety and depression , 1984, Genetic epidemiology.

[5]  Joan Welkowitz,et al.  The personal style inventory: Preliminary validation studies of new measures of sociotropy and autonomy , 1994 .

[6]  The relations between sociotropy and autonomy, positive and negative affect and two proposed depression subtypes. , 1996, The British journal of clinical psychology.

[7]  G. Andrews Comorbidity and the General Neurotic Syndrome , 1996, British Journal of Psychiatry.

[8]  R. Fieve,et al.  Sociotropy and autonomy: relationship to antidepressant drug treatment response and endogenous-nonendogenous dichotomy. , 1992, Journal of abnormal psychology.

[9]  M. Zuckerman Biological Bases of Personality , 2003 .

[10]  G. Fenton,et al.  Cognitive Therapy, Analytic Psychotherapy and Anxiety Management Training for Generalised Anxiety Disorder , 1994, British Journal of Psychiatry.

[11]  R. Hu Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) , 2003 .

[12]  T. Johnson,et al.  Prediction of outcome in neurotic disorder: a 5-year prospective study , 1998, Psychological Medicine.

[13]  Anthony F Jorm Modifiability of Trait Anxiety and Neuroticism: A Meta-Analysis of the Literature , 1989, The Australian and New Zealand journal of psychiatry.

[14]  C. Spielberger,et al.  Manual for the state-trait anxiety inventory (form Y) : "self-evaluation questionnaire" , 1983 .

[15]  D H Barlow,et al.  Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). , 1993, Archives of general psychiatry.

[16]  K. Power,et al.  A controlled comparison of cognitive- behaviour therapy, Diazepam, and placebo, alone and in combination, for the treatment of generalised anxiety disorder , 1990 .

[17]  R. Kessler,et al.  The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. , 1992, Archives of general psychiatry.

[18]  D. Watson,et al.  Negative affectivity: the disposition to experience aversive emotional states. , 1984, Psychological bulletin.

[19]  S. Mineka,et al.  Temperament, personality, and the mood and anxiety disorders. , 1994, Journal of abnormal psychology.

[20]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[21]  A. Beck,et al.  Cognitions, attitudes and personality dimensions in depression. , 1983 .

[22]  P. Tyrer,et al.  The general neurotic syndrome: a coaxial diagnosis of anxiety, depression and personality disorder , 1992, Acta psychiatrica Scandinavica.

[23]  T. Brown,et al.  Comorbidity among anxiety disorders: implications for treatment and DSM-IV , 1992 .

[24]  Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. , 1998 .

[25]  T. Tuma Effect of Age on the Outcome of Hospital Treated Depression , 1996, British Journal of Psychiatry.

[26]  S. Kennedy,et al.  Sociotropy, Autonomy, and Patterns of Symptoms in Patients with Major Depression: A Comparison of Dimensional and Categorical Approaches , 1997, Cognitive Therapy and Research.

[27]  M. Rutter,et al.  A 15–20 Year Follow-Up of Adult Psychiatric Patients , 1995, British Journal of Psychiatry.

[28]  D. Watson,et al.  Structures of personality and their relevance to psychopathology. , 1994, Journal of abnormal psychology.

[29]  K. Jamison,et al.  Sociotropy/autonomy and vulnerability to specific life events in patients with unipolar depression and bipolar disorders. , 1989, Journal of abnormal psychology.

[30]  D. Barlow,et al.  Structure of anxiety and the anxiety disorders: a hierarchical model. , 1996, Journal of abnormal psychology.

[31]  R. Kessler,et al.  Panic disorder in women: a population-based twin study , 1993, Psychological Medicine.

[32]  E. Peselow,et al.  Relations of sociotropic and autonomous personality characteristics to specific symptoms in depressed patients. , 1989, Journal of abnormal psychology.

[33]  C. Spielberger,et al.  STAI manual for the State-trait anxiety inventory ("self-evaluation questionnaire") , 1970 .

[34]  J. Angst,et al.  Outcome of panic and depression in a seven‐year follow‐up: results of the Zurich study , 1989, Acta psychiatrica Scandinavica.

[35]  T. Borkovec,et al.  Effects of psychotherapy on comorbid conditions in generalized anxiety disorder. , 1995, Journal of consulting and clinical psychology.

[36]  D. Klein Delineation of two drug-responsive anxiety syndromes , 1964, Psychopharmacologia.