Category: Adult Anxiety - GAD
Background and Study
Aim: Theoretically, lack of perceived controllability (PC) and personal mastery (PM) confers heightened susceptibility to the development of anxiety disorders (Bandura, 1977; Barlow, 2000). Empirically, clinical depression and generalized anxiety disorder (GAD) show a strong prospective link. However, no studies have investigated whether PC and PM function as mechanisms to explain the longitudinal depression-anxiety connection. This study aimed to address this.
Method: 4,963 community-dwelling middle-aged adults (M = 46.46 ± 12.51 years, 53% female, 85% college educated) participated in three waves of data collection over 18 years, with each wave approximately nine years apart from another. Mediation analyses using structural equation modelling were conducted to determine whether (a) time 1 depression predicted time 3 GAD and (b) time 2 PC and PM mediated the proposed link. Time 1 GAD was controlled for in each step of the mediation analyses. The psychometrically reliable and valid Sense of Control scale (Lachman & Weaver, 1998) was used to assess PC and PM.
Results: The overall pattern of practical fit indices suggested that the measurement model demonstrated good fit [Χ2(df = 693) = 9098.024, p < .001; CFI = .963; TLI = .961; RMSEA = .049]. Total effects analyses revealed that time 1 depression severity significantly predicted greater time 3 GAD severity 18 years later (b = 0.158, SE = 0.035 p < .001). Indirect effects analyses showed that time 2 PC (b = 0.047, 99% confidence interval (CI) [0.014, 0.054]), but not PM (b = 0.007, 99% CI [-0.004, 0.010]), mediated the prospective link between depression and GAD severity. Higher baseline depression led to lower time 2 PC (b = -0.195, SE = 0.037, p < .001), which in turn uniquely contributed to greater time 3 GAD severity (b = -0.175, SE = 0.022, p < .001). Conclusion: Lack of perceived controllability functions as both a distal risk factor and mechanism by which clinical depression predicts GAD close to two decades later.