80 COGNITIVE THEORY AND RESEARCH ON ANXIETY
cognitive model, then, asserts that anxiety and depression can be distinguished by the
content (and temporal orientation) of the negative automatic thoughts and interpreta-
tions generated by the individual.
In our own studies future- oriented threat- related cognitions distinguished panic
and GAD from major depression/dysthymia (Clark, Beck, & Beck, 1994) and threat-
related cognitions showed a closer, more specific relation with an anxiety than a depres-
sion symptom dimension (Clark, Beck, & Stewart, 1990; Clark, Steer, Beck, & Snow,
1996). These findings have been supported in other studies, although anxious cognitions
appear to have a greater degree of nonspecificity than depressive cognitions (e.g., Beck,
Brown, Steer, Eidelson, & Riskind, 1987; Ingram, Kendall, Smith, Donnell, & Ronan,
1987; Jolly & Dykman, 1994; Jolly & Kramer, 1994; Jolly, Dyck, Kramer, & Wherry,
1994; Schniering & Rapee, 2004). In a meta- analysis of 13 studies, R. Beck and Per-
kins (2001) found only partial support for the content- specificity hypothesis. Anxious
and depressive cognition measures were significantly correlated with both their corre-
sponding and noncorresponding mood/symptom measures and the cognition measures
showed an average correlation of .66 with each other. Yet, quantitative comparisons did
reveal that the depressive cognition measures had significantly higher correlations with
depression than with anxious symptoms, but the anxious cognitions were equally corre-
lated with depression and anxiety. The authors concluded that threat- related cognitions
may not have the same degree of specificity as depressive cognitions (R. Beck & Perkins,
2001; see similar conclusion reached in review by Clark et al., 1999), although certain
clinical populations or levels of symptom severity may show more or less specificity
(Clark et al., 1996; Ambrose & Rholes, 1993).
The apparent lack of specificity for anxious cognitions may reflect a greater degree
of heterogeneity for anxious than depressive cognitions. R. Beck and Perkins (2001)
suggest two possibilities for the lack of specificity with anxious cognitions. Is it possible
that a subset of anxious thought can be identified that is specific to particular anxiety
disorders, whereas other types of anxious thinking may be more generally related to
anxiety and depression? Or depressive cognitions may show greater specificity because
they are related to low positive affect, which is a specific mood– personality construct
of depression, and anxious cognition is less specific because it is the cognitive face of
table 3.2. types of automatic thoughts and images that Characterize specific
anxiety Disorders
Anxiety disorder Thematic content of automatic thought/image
Panic with/without agoraphobic
avoidance... of physical catastrophe (e.g., fainting, heart attack,
dying, going crazy)
Generalized anxiety disorder... of possible future loss and failure in valued life domains
as well as fear of losing control or inability to cope
Social phobia... of negative evaluation by others, humiliation, poor
social performance
Obsessive–compulsive disorder... of losing mental or behavioral control that results in
serious harm to self or others.
Posttraumatic stress disorder... of past trauma and its sequelae