A Comparative Cross-sectional Study of Emotional Schemas, Anxiety Sensitivity, Repetitive Negative Thoughts, Cognitive Flexibility, COVID-19 Anxiety, and Attachment to God in Individuals with Mood and Anxiety Disorders

Background: Emotional schemas are pervasive mental structures associated with a wide array of psychological symptoms. Cognitive flexibility (CF) and attachment to God are considered adaptive psychological constructs. Objectives: The present study aimed to compare emotional schemas, anxiety sensitivity (AS), repetitive negative thoughts (RNTs), CF, COVID-19 anxiety, and attachment to God between individuals with mood and anxiety disorders. Methods: This cross-sectional study involved 170 participants, categorized into two groups: Eighty four diagnosed with mood disorders and 86 with anxiety disorders. The participants were residents of Tehran, Iran, from January to June 2024. Data collection and comparison across the two groups were conducted using six instruments: The Anxiety Sensitivity Index (ASI), Repetitive Negative Thinking (RNT) Questionnaire, Cognitive Flexibility Inventory (CFI), Attachment to God Inventory (AGI), COVID-19 Anxiety Scale (CAS), and Leahy Emotional Schemas Scale (LESS). ANOVA was used for data analysis with SPSS-26. Results: The Wilk’s Lambda test indicated a significant overall effect of the group (P < 0.001, F = 2.657). Patients with anxiety scored significantly higher on the simplistic view of emotion, devaluation, and alternatives compared to patients with depression. Conversely, patients with depression scored significantly higher on incomprehensibility, guilt, loss of control, duration, low expression, and RNTs than those with anxiety. Conclusions: The study found that RNTs are prevalent in both depression and anxiety, contributing to the exacerbation and persistence of these disorders. Targeting RNTs could benefit selective preventive interventions. Addressing RNTs, emotional schemas, and CF in treatment, along with early selective preventive interventions, may help mitigate their impact. Shared risk factors underscore the importance of early clinical detection and intervention.