Volume 23, Issue 4 (Winter 2018)                   IJPCP 2018, 23(4): 408-423 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ranjbari T, Karimi J, Mohammadi A, Norouzi M R. An Evaluation of the Contributions of the Triple Vulnerability Model to the Prediction of Emotional Disorders. IJPCP. 2018; 23 (4) :408-423
URL: http://ijpcp.iums.ac.ir/article-1-2577-en.html
1- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
2- Department of Psychology, Faculty of Literature and Humanities, Malayer University, Malayer, Iran , E-mail: dr.karimi10@yahoo.com
3- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
4- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
Abstract:   (3739 Views)
Objectives The triple vulnerability model includes three types of vulnerability in terms of emotional disorders: general biological vulnerability, general psychological vulnerability, and disorder-specific psychological vulnerability. Since previous studies have mostly addressed only one of these components, this study was conducted to examine all the three components of the triple vulnerability model at the same time in patients suffering from emotional disorders and normal people.
Methods Using a causal-comparative design, 20 patients with obsessive-compulsive disorder, 20 patients with major depressive disorder, and 20 patients with generalized anxiety disorder were compared with 20 normal people (control group). The data were collected from March to June 2015. The patients and control group were selected through convenience sampling from the people attending private psychotherapy clinics in the city of Urmia and the normal people living in Urmia, respectively. The patients and control groups were matched with each other with regard to some demographic variables. A multivariate analysis of variance (MANOVA) was conducted to determine the differences between the patients and the control group.
Results Patients suffering from generalized anxiety disorder, obsessive-compulsive disorder, and major depressive disorder were more vulnerable to general biological vulnerability and general psychological vulnerability (P=0.001). With regard to disorder-specific psychological vulnerabilities, a significant difference was found between the patients with generalized anxiety and the control group where patients being more intolerant of uncertainty (P=0.001). We also found that obsessive-compulsive patients had more thought-action fusion and major depressive patients had more dysfunctional attitudes compared with the control group.
Conclusion Because of the significant difference between patients with emotional disorders and control group in terms of the dimensions of the triple vulnerability model, it can be argued that this model could be envisaged as comprehensive and suitable etiological and diagnostic criteria for these patients.
Full-Text [PDF 3173 kb]   (1523 Downloads) |   |   Full-Text (HTML)  (2417 Views)  
Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2016/09/21 | Accepted: 2017/04/24 | Published: 2018/01/1

1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the Na-tional Comorbidity Survey Replication. Archives of General Psychiatry. 2005; 62(6):593-602. doi: 10.1001/archpsyc.62.6.593 [DOI:10.1001/archpsyc.62.6.593]
2. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005; 62(6):617-27. doi: 10.1001/archpsyc.62.6.617 [DOI:10.1001/archpsyc.62.6.617]
3. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: An update from the WHO World Men-tal Health (WMH) surveys. Epidemiologia e Psichiatria Sociale. 2009; 18(1):23-33. doi: 10.1017/s1121189x00001421 [DOI:10.1017/S1121189X00001421]
4. Costa e Silva JA. The public health impact of anxiety disorders: a WHO perspective. Acta Psychiatrica Scandinavica. 1998; 98(s393):2-5. doi: 10.1111/j.1600-0447.1998.tb05959.x [DOI:10.1111/j.1600-0447.1998.tb05959.x]
5. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Philadelphia, Pennsylvania: Lippincott Wil-liams & Wilkins; 2007.
6. Kessler RC, Gruber M, Hettema JM, Hwang I, Sampson N, Yonkers KA. Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychological Medicine. 2008; 38(3):365-74. doi: 10.1017/s0033291707002012 [DOI:10.1017/S0033291707002012]
7. Mirzadehahari Z, Mohammadi F, Eini zinab H, Khosravi M, mousavi N, Agasi M. [Survey of association between major depression disorder in women and household food insecurity (Prsian)]. Iranian Journal of Nutrition Sciences & Food Technology. 2015; 10(1):9-20.
8. Kenny MA, Williams JMG. Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy. Behaviour Research and Therapy. 2007; 45(3):617-25. doi: 10.1016/j.brat.2006.04.008 [DOI:10.1016/j.brat.2006.04.008]
9. Hettema JM, Prescott CA, Myers JM, Neale MC, Kendler KS. The structure of genetic and environmental risk factors for anxiety disorders in men and wom-en. Archives of General Psychiatry. 2005; 62(2):182-9. doi: 10.1001/archpsyc.62.2.182 [DOI:10.1001/archpsyc.62.2.182]
10. Karayiorgou M, Altemus M, Galke BL, Goldman D, Murphy DL, Ott J, et al. Genotype determining low catechol-O-methyltransferase activity as a risk fac-tor for obsessive-compulsive disorder. Proceedings of the National Academy of Sciences. 1997; 94(9):4572-5. doi: 10.1073/pnas.94.9.4572 [DOI:10.1073/pnas.94.9.4572]
11. Vink D, Aartsen MJ, Schoevers RA. Risk factors for anxiety and depression in the elderly: A review. Journal of affective disorders. 2008;106(1):29-44. doi: 10.1016/j.jad.2007.06.005 [DOI:10.1016/j.jad.2007.06.005]
12. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Association Publish-ing; 2013.
13. Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety disorders. Journal of Abnormal Psychology. 1994; 103(1):103. doi: 10.1037//0021-843x.103.1.103 [DOI:10.1037//0021-843X.103.1.103]
14. Leahy RL, Holland SJ, McGinn LK. Treatment plans and interventions for depression and anxiety disorders. New York: Guilford Press; 2011.
15. Zhang X, Norton J, Carriere I, Ritchie K, Chaudieu I, Ancelin M. Risk factors for late-onset generalized anxiety disorder: results from a 12-year prospective cohort (The ESPRIT study). Translational Psychiatry. 2015; 5(3):e536. doi: 10.1038/tp.2015.31 [DOI:10.1038/tp.2015.31]
16. Blanco C, Rubio J, Wall M, Wang S, Jiu CJ, Kendler KS. Risk factors for anxiety disorders: Common and specific effects in a national sample. Depression and Anxiety. 2014; 31(9):756-64. doi: 10.1002/da.22247 [DOI:10.1002/da.22247]
17. Brown TA, Barlow DH. Classification of anxiety and mood disorders. In: Barlow DH, editor. Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic. New York: Guilford Press; 2002.
18. Brown TA, Barlow DH. A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Im-plications for assessment and treatment. Psychological Assessment. 2009; 21(3):256-71. doi: 10.1037/a0016608 [DOI:10.1037/a0016608]
19. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology. 2001;110(4):585-99. doi: 10.1037//0021-843x.110.4.585 [DOI:10.1037//0021-843X.110.4.585]
20. Allen L, White K, Barlow D, Shear MK, Gorman J, Woods S. Cognitive-Behavior Therapy (CBT) for panic disorder: Relationship of anxiety and depression comorbidity with treatment outcome. Journal of Psychopathology and Behavioral Assessment. 2010; 32(2):185-92. doi: 10.1007/s10862-009-9151-3 [DOI:10.1007/s10862-009-9151-3]
21. Borkovec T, Abel JL, Newman H. Effects of psychotherapy on comorbid conditions in generalized anxiety disorder. Journal of Consulting and Clinical Psychology. 1995; 63(3):479-83. doi: 10.1037//0022-006x.63.3.479 [DOI:10.1037//0022-006X.63.3.479]
22. Tsao JCI, Lewin MR, Craske MG. The effects of cognitive-behavior therapy for panic disorder on comorbid conditions. Journal of Anxiety Disorders. 1998; 12(4):357-71. doi: 10.1016/s0887-6185(98)00020-6 [DOI:10.1016/S0887-6185(98)00020-6]
23. Tsao JCI, Mystkowski JL, Zucker BG, Craske MG. Effects of cognitive-behavioral therapy for panic disorder on comorbid conditions: Replication and exten-sion. Behavior Therapy. 2002; 33(4):493-509. doi: 10.1016/s0005-7894(02)80013-2 [DOI:10.1016/S0005-7894(02)80013-2]
24. Barlow DH. Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. American Psychologist. 2000; 55(11):1247-63. doi: 10.1037//0003-066x.55.11.1247 [DOI:10.1037//0003-066X.55.11.1247]
25. Barlow DH. Disorders of emotion. Psychological Inquiry. 1991; 2(1):58-71. doi: 10.1207/s15327965pli0201_15 [DOI:10.1207/s15327965pli0201_15]
26. Suárez L, Bennett S, Goldstein C, Barlow DH. Understanding anxiety disorders from a "triple vulnerability" framework. In: Antony MM, Stein MB, edi-tors. Oxford Handbook of Anxiety and Related Disorders. Oxford: Oxford University Press; 2009.
27. Barlow DH. Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford Press; 2002.
28. Brown TA, Naragon-Gainey K. Evaluation of the unique and specific contributions of dimensions of the triple vulnerability model to the prediction of DSM-IV anxiety and mood disorder constructs. Behavior Therapy. 2013; 44(2):277-92. doi: 10.1016/j.beth.2012.11.002 [DOI:10.1016/j.beth.2012.11.002]
29. Afshar H, Roohafza H, Hassanzadeh-Keshteli A, Sharbafchi MR, Feizi A, Adibi P. Association of personality traits with psychological factors of depres-sion, anxiety, and psychological distress: a community based study. International Journal of Body, Mind and Culture. 2015; 2(2):105-14.
30. Anderson KG, Dugas MJ, Koerner N, Radomsky AS, Savard P, Turcotte J. Interpretive style and intolerance of uncertainty in individuals with anxiety dis-orders: A focus on generalized anxiety disorder. Journal of Anxiety Disorders. 2012; 26(8):823-32. doi: 10.1016/j.janxdis.2012.08.003 [DOI:10.1016/j.janxdis.2012.08.003]
31. Cowie J, Clementi MA, Alfano CA. Examination of the Intolerance of Uncertainty Construct in Youth With Generalized Anxiety Disorder. Journal of Clini-cal Child & Adolescent Psychology. 2016:1-9. doi: 10.1080/15374416.2016.1212358 [DOI:10.1080/15374416.2016.1212358]
32. Jones R, Bhattacharya J. A role for the precuneus in thought–action fusion: Evidence from participants with significant obsessive–compulsive symptoms. NeuroImage: Clinical. 2014; 4:112-21. doi: 10.1016/j.nicl.2013.11.008 [DOI:10.1016/j.nicl.2013.11.008]
33. Thomas J, Altareb B. Cognitive vulnerability to depression: an exploration of dysfunctional attitudes and ruminative response styles in the United Arab Emirates. Psychology and Psychotherapy: Theory, Research and Practice. 2012; 85(1):117-21. doi: 10.1111/j.2044-8341.2011.02015.x [DOI:10.1111/j.2044-8341.2011.02015.x]
34. Costa PT, McCrae RR. Normal personality assessment in clinical practice: The NEO Personality Inventory. Psychological Assessment. 1992; 4(1):5-13. doi: 10.1037//1040-3590.4.1.5 [DOI:10.1037//1040-3590.4.1.5]
35. McCrae RR, Costa Jr PT. The five-factor theory of personality. In: John OP, Robins RW, Pervin LA, editors. Handbook of Personality: Theory and Research. New York: Guilford Press; 2008.
36. Costa PT, McCrae RR. Four ways five factors are basic. Personality and Individual Differences. 1992; 13(6):653-65. doi: 10.1016/0191-8869(92)90236-i [DOI:10.1016/0191-8869(92)90236-I]
37. Garoosi MT. [New approaches to personality assessment: Application of factor analysis in personality studies (Persian)]. Tabriz: Jamepazhooh; 2001.
38. Brown TA, White KS, Forsyth JP, Barlow DH. The structure of perceived emotional control: Psychometric properties of a revised anxiety control question-naire. Behavior Therapy. 2004; 35(1):75-99. doi: 10.1016/s0005-7894(04)80005-4 [DOI:10.1016/S0005-7894(04)80005-4]
39. Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press; 2009.
40. Gwilliam P, Wells A, Cartwright-Hatton S. Dose meta-cognition or responsibility predict obsessive–compulsive symptoms: a test of the metacognitive model. Clinical Psychology & Psychotherapy. 2004; 11(2):137-44. doi: 10.1002/cpp.402 [DOI:10.1002/cpp.402]
41. Myers SG, Wells A. Obsessive-compulsive symptoms: the contribution of metacognitions and responsibility. Journal of Anxiety Disorders. 2005; 19(7):806-17. doi: 10.1016/j.janxdis.2004.09.004 [DOI:10.1016/j.janxdis.2004.09.004]
42. Khoramdel K, Rabiee M, Molavi H, Neshat-Doost H. [A study psychometric properties of Thought Fusion Instrument (TFI) in student (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2010; 16(1):74-8.
43. Ebrahimi A, Neshatdoost H, Kalantari M, Molavi H, Asadollahi G. [Contributions of dysfunctional attitude scale and general health subscales to predic-tion and odds ratio of depression (Persian)]. Journal of Shahrekord University of Medical Sciences. 2003; 9(4):8-52.
44. Freeston MH, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Personality and Individual Differences. 1994; 17(6):791-802. doi: 10.1016/0191-8869(94)90048-5 [DOI:10.1016/0191-8869(94)90048-5]
45. Buhr K, Dugas MJ. The intolerance of uncertainty scale: psychometric properties of the English version. Behaviour Research and Therapy. 2002; 40(8):931-45. doi: 10.1016/s0005-7967(01)00092-4 [DOI:10.1016/S0005-7967(01)00092-4]
46. Akbari M HH, Andoz Z. [Predictors of worry in student (Persian)]. Paper presented at: The 5th National Seminar on Student's Mental Health. 12-13 May 2010; Tehran, Iran.
47. Spinhoven P, Elzinga BM, van Hemert AM, de Rooij M, Penninx BW. A longitudinal study of facets of extraversion in depression and social anxiety. Per-sonality and Individual Differences. 2014; 71:39-44. doi: 10.1016/j.paid.2014.07.014 [DOI:10.1016/j.paid.2014.07.014]
48. Brown TA. Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. Journal of Abnormal Psychology. 2007; 116(2):313-28. doi: 10.1037/0021-843x.116.2.313 [DOI:10.1037/0021-843X.116.2.313]
49. Watson D, Gamez W, Simms LJ. Basic dimensions of temperament and their relation to anxiety and depression: A symptom-based perspective. Journal of Research in Personality. 2005; 39(1):46-66. doi: 10.1016/j.jrp.2004.09.006 [DOI:10.1016/j.jrp.2004.09.006]
50. Grossarth-Maticek R, Eysenck HJ. Personality, stress and disease: Description and validation of a new inventory. Psychological Reports. 1990; 66(2):355-73. doi: 10.2466/pr0.1990.66.2.355 [DOI:10.2466/pr0.1990.66.2.355]
51. Matthews G, Gilliland K. The personality theories of HJ Eysenck and JA Gray: A comparative review. Personality and Individual Differences. 1999; 26(4):583-626. doi: 10.1016/s0191-8869(98)00158-5 [DOI:10.1016/S0191-8869(98)00158-5]
52. Barlow DH, Sauer-Zavala S, Carl JR, Bullis JR, Ellard KK. The nature, diagnosis, and treatment of neuroticism. Clinical Psychological Science. 2013; 2(3):344–65. doi: 10.1177/2167702613505532 [DOI:10.1177/2167702613505532]
53. Barlow D, Durand V. Abnormal psychology: an integrative approach. Boston, Massachusetts: Cengange Publisher; 2014.
54. Fischer S, Cleare A. HPA axis functioning as a predictor of psychotherapy response in patients with depression and anxiety disorders–A systematic review and meta-analysis. Psychoneuroendocrinology. 2015; 61:23-4. doi: 10.1016/j.psyneuen.2015.07.454 [DOI:10.1016/j.psyneuen.2015.07.454]
55. Gallagher MW, Bentley KH, Barlow DH. Perceived control and vulnerability to anxiety disorders: A meta-analytic review. Cognitive Therapy and Re-search. 2014; 38(6):571-84. doi: 10.1007/s10608-014-9624-x [DOI:10.1007/s10608-014-9624-x]
56. Moulding R, Kyrios M, Doron G, Nedeljkovic M. Mediated and direct effects of general control beliefs on obsessive compulsive symptoms. Canadian Jour-nal of Behavioural Science/Revue canadienne des sciences du comportement. 2009; 41(2):84-92. doi: 10.1037/a0014840 [DOI:10.1037/a0014840]
57. Chapman LK, Kertz SJ, Woodruff-Borden J. A structural equation model analysis of perceived control and psychological distress on worry among African American and European American young adults. Journal of Anxiety Disorders. 2009; 23(1):69-76. doi: 10.1016/j.janxdis.2008.03.018 [DOI:10.1016/j.janxdis.2008.03.018]
58. Paulus DJ, Vanwoerden S, Norton PJ, Sharp C. From neuroticism to anxiety: Examining unique contributions of three transdiagnostic vulnerability factors. Personality and Individual Differences. 2016; 94:38-43. doi: 10.1016/j.paid.2016.01.012 [DOI:10.1016/j.paid.2016.01.012]
59. Kërqeli A, Kelpi M, Tsigilis N. Dysfunctional attitudes and their effect on depression. Procedia - Social and Behavioral Sciences. 2013; 84:196-204. doi: 10.1016/j.sbspro.2013.06.534 [DOI:10.1016/j.sbspro.2013.06.534]
60. Jarrett RB, Minhajuddin A, Borman PD, Dunlap L, Segal ZV, Kidner CL, et al. Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders. Behaviour Research and Therapy. 2012; 50(5):280-6. doi: 10.1016/j.brat.2012.01.008 [DOI:10.1016/j.brat.2012.01.008]
61. Williams AD, Lau G, Grisham JR. Thought–action fusion as a mediator of religiosity and obsessive-compulsive symptoms. Journal of Behavior Therapy and Experimental Psychiatry. 2013; 44(2):207-12. doi: 10.1016/j.jbtep.2012.09.004 [DOI:10.1016/j.jbtep.2012.09.004]
62. Myers SG, Wells A. An experimental manipulation of metacognition: A test of the metacognitive model of obsessive-compulsive symptoms. Behaviour Re-search and Therapy. 2013; 51(4):177-84. doi: 10.1016/j.brat.2013.01.007 [DOI:10.1016/j.brat.2013.01.007]
63. Pourfaraj Omran M. [Comparison of Thought-Action Fusion (TAF) in obsessive -compulsive disorder (OCD), depression and comorbidity of this two dis-orders and normal group (Persian)]. Quarterly Journal of Psychological Studies. 2009; 5(1):35-50.
64. Bakhshipour Roodsari A, Faraji R. [Relationship between thought-action fusion with obsessive-compulsive symptoms in patients with obsessive-compulsive disorder (Persian)]. Contemporary Psychology. 2011; 5(2):15-22.
65. Wells A. Emotional disorders and metacognition: Innovative cognitive therapy. Hoboken, New Jersey: John Wiley & Sons; 2000.
66. Wells A. Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Hoboken, New Jersey: John Wiley & Sons; 1997.
67. Buhr K, Dugas MJ. Fear of emotions, experiential avoidance, and intolerance of uncertainty in worry and generalized anxiety disorder. International Journal of Cognitive Therapy. 2012; 5(1):1-17. doi: 10.1521/ijct.2012.5.1.1 [DOI:10.1521/ijct.2012.5.1.1]
68. McEvoy PM, Mahoney AE. To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy. 2012; 43(3):533-45. doi: 10.1016/j.beth.2011.02.007 [DOI:10.1016/j.beth.2011.02.007]
69. Asadi S, Abedini M, Poursharifi H, Nikokar M. [The relationship between intolerance of uncertainty and rumination with worry on student population (Persian)]. Journal of Clinical Psychology. 2013; 4(4):83-92.
70. Shahjoee T, Mahmood Aliloo M, Bakhshipour Roodsari A, Fakhari A. [Intolerance of uncertainty and worry among patients with generalized anxiety dis-order and obsessive-compulsive disorder (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2012; 17(4):304-12.

Add your comments about this article : Your username or Email:

Send email to the article author

© 2019 All Rights Reserved | Iranian Journal of Psychiatry and Clinical Psychology

Designed & Developed by : Yektaweb