Do anxiety and depression cluster into distinct groups?: a test of tripartite model predictions in a community sample of youth

Abstract

Because of their high comorbidity and strong associations, the distinctiveness of anxiety and depression in youth continues to be debated. In this study we used cluster analysis in a community sample (n=225) of youth to test tripartite model predictions regarding the grouping of individuals based on their levels of anxiety and depression symptoms. Findings were consistent with tripartite model predictions that four groups would emerge (primarily elevated on anxiety symptoms only, elevated on depression symptoms only, elevated on both anxiety and depression symptoms, and a low symptom group). Analyses using specific tripartite model variables and parent report of internalizing symptoms provided additional support for the groupings and tripartite model predictions. Across age groupings, the clustering of anxiety and depression symptoms was consistent with some hypothesized developmental differences in the expression of internalizing symptoms in youth. Findings add support for the tripartite model in youth, and support the idea that anxiety and depression do represent unique syndromes in youth. Depression and Anxiety 23:453-460, 2006. Published 2006 Wiley-Liss, Inc.

Common and Specific Emotion-related Predictors of Anxious and Depressive Symptoms in Youth

“…Given current conceptualizations of the disorders, Clark and Watson [1] proposed that negative affect would be common to both anxiety and depression but that low positive affective experience would be distinctly related to depression whereas physiological hyperarousal would be uniquely correlated with anxiety. Clark and Watson found strong support for their model with adults, and later research found mixed support for the general model with children [2,[32][33][34][35]. For example, in a group of psychiatric inpatient youth, negative affect was related to both anxiety and depression whereas lack of positive affect was related to depression.…”

Symptoms of Anxiety and Depression in Early Adolescence: A Multitrait-Multimethod Factor Analytic Approach

“…Measures of anxiety and depression in children and adolescents have repeatedly been found to correlate strongly [1][2][3][4]. Likewise, diagnosis-based generalized anxiety disorder and major depressive disorder are found to have high levels of comorbidity [5,6].…”

“…Indeed, symptom scales have identified combined symptoms of anxiety and depression, or internalizing problems, as an important emotional syndrome in childhood and adolescence [8], and some research has supported a one-factor model of anxiety and depression [9]. Nevertheless, previous studies of the structure of anxiety and depression in children and adolescents have found inconsistent levels of construct overlap [2,3,10]. Moreover, other research suggests two-factor [11] or three-factor [12] models of anxiety and depression, and that these constructs tend to cluster in distinct groups [2,11].…”

“…Nevertheless, previous studies of the structure of anxiety and depression in children and adolescents have found inconsistent levels of construct overlap [2,3,10]. Moreover, other research suggests two-factor [11] or three-factor [12] models of anxiety and depression, and that these constructs tend to cluster in distinct groups [2,11].…”

An Evaluation of the Applicability of the Tripartite Constructs to Social Anxiety in Adolescents

“…More recent research has supported the utility of all three constructs in children and adolescents in clinical (Joiner, Catanzaro, & Laurent, 1996;Joiner & Lonigan, 2000;Lonigan, Carey, & Finch, 1994) and nonclinical (Cannon & Weems, 2006;Olino, Klein, Lewinsohn, Rohde, & Seeley, 2007;Phillips, Lonigan, Driscoll, & Hooe, 2002) settings.…”