Zabag Reut, Mouadeb Daniella, Haim-Nachum Shilat, Levy-Gigi Einat, Gilboa-Schechtman Eva
Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
Department of Psychology, Yale University, New Haven, Connecticut, USA.
Depress Anxiety. 2025 Sep 15;2025:3055803. doi: 10.1155/da/3055803. eCollection 2025.
Social anxiety (SA) and depressive symptoms frequently coexist, with the onset of SA typically preceding the onset of depression. Individuals experiencing SA-depression comorbidity exhibit increased functional impairments as compared to individuals without this comorbidity. Understanding the mechanisms that underlie the coexistence of SA and depressive symptoms can deepen our theoretical understanding regarding these conditions and contribute to depression prevention efforts. Recent theories suggest that low cognitive flexibility (CF) contributes to the development of depression and may play a role in the relationship between the disorders. However, empirical prospective findings are sparse. We examined whether CF moderates the link between SA and depressive symptoms in two independent preregistered studies: cross-sectional ( = 379) and longitudinal ( = 108, 2-year). Cross-sectionally, higher CF was linked to a weaker relationship between SA and depressive symptoms. Across time, among individuals with low CF at baseline, there was a positive association between SA at baseline and depressive symptoms 2 years later. No such association was found among individuals with high CF. These findings highlight the role of CF in the development of comorbid depressive symptoms among high SA individuals. It may contribute to the clinical prevention of depression through specific psychotherapeutic techniques targeted to enhance CF among SA patients. A preprint of this MS has previously been published.
社交焦虑（SA）和抑郁症状常常同时存在，且SA的发作通常先于抑郁发作。与未合并这种情况的个体相比，患有SA-抑郁共病的个体表现出更严重的功能损害。了解SA和抑郁症状共存背后的机制可以加深我们对这些病症的理论理解，并有助于抑郁症的预防工作。最近的理论表明，低认知灵活性（CF）会导致抑郁症的发展，并且可能在这些疾病之间的关系中起作用。然而，前瞻性实证研究结果很少。我们在两项独立的预先注册研究中检验了CF是否调节SA与抑郁症状之间的联系：横断面研究（n = 379）和纵向研究（n = 108，为期2年）。在横断面研究中，较高的CF与SA和抑郁症状之间较弱的关系相关。随着时间推移，在基线时CF较低的个体中，基线时的SA与2年后的抑郁症状之间存在正相关。在CF较高的个体中未发现这种关联。这些发现突出了CF在高SA个体中共病抑郁症状发展中的作用。它可能通过针对提高SA患者CF的特定心理治疗技术，为抑郁症的临床预防做出贡献。本手稿的预印本此前已发表。
