Depression and Anxiety: Disorders of Emotion or Cognition?

Abstract

Based on developments in emotion theory, Barlow presents a model of psychopathological disorders that is both exciting and broad in its theoretical scope. He suggests that disorders of anxiety and depression (as well as anger and mania) are fundamentally disorders and that they have their origins in the inappropriate and spontaneous firing of certain primitive, basic, negative emotions such as fear (panic in its clinical manifestation) and sadness, respectively, in individuals who are biologically overreactive to stressful life events. These spontaneously firing negative emotions or false alarms occur unpredictably; when they do, they may become the focus of perceptions of uncontrollability among individuals who are also psychologically vulnerable to the development of anxiety and depressive disorders. Thus, those persons who possess an overreactive neurobiological response to stressful life events as well as early experiences with lack of control will be likely to develop clinically significant episodes of anxiety or depression when triggered by unexpected bouts of these negative emotions. In Barlow's view, then, anxiety and depressive disorders share common biological and psychological diatheses as well as a common mediating mechanism, perceptions of uncontrollability over bouts of panic or sadness and the development of anxious apprehension about one's ability to cope with future threats. What determines whether a person becomes anxious and remains so, or also develops depression, is the degree of his or her psychological vulnerability, the severity of current stressors, and the availability of coping mechanisms. According to Barlow, whereas the anxious individual continues to try to cope, the depressed individual has given up. In this commentary, I question Barlow's assumption that anxiety and depressive disorders are fundamentally disorders. In addition, I evaluate Barlow's model of emotional disorders with specific reference to the model's ability to account for the relationship between anxiety and depression. In so doing, I compare Barlow's model to another, more fundamentally cognitive, theory of the relationship between some anxiety and depressive disorders (Alloy, Kelly, Mineka, & Clements, 1990).