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Cognitive Therapy and Research

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12-03-2020 | Original Article

Looming Cognitive Style and Its Associations with Anxiety and Depression: A Meta-analysis

Auteurs: Gerard C. Yeo, Ryan Y. Hong, John H. Riskind

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2020

Abstract

Background

The looming cognitive style (LCS) is a cognitive bias to interpret and generate mental scenarios (i.e., mentally simulate) of threats as rapidly developing and approaching. A rapidly growing and approaching threat is likely to evoke a greater experience of urgency and anxiety in individuals compared to a threat that is interpreted to be static. Individuals who possess the LCS tend to perceive mentally simulated threats as rapidly intensifying and approaching, and this future-oriented prospection (or future-oriented thinking) is assumed to put them at risk of anxiety and depression.

Methods

The current meta-analytic review examined the strength of the relations between the LCS and different subtypes of anxiety (i.e., nonspecific anxiety, social anxiety, obsessions-compulsions, fears, and worry) and depression. Articles were retrieved from online databases and unpublished data sets. A total of 141 effect sizes were obtained from 61 articles with 69 independent samples after selection criteria were met.

Results

Random- and mixed-effects models indicated significant mean effect sizes of moderate magnitude. The relations between LCS and the anxiety subtypes were generally significantly stronger than that of depression, in particular for nonspecific anxiety, social anxiety, and worry. Additionally, sample type and study quality emerged as significant moderators for the effect sizes for certain symptoms.

Conclusions

These results support the idea that LCS is a transdiagnostic vulnerability factor for various anxiety subtypes and that it is more specific to anxiety than to depression. Clinical implications and future directions are discussed.

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Although OCD and PTSD are no longer classified under “Anxiety Disorders” in the DSM-5 (a move not accepted by all experts; e.g., Abramowitz 2018), we included studies associated with obsessions-compulsions (OC) for two reasons. First, anxiety remains a significant experience of individuals with OC and DSM-5 recognizes the close links between anxiety and OC-related syndromes. Second, quite a number of studies (see p. 7) had documented the robust relation between LCS and OC and they were done prior to the publication of DSM-5.

Although the LMSQ contains an item that pertains to anxiety/worry, this item should not be including in the computation of the scale score, according to the scoring instruction. Our review of the included studies showed that most of the studies that used the LMSQ had explicitly stated the non-inclusion of this item in scoring the LMSQ. A small number of studies were not explicit on this point, but we assumed that the standard scoring procedure had been adhered to.

We speculated that the nonsignificant difference between the effect sizes for depression versus (a) OC (independent samples only) and (b) fears (see Table 3) was partly due to low statistical power (i.e., few number of studies available). For social anxiety, which showed a significant difference in effect size magnitude compared to depression, the number of available studies was also low. However, the strong mean effect size for social anxiety could be attributable to the observation that half of the LSMQ vignettes depict social threats (e.g., an impending breakup of a romantic relationship).

With regard to the vignette-based assessment of the LMSQ, we acknowledge that there are conflicting accounts on the role of visualization on anxiety. The avoidance theory of worry (Borkovec et al. 2004) suggests that worry is linked to reduced concreteness in visualization (McGowan et al. 2017). However, there is evidence suggesting that, compared to healthy counterparts, individuals with anxiety symptoms/disorders more readily visualize vivid negative images (e.g., Hirsch and Holmes 2007; Moscovitch et al. 2011). The LMSQ vignettes might tap into more imagery-based representation of impending threats compared to a statement-based questionnaire. LCS could also predict worry if it is an attempt to reduce visualization.

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Titel: Looming Cognitive Style and Its Associations with Anxiety and Depression: A Meta-analysis
Auteurs: Gerard C. Yeo
Ryan Y. Hong
John H. Riskind
Publicatiedatum: 12-03-2020
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-020-10089-1

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