Department of Psychology, The New School for Social Research, 6 E 16(th) St, New York, NY 10003, USA.
Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA.
J Affect Disord. 2024 Dec 15;367:38-48. doi: 10.1016/j.jad.2024.08.031. Epub 2024 Aug 13.
Anxiety and depression are often comorbid and chronic disorders. Previous research indicates that positivity relinquishment is a moderator of anxiety and depression, such that only anxious individuals who endorsed relinquishing positivity were also depressed. We sought to extend those findings by conducting three network analyses with self-report measures of anxiety, depression, activity avoidance, and perceived positivity of avoided activities (N = 104). We pre-registered our hypothesis for the first two networks that relinquishment of positivity would emerge as a central bridge symptom between anxiety and depressive symptoms. After combining redundant nodes, we estimated three networks and investigated the bridge symptoms in each network. Relinquishment of positivity bridged the symptom clusters in the first network, and avoidance of positivity was found to bridge the two symptom clusters of anxiety and depression in networks two and three. Additionally, an anhedonia circuit was uncovered in all three networks in which loss of interest/worthlessness, loss of energy, and loss of pleasure/pessimism connected to anxiety through relinquishment or avoidance. Our findings suggest that both relinquishment of positivity as well as avoidance of positivity could be potential pathways explaining the development and maintenance of anxiety and depression and should be properly targeted in treatment.
焦虑和抑郁常常是共病和慢性疾病。先前的研究表明,积极情绪放弃是焦虑和抑郁的一个调节因素,即只有那些认可放弃积极情绪的焦虑个体才会同时感到抑郁。我们试图通过对 104 名参与者进行自我报告的焦虑、抑郁、活动回避和回避活动的积极感知的三个网络分析来扩展这些发现。我们预先注册了我们的假设,即前两个网络中的积极情绪放弃将作为焦虑和抑郁症状之间的中心桥梁症状出现。在合并冗余节点后,我们估计了三个网络,并在每个网络中研究了桥梁症状。积极情绪放弃在第一个网络中的症状群之间架起了桥梁,而在网络 2 和网络 3 中,回避积极情绪被发现架起了焦虑和抑郁的两个症状群之间的桥梁。此外,在所有三个网络中都发现了一种快感缺失回路,其中兴趣/价值丧失、能量丧失和愉悦/悲观丧失通过放弃或回避与焦虑相关。我们的研究结果表明,积极情绪的放弃和回避都可能是解释焦虑和抑郁的发展和维持的潜在途径,在治疗中应加以适当关注。