Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.
Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression.



Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design.



The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect.



The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression.



The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness.
Department of Medical and Clinical Psychology, Tilburg University, The Netherlands. e.a.p.rutten@uvt.nl.
Elisabeth A P
EA
Rutten
Vincent van Gogh Mental Health Care, Helmond, The Netherlands.
Nathan
N
Bachrach
Department of Psychiatry, Institute for Research in Extramural Medicine, VU-University Medical Centre and GGZinGeest Amsterdam, The Netherlands.
Anton J L M
AJ
van Balkom
Faculty of Educational Sciences, Centre for Educational Measurement (CEMO), University of Oslo, Norway.
Johan
J
Braeken
GGZ Breburg, Tilburg, The Netherlands.
Machteld A
MA
Ouwens
Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
Marrie H J
MH
Bekker
D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology*; D001242:Assertiveness; D001364:Awareness; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology*; D004522:Educational Status; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009426:Netherlands; D026684:Personal Autonomy; D011569:Psychiatric Status Rating Scales; D012649:Self Concept
alexithymia; anxiety; assertiveness; autonomy; autonomy-connectedness; depression