Direct and Interactive Effects of Distress Tolerance andAnxiety Sensitivity on Generalized Anxiety and Depression

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1、CognTherRes(2014)38:530–540DOI10.1007/s10608-014-9623-yORIGINALARTICLEDirectandInteractiveEffectsofDistressToleranceandAnxietySensitivityonGeneralizedAnxietyandDepressionNicholasP.Allan•RichardJ.Macatee•AaronM.Norr•NormanB.SchmidtPublishedonline:1June

2、2014ÓSpringerScience+BusinessMediaNewYork2014AbstractAnxietysensitivityanddistresstoleranceareIntroductionbothhypothesizedriskfactorsforgeneralizedanxietydisorder(GAD)andmajordepressivedisorder(MDD).Generalizedanxietydisorder(GAD)andmajordepressiveHow

3、ever,itisunclearwhetherthesefactorssynergisticallydisorder(MDD)oftenco-occur(e.g.,Kessleretal.1999).influenceGADandMDDandrelatedsymptoms.UsingThishasledinvestigatorstospeculatewhetherthesedisor-latentvariablemethods,directandinteractiverelationsdersmay

4、reflectthesamedisorderprocess(seeHettema2008betweenanxietysensitivityanddistresstolerancewithforareview),citingevidencefromtwinstudiesindicatingworryanddepressivesymptomsandwithGADandMDDcloselysharedgeneticsusceptibility(Kendleretal.2007;diagnosesweree

5、xaminedin347outpatients.InteractiveRoyetal.1995),pharmacotherapyresponse(KuzmaandeffectsofanxietysensitivityanddistresstolerancewereBlack2004),andpersonalitytraits(i.e.,neuroticism;WatsonfoundforworryandGAD/MDD.Theinteractionsgener-etal.2005).However,

6、somestudieshavedocumenteddis-allysuggestedthatanxietysensitivityconfersagreaterriskorder-specificenvironmental(e.g.,parentaloverprotectionforworryandGAD/MDDathigherlevelsofdistresstol-inGAD)andtemperamental(e.g.,lowpositiveemotionalityerance,andthatdis

7、tresstoleranceconfersagreaterriskforinMDD)riskfactors(Beesdoetal.2010;Moffittetal.2007).worryandGAD/MDDatlowerlevelsofanxietysensitiv-Giventheevidencethatenvironmentalfactorsmaybeity.Giventheinteractiveeffectsofanxietysensitivityandresponsiblefordiffer

8、entialdisorderexpression(Royetal.distresstoleranceforGAD/MDD,interventionstargeting1995),itisimportanttoidentifycommonanddistinctriskbothriskfactorsmayprovemoreefficaciousthantargetingfactorsthatmayreflectenvironmentally-mediatedexpres-eachindiv