A Test of the Tripartite Model of Anxiety and Depression in Elementary and High School Boys and Girls

The applicability of the tripartite model of emotion, which distinguishes the shared aspect of depression and anxiety, negative affect (NA), from their respective specific components of low positive affect (PA) and physiological hyperarousal (PH), was examined in 472 elementary and high school students. The relations among depression, anxiety, and the three tripartite dimensions were examined for the total sample and across four subgroups based on age and gender. High school girls reported more depression, anxiety, NA, and PH than the other groups, and lower PA as assessed by the PANAS-C, but not the AFARS. Using structural equation modeling, the tripartite model proved to be a reasonably good fit for the total sample. Among the subgroups, the best fit was found for high school girls. However, several findings for the total sample and for individual subgroups were not consistent with the tripartite model, raising issues related to the independence and specificity of the tripartite constructs and their measurement. Alternative age- and gender-specific models to better account for the shared and unique aspects of depression and anxiety in children need to be explored.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

Assessment of Tripartite Factors of Emotion in Children and Adolescents I: Structural Validity and Normative Data of an Affect and Arousal Scale

The authors developed and evaluated a self-report measure for children designed to assess factors of the tripartite model of emotion (Clark & Watson, 1991). Factor analytic results from a large, multi-ethnic sample (n = 1,289) supported the structural validity of the scale, with the additional suggestion that negative affect appeared to contain two lower order dimensions in the item pool. Confirmatory factor analysis in an independent sample of 300 children and adolescents suggested favorable structure. Consistent with prediction, positive and negative affect emerged as relatively orthogonal dimensions. Physiological hyperarousal was found to be positively correlated with negative affect. Normative data are presented, and tests for differences by sex, grade level, and ethnicity demonstrated nonsignificant or minimal differences between groups. The implications for the assessment of tripartite factors and their relation to psychopathology in youth are discussed.     

Sex differences in the indirect effects of cognitive processes on anxiety through emotion regulation difficulties

Drawing on a gender roles theory of emotion regulation, we examined the specific facets of emotion regulation difficulties through which higher-order cognitive abilities may be related to anxiety. Participants (N = 225) completed self-report measures of emotion regulation difficulties and anxiety, and were administered neuropsychological tests assessing abstract reasoning and inhibition. PROCESS (Hayes, 2012) was used to estimate the direct and indirect effects of both inhibition and abstract reasoning on anxiety symptoms, with six dimensions of emotion regulation difficulties serving as multiple mediators operating in parallel. Results suggest that the relation between higher-order cognitive abilities and anxiety operate through distinct, sex-dependent emotion dysregulation mechanisms. For females, higher levels of inhibition and abstract thinking were associated with poorer clarity of emotions, which in turn, was associated with higher levels of anxiety symptoms. As such, over-attentiveness to, or over-analysis of, emotions may be particularly detrimental among females who have relatively higher abstract reasoning abilities. For males, higher inhibition was associated with greater perceived effectiveness in regulating negative emotions, which in turn, was associated with lower levels of anxiety symptoms. This finding suggests that mood regulation expectancies may be particularly important in understanding the pathogenesis of anxiety in males.     

Psychological vulnerabilities in patients with major depression vs panic disorder

The tripartite model (Clark & Watson, 1991: Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336) posits that anxiety and depression share nonspecific features of neuroticism but that somatic arousal appears unique to anxiety, and low positive affect appears unique to depression. The present study controlled for these higher-order effects and evaluated the relative contributions of four, specific lower-order vulnerabilities (anxiety sensitivity, rumination, self-criticism, self-oriented perfectionism). Participants were 38 depressed patients and 38 patients with panic disorder matched as closely as possible for age and gender, and all were diagnosed using the same structured interview by an experienced clinician. Results from hierarchical logistic regression analysis were consistent with predictions from the tripartite model in that only the unique features of arousal and positive affectivity differentiated the two diagnostic groups. At a lower-order level, only anxiety sensitivity (and its facet of fear of physical symptoms) and a ruminative response style demonstrated incremental predictive ability. The discussion focuses on the relationships among these higher-order and lower-order variables, and their potential importance for understanding specific manifestations of psychopathology.     

Facets of Emotion Regulation and Emotional Disorder Symptom Dimensions: Differential Associations and Incremental Validity in a Large Clinical Sample

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. The best-fitting measurement model of emotion regulation included four dimensions: Problematic Responses, Poor Recognition/Clarity, Negative Thinking, and Emotional Inhibition/Suppression. Although many zero-order associations between the four latent emotion regulation dimensions and five latent symptom dimensions were significant, few associations remained significant in a structural regression model that included neuroticism. Specifically, Negative Thinking and Problematic Responses incrementally predicted depression symptoms, while Emotional Inhibition/Suppression predicted both social anxiety and depression symptoms. Associations between neuroticism and the emotional disorder dimensions were similar regardless of whether the emotion regulation dimensions were held constant. These results suggest that self-reported emotion regulation dimensions are associated with the severity and expression of a range of emotional disorder symptoms, but that some emotion regulation dimensions have limited incremental validity after accounting for general emotional reactivity. Studies of emotion regulation should assess neuroticism as a key covariate.     

Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale

The practical significance of assessing disorders of emotion in children is well documented, yet few scales exist that possess conceptual if not empirical relevance to dimensions of DSM anxiety or depressive disorders. The current study evaluated an adaptation of a recently developed anxiety measure (Spence Children's Anxiety Scale; [Spence, S. H. (1997). Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology, 106, 280-297; Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545-566]), revised to correspond to dimensions of several DSM-IV anxiety disorders as well as major depression. This investigation involved initial evaluation of the factorial validity of the revised measure in a school sample of 1641 children and adolescents and reliability and validity in an independent sample of 246 children and adolescents. Results yielded an item set and factor definitions that demonstrated structure consistent with DSM-IV anxiety disorders and depression. The revised factor structure and definitions were further supported by the reliability and validity analyses. Some implications for assessment of childhood anxiety and depressive disorders are discussed.     

Hierarchical model of vulnerabilities for emotional disorders

Clark and Watson's (1991) tripartite model of anxiety and depression has had a dramatic impact on our understanding of the dispositional variables underlying emotional disorders. More recently, calls have been made to examine not simply the influence of negative affectivity (NA) but also mediating factors that might better explain how NA influences anxious and depressive syndromes (e.g. Taylor, 1998; Watson, 2005). Extending preliminary projects, this study evaluated two hierarchical models of NA, mediating factors of anxiety sensitivity and intolerance of uncertainty, and specific emotional manifestations. Data provided a very good fit to a model elaborated from preliminary studies, lending further support to hierarchical models of emotional vulnerabilities. Implications for classification and diagnosis are discussed.     

Testing Structural Models of DSM-IV Symptoms of Common Forms of Child and Adolescent Psychopathology

Confirmatory factor analyses were conducted of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptoms of common mental disorders derived from structured interviews of a representative sample of 4,049 twin children and adolescents and their adult caretakers. A dimensional model based on the assignment of symptoms to syndromes in DSM-IV fit better than alternative models, but some dimensions were highly correlated. Modest sex and age differences in factor loadings and correlations were found that suggest that the dimensions of psychopathology are stable across sex and age, but slightly more differentiated at older ages and in males. The dimensions of symptoms were found to be hierarchically organized within higher-order “externalizing” and “internalizing” dimensions, which accounted for much of their variance. Major depression and generalized anxiety disorder were substantially correlated with both the “externalizing” dimension and the “internalizing” dimension, however, suggesting the need to reconceptualize the nature of these higher-order dimensions.     

Anxiety and Depression in Children and Adolescents: A Factor-Analytic Examination of the Tripartite Model

The tripartite model of Clark and Watson (1981) suggests that the oft-observed covariation between anxiety and depression can best be understood by examining three related yet distinct constructs: negative affectivity, positive affectivity, and elevated physiological arousal. In the present study, 510 boys and girls in the 4th, 7th, and 10th grades completed the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Confirmatory factor analyses were conducted to determine the goodness of fit of single-factor (i.e., negative affectivity), two-factor (i.e., anxiety and depression), and three-factor models (i.e., negative affectivity, positive affectivity, and physiological arousal). Analyses were conducted by examining each of the models in the whole sample first and then separately for boys and girls and for fourth, seventh, and tenth grade youths. Results failed to support the tripartite theory; rather, the findings supported a two-factor model in all cases. These factors represented the general constructs of anxiety and depression, and these factors remained significantly interrelated. Consistent with previous findings, the strength of these relations was stronger for boys than girls and for children than adolescents.     

Relevance of the Tripartite Dimensions of Affect for Anxiety and Depression in Youth: Examining Sex and Psychopathology Status

Using a combined sample (N = 1,215) of referred children and children from the general population aged between 8 and 14 years, the present study addressed two research goals: First, latent mean differences (depending on the individual’s sex or psychopathology level) in anxiety, depression, Positive Affect (PA), Negative Affect (NA) and Physiological Hyperarousal (PH) were examined. Secondly, the structure of anxiety and depression was investigated from a tripartite model perspective in boys and girls with high versus low levels of psychopathology respectively. When relating the latent mean level differences in NA, PA, and PH with those in anxiety and depression, the results suggest that higher levels (depending on the individual’s sex and psychopathology status) of anxiety or depression are associated with higher levels of PH and lower levels of PA, whereas no consistent pattern was found between mean level differences in NA on the one hand and mean level differences in anxiety/depression on the other. Results further demonstrated that a better fit was obtained for the dual than for the unitary construct representation in boys or girls with high or low levels of psychopathology, thereby suggesting that a valid distinction can be made between anxiety and depression in children between 8 and 14 years old, irrespective of their sex or level of psychopathology. However, when looking at the structural relations of the dual construct representation of anxiety and depression with NA, PA and PH in each of the four groups separately, it became evident that the PH and PA tripartite dimensions could not account for the unique aspects of anxiety and depression respectively. Moreover, PH rather than NA was found to be common for anxiety and depression.     

An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale

The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, Journal of Psychopathology and Behavioral Assessment 26:41?C54, 2004) is a popular multidimensional self-report measure of emotion regulation. The present study sought to examine the latent factor structure of the DERS. An examination of latent factor intercorrelations and a higher-order confirmatory factor analysis (CFA) suggested that the DERS-AWARENESS dimension may not represent the same higher-order emotion regulation construct as the other five DERS dimensions. Furthermore, findings supported the adequacy of a revised five-factor model of the DERS in which the AWARENESS dimension was removed. This revised DERS total scale did not diminish concurrent relations between the DERS and outcomes relevant to the emotion regulation domain (i.e., depression, anxiety, posttraumatic stress symptoms). Implications for the conceptualization and assessment of emotion regulation are discussed.     

A test of the tripartite model of depression and anxiety in older adult psychiatric outpatients

This study examined the tripartite model of depression and anxiety in 131 psychiatric outpatients, ages 55-87. Confirmatory factor analyses revealed that a 3-factor model provided an adequate fit to the observed data, that the 3-factor model was empirically superior to 1- or 2-factor models, and that the 3-factor structure obtained in the current sample of older adult outpatients converged with that obtained on a separate, younger 'sample. Negative affect was significantly related to depression and anxiety symptoms and syndromes, and positive affect was more highly related to depression than anxiety symptoms and syndromes. Ways for taking into account possible age-associated differences in emotion in older adults and thus improving the conceptual model of anxiety and depression are briefly noted.     

Anxiety sensitivity and the five-factor model of personality.

Relations between anxiety sensitivity (AS) and the higher-order and lower-order dimensions of the 'Big Five' model of personality were examined in 317 university students. AS was significantly associated with a number of personality domains and facets of the NEO-PI-R. Regression analyses indicated that only the higher-order domains of neuroticism and extraversion (negatively) and the lower-order N facets of anxiety and self-consciousness, significantly predicted AS. Three lower-order factors within AS were identified and were also compared to NEO-PI-R domains and facets. In a hierarchical regression, the three AS factors significantly predicted variance in a measure of panic-related anxiety after the effects of the six N facets were statistically controlled. Results are discussed in the context of previous work with a Big Three taxonomy of personality and implications for understanding the nature and possible origins of AS are outlined.     

Aging and symptoms of anxiety and depression: structural invariance of the tripartite model

Negative affect measures were evaluated in a cross-sectional community sample of adults aged 18-93 (N = 335) to examine the structure of neuroticism, anxiety, and depressive symptoms in young, middle, and older adult cohorts. Structural equation modeling was used to contrast 3 nested models: a 1-factor general distress model; a 2-factor high negative-low positive affect model; and a 3-factor "tripartite model" reflecting a higher order Negative Affect factor that is common to depression and anxiety problems and 2 lower order factors, Low Positive Affect (mostly specific to depression) and Arousal (specific to anxiety/panic). As expected, the tripartite model fit best for all age groups. Further, multigroup analyses indicated age invariance for the tripartite model, suggesting the model can be effectively applied with older populations.     

Mapping discrete and dimensional emotions onto the brain: controversies and consensus

A longstanding controversy in the field of emotion research has concerned whether emotions are better conceptualized in terms of discrete categories, such as fear and anger, or underlying dimensions, such as arousal and valence. In the domain of neuroimaging studies of emotion, the debate has centered on whether neuroimaging findings support characteristic and discriminable neural signatures for basic emotions or whether they favor competing dimensional and psychological construction accounts. This review highlights recent neuroimaging findings in this controversy, assesses what they have contributed to this debate, and offers some preliminary conclusions. Namely, although neuroimaging studies have identified consistent neural correlates associated with basic emotions and other emotion models, they have ruled out simple one-to-one mappings between emotions and brain regions, pointing to the need for more complex, network-based representations of emotion.     

Sixteen-item Anxiety Sensitivity Index: confirmatory factor analytic evidence, internal consistency, and construct validity in a young adult sample from the Netherlands

The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420) from the Netherlands. Confirmatory factor analysis was used to comparatively evaluate two-factor, three-factor, and four-factor models of the anxiety sensitivity construct. Support was found for a hierarchical structure of anxiety sensitivity, with one global higher-order factor and four lower-order factors. Internal consistency for the global and lower-order factors of the 16-item ASI was adequate. Convergent and discriminant associations between the 16-item ASI and general mood and panic-specific variables were consistent with anxiety sensitivity theory. In addition, incremental validity of the anxiety sensitivity construct was established, relative to negative affectivity, for unexpected panic attacks and agoraphobic avoidance.     

Psychometric Properties of the Childhood Anxiety Sensitivity Index in A sample of Catalan School Children

This study tested the utility of assessing anxiety sensitivity (AS) in children by investigating the long term stability and psychometric properties of a Catalan version of the Childhood Anxiety Childhood Anxiety Sensitivity Index (CASI, Silverman et al ., 1991, Journal of Clinical Child Psychology , 20 , 162-168) in a sample of 291 elementary-school children. The Catalan CASI demonstrated acceptable internal consistency and convergent validity estimates, similar to previous research with the English version. The measure also showed incremental validity in relation to other measures of anxiety and test-retest analyses suggested considerable three month and one-year stability in children's level of AS. Finally, a principal component analysis of the Catalan CASI yielded five lower-order factors grouped on a unique higher-order factor. The similarity of the findings to previous research on the CASI and on AS in English speaking children and adults is discussed and some suggestions for future investigations are presented.     

Emotional reactivity and cognitive regulation in anxious children

Recent models of anxiety disorders emphasize abnormalities in emotional reactivity and regulation. However, the empirical basis for this view is limited, particularly in children and adolescents. The present study examined whether anxious children suffer both negative emotional hyper-reactivity and deficits in cognitive emotion regulation. Participants were 49 children aged 10-17 with generalized anxiety disorder, social anxiety, or separation anxiety disorder as their primary diagnosis, as well as 42 age- and gender-matched non-anxious controls. After completing a diagnostic interview and self-report questionnaires, participants were presented with pictures of threatening scenes with the instructions either to simply view them or to use reappraisal, a cognitive emotion regulation strategy, to decrease their negative emotional response. Emotion ratings, content analysis of reappraisal responses, and reports of everyday use of reappraisal were used to assess negative emotional reactivity, reappraisal ability, efficacy and frequency. Relative to controls, children with anxiety disorders (1) experienced greater negative emotional responses to the images, (2) were less successful at applying reappraisals, but (3) showed intact ability to reduce their negative emotions following reappraisal. They also (4) reported less frequent use of reappraisal in everyday life. Implications for the assessment and treatment of childhood anxiety disorders are discussed.