title: Hidden scars in depression? Implicit and explicit self-associations following recurrent depressive episodes.
abstract: To help explain the recurrent nature of major depressive disorder, we tested the hypothesis that depressive episodes and/or the duration of depressive symptoms may give rise to persistent dysfunctional implicit and/or more explicit self-associations, which in turn may place people at risk for the recurrence of symptoms. We therefore examined, in the context of the Netherlands Study of Depression and Anxiety, whether the strength of self-depressed associations at baseline was related to the number of past episodes (retrospective analysis; n = 666), and whether the duration of symptoms between baseline and follow-up predicted self-depressed associations at 2-year follow-up (prospective analysis; n = 726). The lifetime Composite International Diagnostic Interviews and Life Chart Interview were used to index the number of depressive episodes; the Implicit Association Test and its explicit equivalent were used to index self-associations. Consistent with the hypothesis that self-depressed associations strengthen following prolonged activation of negative self-associations during depressive episodes, individuals' implicit and explicit self-depressed associations correlated positively both with the number of prior depressive episodes at baseline and with the duration of depressive symptoms between baseline and 2-year follow-up. There was evidence that these relationships held, particularly in the prospective study, even when controlling for neuroticism and current depressive symptoms, whereas the retrospective relationship between number of episodes and implicit self-associations fell just short of significance.
authors.affiliation: Department of Clinical Psychology, University of Groningen.
authors.forename: Hermien J
authors.initials: HJ
authors.lastname: Elgersma
authors.affiliation: Department of Clinical Psychology, University of Groningen.
authors.forename: Klaske A
authors.initials: KA
authors.lastname: Glashouwer
authors.affiliation: Department of Clinical Psychology, University of Groningen.
authors.forename: Claudi L H
authors.initials: CL
authors.lastname: Bockting
authors.affiliation: Department of Psychiatry/EMGO Institute, VU University Medical Centre.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: Department of Clinical Psychology, University of Groningen.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: de Jong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001244:Association; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011581:Psychological Tests; D011930:Reaction Time; D012008:Recurrence; D012044:Regression Analysis; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult