Lecture:
Lahey,
Barlow,
and
[opMonal]
Ormel
papers
EmoMonal
disorders:
symptoms
&
burden
Informed
ciMzens
and
taxpayers
PSYC
210:
How
does
T&P
contribute
to
emoMonal
disorders?
Part
1
of
3
Focus
on
N/NE
AJ
Shackman
7
April
2015
Lahey
Amer
Psychol
2009
Lahey
Amer
Psychol
2009
Lahey
Amer
Psychol
2009
Family
of
Disorders
Generalized
Anxiety
(GAD))
Panic
Post-TraumaAc
Stress
(PTSD)
Social
Anxiety
/
Social
Phobia
Other
Specic
Phobias
General
About
aJacks
About
trauma
cues
About
social
interacLons
e.g.,
dogs,
spiders
hSp://www.adaa.org/about-adaa/press-room/facts-staAsAcs
&
hSp://www.nimh.nih.gov/StaAsAcs/index.shtml
Family
of
Disorders
Generalized
Anxiety
(GAD))
Panic
Post-TraumaAc
Stress
(PTSD)
Social
Anxiety
/
Social
Phobia
Other
Specic
Phobias
General
About
aJacks
About
trauma
cues
About
social
interacLons
e.g.,
dogs,
spiders
hSp://www.adaa.org/about-adaa/press-room/facts-staAsAcs
&
hSp://www.nimh.nih.gov/StaAsAcs/index.shtml
MDD: Signs
MDD: Signs
MDD: Common
MDD: Common
MDD: Common
1 Euro = $1.09
1 Euro = $1.09
1 Euro = $1.09
1 Euro = $1.09
Boeom
Line
N/NE
confers
substan6al
risk
for
emo6onal
disorders
and
emo6onal
disorders
are
a
big
deal
Whadya
mean
risk?
Boeom
Line
N/NE
confers
substan6al
risk
for
emo6onal
disorders
and
emo6onal
disorders
are
a
big
deal
Whadya
mean
risk?
N/NE
is
The
strongest
predictor
of
categorical
emoAonal
disorder
diagnoses
(Kotov
et
al.,
2010)
The
strongest
predictor
of
conLnuous
symptoms
(self-report
and
clinical
raAngs)
that
cut
across
disorders
Especially
strongly
linked
to
general
distress/negaAve
aecAvity
(e.g.,
depressed
mood,
anxious
mood,
worry),
which
lies
at
the
core
of
the
emoAonal
disorders
Remains
predicAve
of
anxiety
and
depression
symptoms
even
aler
eliminaAng
overlapping
content
(Uliaszek
et
al.,
2009)
Lahey Amer Psychol 2009; cf. Kotov et al Psych Bull 2010; Watson &Naragon-Gainey CPS 2014
N/NE
is
The
strongest
predictor
of
categorical
emoAonal
disorder
diagnoses
(Kotov
et
al.,
2010)
The
strongest
predictor
of
conLnuous
symptoms
(self-report
and
clinical
raAngs)
that
cut
across
disorders
Especially
strongly
linked
to
general
distress/negaAve
aecAvity
(e.g.,
depressed
mood,
anxious
mood,
worry),
which
lies
at
the
core
of
the
emoAonal
disorders
Remains
predicAve
of
anxiety
and
depression
symptoms
even
aler
eliminaAng
overlapping
content
(Uliaszek
et
al.,
2009)
Lahey Amer Psychol 2009; cf. Kotov et al Psych Bull 2010; Watson &Naragon-Gainey CPS 2014
N/NE
is
The
strongest
predictor
of
categorical
emoAonal
disorder
diagnoses
(Kotov
et
al.,
2010)
The
strongest
predictor
of
conLnuous
symptoms
(self-report
and
clinical
raAngs)
that
cut
across
disorders
Especially
strongly
linked
to
general
distress/negaAve
aecAvity
(e.g.,
depressed
mood,
anxious
mood,
worry),
that
lies
at
the
core
of
the
emoAonal
disorders
Remains
predicAve
of
anxiety
and
depression
symptoms
even
aler
eliminaAng
overlapping
content
(Uliaszek
et
al.,
2009)
Lahey Amer Psychol 2009; cf. Kotov et al Psych Bull 2010; Watson &Naragon-Gainey CPS 2014
N/NE
is
The
strongest
predictor
of
categorical
emoAonal
disorder
diagnoses
(Kotov
et
al.,
2010)
The
strongest
predictor
of
conLnuous
symptoms
(self-report
and
clinical
raAngs)
that
cut
across
disorders
Especially
strongly
linked
to
general
distress/negaAve
aecAvity
(e.g.,
depressed
mood,
anxious
mood,
worry),
that
lies
at
the
core
of
the
emoAonal
disorders
Remains
predicAve
of
anxiety
and
depression
symptoms
even
aler
eliminaAng
overlapping
content
(Uliaszek
et
al.,
2009)
Lahey Amer Psychol 2009; cf. Kotov et al Psych Bull 2010; Watson &Naragon-Gainey CPS 2014
Why?
???
Risk
???
Risk
MDD
ANX
N/NE
DEP
ANX
N/NE
DEP
ANX
N/NE
DEP
Internalizing
Spectrum
Of
Disorders
(a.k.a.
EmoMonal
Dxes)
NO!
YES!
NO!
YES!
NO!
YES!
0000
Common
geneMc
substrate
would
help
to
explain
why
N/NE
is
a
risk
factor
for
mulMple
emoMonal
disorders
Common
geneMc
substrate,
one
shared
by
mulMple
DXes
and
N/NE,
would
help
to
explain
why
N/NE
is
a
risk
factor
for
mulMple
emoMonal
disorders
Common
geneMc
substrate,
one
shared
by
mulMple
DXes
and
N/NE,
would
help
to
explain
why
N/NE
is
a
risk
factor
for
mulMple
emoMonal
disorders
Common
geneMc
substrate,
one
shared
by
mulMple
DXes
and
N/NE,
would
help
to
explain
why
N/NE
is
a
risk
factor
for
mulMple
emoMonal
disorders
Common
geneMc
substrate,
one
shared
by
mulMple
DXes
and
N/NE,
would
help
to
explain
why
N/NE
is
a
risk
factor
for
mulMple
emoMonal
disorders
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
make-up
of
the
common
cause
Interim Summary
4. Treatments
cause
parallel,
non-specic
decreases
5. Environmental
pathogens
like
stress
cause
parallel,
non-specic
increases
4-5
provide
more
mechanis6c
evidence
that
T&P
(N/NE)
and
psychopathology
(emo6onal
disorders)
reect
a
common
substrate
6. Shared
heritability,
suggesMng
shared
genes
7. Shared
brain
circuitry
6-7
begin
to
address
the
biological
origins
of
the
common
cause
Temperamental Risk
Yes
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
individual
dierences
in
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
1.
There
are
substanMal
similariMes
and
co-morbidity
between
the
anxiety
and
depressive
disorders.
Spectra,
not
fundamentally
dierent
natural
kinds
2.
3.
4.
5.
6.
All
in
all,
this
evidence
suggests
that
N/NE
and
EmoMonal
Disorders
are
not
fundamentally
dierent,
but
instead
reect
a
common
cause
Low
E/PE
High
N/NE
TriparMte Model: Clark & Watson JAP 1991; Watson et al JAP 1995a, b
Low
PE
High
N/NE
TriparMte Model: Clark & Watson JAP 1991; Watson et al JAP 1995a, b
Extra Slides
Future Challenges