CTR 2nd revision 210110 - Open Research Exeter (ORE)

advertisement
Personal goal systems in anxiety and depression
Dysphoria, anxiety, and reduced facilitation in adolescents’ personal goal systems
Joanne M. Dickson
Nicholas J. Moberly
University of Liverpool
University of Exeter
Correspondence
Dr Joanne M. Dickson
Division of Clinical Psychology
Whelan Building
Brownlow Hill
Liverpool
L69 3GB
Email: j.dickson@liv.ac.uk
Tel: +44-(0)151-794 5536
Fax: +44-(0)151-794 5537
1
Personal goal systems in anxiety and depression
2
Abstract
The study investigated whether symptoms of anxiety and depression are
independently associated with reduced goal facilitation in a school sample of
adolescents (N = 119). Participants listed their goals and rated the extent to which
they facilitated or inhibited each other. Anxious and depressive symptoms were both
associated with reduced levels of goal facilitation, although regression analyses
revealed that depressive symptoms but not anxious symptoms were independently
associated with reduced levels of goal facilitation. Similarly, ratings of distress and
repetitive thinking associated with participants’ most conflicting goals were
independently associated with depressive symptoms but not anxious symptoms. There
was no association between the number of goals listed and anxious or depressive
symptoms. Results suggest that dysphoria, but not anxiety, is independently
associated with reduced coherence in personal goal systems and a negative
preoccupation with conflicting goals.
Personal goal systems in anxiety and depression
3
Anxiety and depression are serious mental health problems that remain among
the most prevalent and recurring forms of emotional disturbance that young people
experience (Wittchen, Nelson, & Lachner, 1998). Even moderate levels of anxiety
and depression have been shown to impact negatively on the quality of life of young
people (Kendall & Brady, 1995) and studies have shown that these emotional
conditions in youth represent risk factors for the development of later adult
psychopathology (e.g., Ollendick, 1998). It is only relatively recently that research has
begun to examine psychological processes associated with adolescent anxiety and
depression from a motivational perspective (e.g., Dickson, 2004). Studying anxiety
and dysphoria concurrently provides an opportunity to examine shared and distinct
psychological features characterizing these emotional conditions.
Prominent theories of motivation (e.g., Gray, 1982) and self-regulation (e.g.,
Carver & Scheier, 1998) contend that human behaviour is fundamentally a goaldriven activity. Goal pursuit is thought to play a particularly important role in the
development of self-defining processes and identity formation during adolescence
(Nurmi, 1993). Despite the importance of goal motivation in people’s lives, we know
little about goal processes that may be linked to anxiety and depression in
adolescence. This study examined whether symptoms of anxiety and depression in
adolescence are associated with shared and/or distinct patterns of goal motivation,
specifically in terms of reduced levels of mutual facilitation among goals and
increased distress and repetitive thought relating to the pursuit of conflicting goals.
Personal goals have been defined as cognitive representations of possible
states or outcomes that an individual seeks to attain (Austin & Vancouver, 1996).
Previous research with adult samples has demonstrated that successful pursuit of
personal goals or strivings is related to various measures of subjective well-being,
Personal goal systems in anxiety and depression
4
such as positive affect and life satisfaction (e.g., Sheldon & Houser-Marko, 2001).
Striving to pursue one’s personal goals, irrespective of whether goals are achieved, is
believed to promote psychological well-being, positive adaptations to daily life, and
personality development (Sheldon, Kasser, Smith, & Share, 2002). However, goal
content and organization may moderate the association between goal striving and
psychological well-being.
Recent research indicates that distinct patterns of goal orientation differentiate
anxious and depressed adolescents, relative to controls (Dickson & MacLeod, 2006;
Dickson & MacLeod, 2004). Empirically, anxiety and depression have both been
associated with increased avoidance motivation whereas depression has been uniquely
characterised by reduced approach motivation (e.g., Dickson & MacLeod, 2004).
These findings are concordant with theoretical models that propose a two-system
view of motivation, such as Gray’s (1982) early model of motivation, comprising a
behavioural activation system (BAS) or reward-driven system and a behavioural
inhibition system (BIS) or punishment-driven system.
However, examining goal orientation separately in relation to measures of
emotional disturbance may oversimplify the functioning of personal goal systems.
One reason why life is challenging is because it involves the simultaneous pursuit of
multiple goals. Some of these goals may be mutually facilitatory (e.g., maintain a
healthy lifestyle and avoid taking drugs), but some goals may conflict with one
another (e.g., study for my exams and party every night), creating a sense of
ambivalence and tension. Sheldon and Kasser (1995) contend that it is the integration
of personally meaningful goals within a coherent self-system that is linked to
psychological well-being and development, rather than goal achievement per se.
Anxiety and depression may be associated with difficulties establishing a
Personal goal systems in anxiety and depression
5
motivationally coherent self-system. For example, Emmons and King (1988) found
that conflict between undergraduates’ personal strivings was associated with
increased negative affect, and anxious and depressive symptoms.
In this study, we attempted to replicate the finding that anxious and depressive
symptoms are associated with reduced goal facilitation in an adolescent sample.
Depressive symptoms are associated with reduced levels of approach motivation
(Dickson & MacLeod, 2006) and negatively biased thinking (Beck, 1967), both of
which may result in perceived difficulties managing and attaining multiple goals and
therefore lower ratings of goal facilitation. Equally, because anxiety involves concern
about future threat and uncertainty (Barlow, 2000), anxious individuals may be
particularly concerned with future goal outcomes. This may lead them to focus on
problematic aspects of future goals and therefore to perceive lower levels of mutual
facilitation between goals. Prior research has however not examined whether
depressive and anxious symptoms each predict distinct variance in goal facilitation, so
we tested whether anxious and depressive symptoms are independently associated
with reduced levels of goal facilitation when controlling for each other.
As a secondary aim, we investigated the association between depressive
symptoms, anxious symptoms and distress and repetitive thinking about conflicting
goals. An experience-sampling study by Emmons and King (1988, Study 3) found
that undergraduates spent more time thinking about their conflicting strivings than
their non-conflicting strivings, and that this tendency was strongest for people
reporting high levels of anxiety and depression. Negatively-valenced, repetitive
thought has been associated with anxiety and depression through the overlapping
cognitive phenomena of worry and rumination (Fresco, Frankel, Mennin, Turk, &
Heimberg, 2002). We therefore predicted that symptoms of anxiety and depression
Personal goal systems in anxiety and depression
6
would be associated with higher ratings of distress and repetitive thinking in relation
to conflicting goals..
Method
Participants
One hundred and nineteen participants were recruited (74 female, 41 males, 4
gender unreported) from two Australian secondary schools. Students invited to
participate were selected from classes available on testing days, as arranged by school
coordinators. Participants’ ages ranged from 16-19 years (mode = 17).
Measures
Goal Task (Dickson & MacLeod, 2004). An adapted version of this measure
was used to assess the number of personally meaningful, relevant and plausible goals
generated by participants within a short time period (150 seconds). This task defines
personal goals as experiences that individuals think they will typically be trying to
attain or trying to avoid. Participants write down goals that they think would
characterize them sometime in the future (e.g., next week, next month, next year),
using short written statements. Several pilot tests with small groups of students found
that virtually no additional response was given after 150 seconds, although this time
limit was imposed to reduce variation due to task effort and motivation.
Goal Matrix. The goal matrix, modeled partly on Emmons & King’s (1988)
striving instrumentality matrix, was designed to measure the overall mean degree of
goal facilitation. Instructions for this task state that some goals help to facilitate the
pursuit of other goals, some goals inhibit or hinder the pursuit of other goals, and
some goals are independent of one another (i.e., they neither help nor hinder the
pursuit of other goals). An example of each goal pair combination is provided for
illustrative purposes. For each of the goals generated in the Goal Task, participants
Personal goal systems in anxiety and depression
7
rate the extent to which the pursuit of each goal facilitates or inhibits the pursuit of
every other goal, with no time limit. Possible ratings for each goal pair range from +4
(very strongly facilitates) to –4 (very strongly inhibits). Zero ratings indicate that a
goal neither facilitates nor inhibits the pursuit of another goal. An overall goal
facilitation score is calculated as the mean of all goal pair ratings. The author and an
independent rater later checked participants’ goal responses to confirm that
participants understood the instructions accompanying the goal matrix.
Goal Ratings. Participants rated distress and repetitive thinking for the two
goals that “conflicted or inhibited each other most”. Distress was assessed by the
question: “To what extent do you experience feeling bothered or concerned about
pursuing these goals?” Participants responded on a 7-point scale from 1 (not at all) to
7 (extremely). Repetitive thinking was assessed by the question: “How much time do
you spend thinking about these goals?” For this item, participants responded on a 7point scale from 1 (don’t think about these goals at all) to 7 (think about these goals
all the time).
The Beck Anxiety Inventory (BAI; Beck & Steer, 1993) and the Beck
Depression Inventory (BDI; Beck & Steer, 1987) are both widely used 21-item selfreport measures of anxious and depressive symptomatology respectively. For each
scale, each item is rated on 4-point scales with options of increasing severity. Despite
high levels of comorbidity between anxiety and depression, the BAI was developed as
an orthogonal measure to the BDI (Beck, Steer, Garbin, 1988). Both measures have
shown good reliability and successfully differentiate anxious and depressed diagnostic
groups from each other and from non-clinical groups (Beck, Epstein, Brown, & Steer,
1988; Fydrich, Dowdall, & Chambless, 1992) as well as high anxious and low
anxious, and high dysphoric and low dysphoric adolescent school samples (e.g.,
Personal goal systems in anxiety and depression
8
Dickson & MacLeod, 2004). In this study, the alpha reliability was .91 for the BAI
and .90 for the BDI.
Procedure
Testing took place in classroom settings (groups of 10–25 students) and lasted
approximately 1 hr. Participants first completed the Goal Task, then the Goal Matrix,
before selecting their most conflicting goal pair and rating it for distress and repetitive
thinking. Finally, participants completed the BDI and then the BAI. Participants
enclosed all materials in sealed envelopes before being thanked and debriefed.
Results
BAI and BDI scores were positively skewed and were successfully roottransformed to normalize their distributions. One participant failed to complete the
goal matrix and ratings. The overall goal facilitation score of another participant was
identified as a univariate outlier (score = –1.61, z = 3.73) and adjusted so that it was
less extreme (adjusted score = –1.22, z = 3.28; cf. Tabachnik & Fidell, 2001). The
number of goals listed by each participant (range = 3-12, M = 7.4, SD = 2.2) was not
significantly correlated with any variable and is not included in further analyses.
Participants listed very few avoidance goals (median = 0% per person).
Correlations between variables are presented in Table 1. BAI score and BDI
score were positively correlated and were each negatively correlated with overall goal
facilitation. Further, BAI score and BDI score were positively correlated with the
extent to which participants reported distress and repetitive thinking relating to their
most conflicting goals. Overall goal facilitation was negatively correlated with
distress, but not repetitive thinking, relating to the pursuit of participants’ most
conflicting goals. BDI score remained significantly correlated with distress (r = .29, p
= .003) and repetitive thinking (r = .36, p < .001) relating to conflicting goals when
Personal goal systems in anxiety and depression
9
controlling for BAI score. However, BAI score was not significantly correlated with
either distress (r = –.02, p = .84) or repetitive thinking (r = .12, p = .24) relating to
conflicting goals when controlling for BDI score.
Regression analysis
To examine the relative contributions of anxious symptoms, depressive
symptoms and gender in predicting overall goal facilitation, we used hierarchical
multiple regression analysis. Both BAI score and BDI score were each centred on
their respective means to reduce multicolinearity. BAI score, BDI score and gender
were entered simultaneously in the first step. To assess whether the association
between anxious and depressive symptoms and overall goal facilitation differed
between males and females, the interaction between each scale and gender was
entered in the second step. Results of each model are presented in Table 2. In the first
step, BDI score was significantly negatively associated with overall goal facilitation,
β = –.34, t(110) = 2.89, p = .005, but neither BAI score nor gender were significantly
associated with overall goal facilitation. After the first step, the overall model was
significant, F(3, 110) = 7.71, p < .001. However, inclusion of the two interactions
between gender and each of the scales in the second step failed to improve the model
fit significantly, F(2, 108) < 1, p = .44.
These results indicate that depressive symptoms, but not anxious symptoms,
are independently associated with (a) reduced goal facilitation and (b) increased
distress and repetitive thinking about conflicting goals in non-clinical adolescents.
Gender neither significantly predicted overall goal facilitation nor moderated the
associations between anxious or depressive symptom levels and goal facilitation.
Discussion
Personal goal systems in anxiety and depression 10
Our results are consistent with Emmons and King’s (1988) finding that
conflict between personal goals is associated with increased levels of negative affect,
anxiety and depression. The present study extends these results to an adolescent
sample, for whom the pursuit of authentic goals is likely to be important for the
formation of a distinct adult identity (Erikson, 1968; Nurmi, 1993). The main
contribution of our study is the finding that depressive symptoms, but not anxious
symptoms, are independently associated with reduced levels of facilitation among
personal goals. An identical pattern of results emerged for ratings of distress and
repetitive thinking about conflicting goals. Notably, anxiety and depressive symptoms
were not associated with the number of goals that participants generated, suggesting
the absence of a general motivational deficit. Our findings agree with previous work
suggesting that anxiety and depression may be differentiated in terms of particular
aspects of adolescents’ personal goal systems (Dickson & MacLeod, 1994). Although
past literature indicates that prevalence rates for girls double those of boys for
depressive symptomatology during adolescence (e.g., Hankin et al., 1999), no gender
differences were observed for depressive or anxious symptoms, or for any goal
variable. This may be attributable to the non-clinical school sample.
Past research informed by Gray’s (1982) motivational theory has characterized
depression in terms of diminished approach goal pursuit. It is possible that both
reduced approach goal pursuit and reduced goal facilitation are manifestations of
reduced BAS activity. The relationship between depression and reduced goal
facilitation is also concordant with cognitive theories that posit pessimism and
hopelessness as prototypical features of depression (e.g., Beck, 1976). Reduced
facilitation among goals may therefore reflect a general pessimistic bias that enhances
perceptions of difficulty in dysphoric mood. Another reason why reduced goal
Personal goal systems in anxiety and depression 11
facilitation may be independently associated with depressive symptoms derives from
Isen’s (1999) research indicating that positive affect is associated with more inclusive
and flexible thinking. Thus, low positive affect may reduce the extent to which
individuals are able to use a broad, inclusive thinking style to perceive integrative
ways in which to pursue multiple different goals. Although low positive affect is a
feature of social anxiety as well as depression (Naragon-Gainey, Watson, & Markon,
2009), our more generalised measure of anxious symptoms (the BAI) probably taps
(low) positive affect to a lesser degree than our measure of depressive symptoms (the
BDI). Thus, low positive affect may partly explain our finding that depressive
symptoms but not anxious symptoms were independently associated with goal
facilitation.
An immediate question relates to whether depressive symptoms are
independently associated with a biased perception of the extent to which one’s goals
facilitate one another or whether depressive symptoms are independently associated
with the pursuit of goals that are inherently less coherent (e.g., the goals ‘Always put
others before myself’ and ‘Be more assertive’). One possibility would be to ask
independent judges to rate participants’ goals for coherence, although this may be
problematic given the highly personal, circumstantial nature of idiographic goals.
If goal pursuit is an inherently future-oriented activity and anxiety relates to
concern about the future, why did we fail to find an independent association between
anxious symptoms and goal facilitation? First, participants’ judgments about goal
facilitation may have been made with reference to thoughts and memories about past
and current problems in goal pursuit, rather than thoughts about future outcomes.
Judgments about goal facilitation may thus be influenced by depressive biases to a
greater extent than anxiety-specific cognitions. Second, anxiety is particularly
Personal goal systems in anxiety and depression 12
associated with increased avoidance motivation (e.g., Dickson & MacLeod, 2004),
but the vast majority of goals listed by participants, using a single goal measure, were
approach goals. Difficulties pursuing approach goals (and even mutually facilitative
approach goals) are likely to be more relevant to depressive than anxious symptoms.
Eliciting approach and avoidance goals separately typically leads participants to
report proportionately more avoidance goals than were observed in this study (e.g.,
Dickson & MacLeod, 2004). Separate measures could yield stronger associations
between anxiety and goal facilitation than our single measure because anxiety may
relate to conflict between avoidance goals specifically.
Our results concerning distress and repetitive thought about conflicting goals
paralleled the goal facilitation findings. As expected, anxious and depressive
symptoms were both associated with distress and repetitive thought about conflicting
goals, but it was only for depressive symptoms that this association was independent.
While distress and repetitive thought are common concomitants of anxiety and
depression (Fresco et al., 2002), the independent association between the former
variables and depressive symptoms may reflect the finding that depressive symptoms
are particularly associated with perceptions that goals are more conflicting.
Some methodological limitations deserve comment. First, the cross-sectional
design means that it is not possible to establish whether adolescent depressive
symptoms and reduced goal coherence are causally related. Depressive symptoms
may decrease the extent to which goals are perceived to facilitate each other, but it is
also possible that decreased goal facilitation exacerbates depressive symptoms.
Second, because we used a non-clinical sample, it is not possible to generalize these
findings to adolescents with a clinical diagnosis of depression or anxiety. Third,
although the BAI is a well-validated measure of anxiety in both clinical and non-
Personal goal systems in anxiety and depression 13
clinical samples, many of its items assess panic-type symptoms. Future research
would benefit from the use of other measures of anxious psychopathology to assess
whether similar results are observed (e.g., addressing relationships between social
anxiety and low positive affect). Fourth, past research has shown that independent
measures of goal facilitation and goal inhibition are differentially linked to
psychological well-being (Riediger & Freund, 2004). The use of independent goal
appraisal measures would provide an opportunity to assess whether combinations of
both high and/or low goal facilitation and inhibition are differentially associated with
adolescent psychopathology. Finally, single items were used to assess distress and
repetitive thinking, although they have high face validity.
Our results indicate that depressive symptoms, but not anxious symptoms, are
independently related to perceptions of reduced facilitation between adolescents’
personal goals, suggesting that deficits in approach motivation and/or depressive
cognitive biases may be specifically associated with reduced goal coherence. The
results point to depression being associated with impaired goal pursuit, thus
potentially limiting opportunities for reward and serving to maintain a cycle of
hopelessness. Future research could examine the association between anxious and
depressive symptoms and the extent to which lower-order goals enable individuals to
achieve higher-order goals. It will also be important to investigate goal facilitation in
adolescents with clinical diagnoses of anxiety, depression and mixed anxietydepression, to test whether these results may generalize to a clinical population.
Personal goal systems in anxiety and depression 14
References
Austin, J. T., & Vancouver, J. B. (1996). Goal constructs in psychology: Structure,
process and content. Psychological Bulletin, 120, 338-375.
Barlow, D. H. (2000). The nature of anxiety: Anxiety, depression, and emotional
disorders. In R. M. Rapee and D. H. Barlow (Eds.), Chronic anxiety (pp.1-28).
London: Guilford Press.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New
York: International Universities Press.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for
measuring clinical anxiety: Psychometric properties. Journal of Consulting
and Clinicial Psychology, 56, 893-897.
Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. San
Antonio: Psychological Corporation Harcourt Bruce Jovanovich Inc.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the
Beck Depression Inventory: Twenty-five years of evaluation. Clinical
Psychology Review, 8, 77-100.
Carver, C. S., & Scheier, M. F. (1998). On the self-regulation of behavior.
Cambridge: Cambridge University Press.
Dickson, J. M., & MacLeod, A. K. (2006). Dysphoric adolescents’ causal
explanations and expectancies for approach and avoidance goals. Journal of
Adolescence, 29, 177-191.
Dickson, J. M., & MacLeod, A. K. (2004). Approach and avoidance goals and
plans: Their relationship to anxiety and depression. Cognitive Therapy and
Research, 28, 415-432.
Emmons, R. A. & King, L. A. (1988). Conflict among personal strivings: Immediate
Personal goal systems in anxiety and depression 15
and long-term implications for psychological and physical well-being. Journal
of Personality and Social Psychology, 54, 1040-1048
Erikson, E. (1968). Identity, youth, and crisis. New York: Norton.
Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002).
Distinct and overlapping features of rumination and worry: The relationship of
cognitive production to negative affective states. Cognitive Therapy and
Research, 26, 179-188.
Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the
Beck Anxiety Inventory. Journal of Anxiety Disorders, 6, 55-61.
Gray, J. (1982). The neuropsychology of anxiety: An enquiry into the functions of the
septo-hippocampal system. Oxford: Oxford University Press.
Hankin, B. L., Abramson, L. Y., Moffitt, t. E., Silva, P. A., McGee, R., & Angell, K.
E. (1998). Development of depression from preadolescence to young
adulthood: Emerging gender differences in a 10-year longitudinal study.
Journal of Abnormal Psychology, 107, 128-141.
Isen, A. M. (1999). Positive affect. In T. Dalgleish & M. Power (Eds.), Handbook of
cognition and emotion (pp. 521-540). Chichester: Wiley.
Kendall, P. C., & Brady, E. U., (1995). Comorbidity in anxiety disorders of
childhood. In K. D. Craig & K. S. Dobson (Eds.), Anxiety and depression in
adults and children (pp. 3-36). London: Sage.
Naragon-Gainey, K., Watson, D., & Markon, K. E. (2009). Differential relations of
depression and social anxiety symptoms to the facets of extraversion/positive
emotionality. Journal of Abnormal Psychology, 118, 299-310.
Nurmi, J. E. (1993). Adolescent development in an age-graded context: The role of
personal beliefs, goals, and strategies in the tackling of developmental tasks
Personal goal systems in anxiety and depression 16
and standards. International Journal of Behavioral Development, 16, 169-189.
Ollendick, T. H. (1998). Panic disorder in children and adolescents: New
developments and directions. Journal of Clinical Child Psychology, 27, 234245.
Riediger, M., & Freund, A. M. (2004). Interference and facilitation among personal
goals: Differential associations with subjective well-being and persistent goal
pursuit. Personality and Social Psychology Bulletin, 30, 1511-1523.
Sheldon, K. M., & Houser-Marko, L. (2001). Self-concordance, goal attainment,
and the pursuit of happiness: Can there be an upward spiral? Journal of
Personality and Social Psychology, 80, 152-165.
Sheldon, K. M., & Kasser, T. (1995). Coherence and congruence: Two aspects of
personality integration. Journal of Personality and Social Psychology, 68,
531-543.
Sheldon, K. M., Kasser, T., Smith, K., & Share, T. (2002). Personal goals and
psychological growth: Testing an intervention to enhance goal attainment and
personality integration. Journal of Personality, 70, 5-31.
Wittchen, H. U., Nelson, C. B., & Lachner, G. (1998). Prevalence of mental disorders
and psychosocial impairments in adolescents and young adults. Psychological
Medicine, 28, 109-126.
Personal goal systems in anxiety and depression
17
Table 1
Correlations and descriptive statistics
Variable
1
2
1. Gender (0 = female, 1 = male)
—
–.10
2. BAI
3. BDI
4. Overall goal facilitation
5. Distress about conflicting goals
6. Repetitive thinking about conflicting goals
—
3
–.14
4
5
.02
–.01
6
.04
M
SD
—
—
.68***
–.33***
.29**
.28**
10.7
9.3
—
–.40***
.44***
.29**
10.0
7.9
.00
1.2
0.8
.35***
4.1
1.7
—
4.8
1.7
—
–.23*
—
Note. BAI = Beck Anxiety Inventory; BDI = Beck Depression Inventory. BAI and BDI are root-transformed scores, but descriptive statistics
refer to untransformed scores. Ns vary 99-119 due to missing data and 19 participants who did not list any conflicting goals. * p < .05. ** p <
.01. *** p <.001.
Personal goal systems in anxiety and depression
Table 2
Multiple regression results for overall goal facilitation
B
SE B
β
Gender
–.06
.14
–.04
BAI
–.05
.06
–.10
BDI
–.20
.07
–.34***
Gender
–.07
.14
–.05
BAI
–.06
.07
–.13
BDI
–.13
.10
–.22
Gender x BAI
.02
.13
.02
Gender x BDI
–.15
.14
–.17
Model Predictor
1
2
Note. R² = .17 for Step 1 (p < .001); ΔR² = .01 for Step 2 (p = .44). *** p < .001
18
Download