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Tripartite Model of Anxiety and Depression

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Tripartite Model of Anxiety and Depression

Watson and Clark (1991) proposed the Tripartite Model of Anxiety and Depression to help explain the comorbidity between anxious and depressive symptoms and disorders. [1] This model divides the symptoms of anxiety and depression into three groups: negative affect, positive affect and physiological hyperarousal. [2][3][1]These three sets of symptoms help explain common and distinct aspects of depression and anxiety. [2]

Factors

Negative Affect

Main Article: Negative affectivity

Negative affect can be defined as, “the extent to which an individual feels upset or unpleasantly engaged, rather than peaceful”. [1] Negative affect is common in individuals with both anxiety and depression and can be described by negative mood states such as subjective distress, fear, disgust, scorn, and hostility. [4] Mood states that are specific to depression include sadness and loneliness that have large factor loadings on Negative Affect. [4] Some common symptoms of negative affect include: insomnia, restlessness, irritability, and poor concentration. [5]

There is a substantial amount of empirical research on Negative Affect and its role in the tripartite model. For example, the Mood and Anxiety Symptom Questionnaire (MASQ)[6] was administered to a sample of college students and a sample of psychiatric patients. The correlations between the specific anxiety scale (anxious arousal) in the MASQ and NA were moderate (rs= .41 and .47), supporting that NA is specific to anxiety disorders, congruent with the tripartite model. [7] Another study consisted of a sample of children (ages 7-14) diagnosed with a principal anxiety disorder. The children completed the Positive and Negative Affect Scale for Children (PANAS-C)[8] The results showed NA was significantly associated with measure of anxiety and depression.[9] A study by Chorpita in 2002, was consistent with the tripartite model. In a large sample of school-aged children, NA was positively correlated with all anxiety and depression scales[10]

Physiological Hyperarousal

Physiological hyperarousal is defined by increased activity in the sympathetic nervous system, in response to threat.[11] Physiological hyperarousal is unique to anxiety disorders.[2][9] Some symptoms of physiological hyperarousal include: shortness of breath, feeling dizzy or lightheaded, dry mouth, trembling or shaking, and sweaty palms. [6][12]

Compared to negative affect and positive affect, physiological hyperarousal has been understudied. [13] [1] Chorpita et al. (2000), proposed an affect and arousal scale in order to measure the tripartite factors of emotion in children and adolescents. In this study, physiological hyperarousal was positively correlated with negative affect but not positive affect. This supports the tripartite model hypothesis, that physiological hyperarousal will distinguish anxiety from depression, which is related to positive affect. [13]Another study by Joiner et al. (1999), analyzed the construct validity of physiological hyperarousal. Data was collected from samples of psychotherapy outpatients, air force cadets, and undergraduate students. Confirmatory factor analyses showed that psychological hyperarousal is a reliable, replicable, valid, and discriminable construct. [14]

Positive Affect

Main Article:Positive affectivity

Positive affect is a dimension that reflects one's level of pleasurable engagement with their environment. (Clark, Steer, and Beck, 1994; Watson et al., 1995). High positive affect is made up of enthusiasm, energy level, mental alertness, interest, joy, social dominance, adventurousness, and activeness (Watson, Clark, and Carey, 1988; Watson et al. 1995; Anderson and Hope, 2008). In contrast, a low level of positive affect, or absence of, is called anhedonia (Joiner, 1996). Anhedonia is described as the loss of interest or the inability to experience pleasure when experiencing things that used to be pleasurable (Ho & Sommers, 2013). Low levels of positive affect in the Tripartite Model characterize depression (Watson et. al 1995; Joiner, 1996). Signs of low positive affect include fatigue, loneliness, sadness, and lethargy (Watson et. al 1995; Watson & Tellegen, 1985). Positive Affect is important because it is a construct used in order to differentiate depression from anxiety (Anderson & Hope, 2008; Gençöz, 2002)

References

  1. ^ a b c d Anderson, E., & HOPE, D. (2008). A review of the tripartite model for understanding the link between anxiety and depression in youth. Clinical Psychology Review, 28(2), 275-287. doi:10.1016/j.cpr.2007.05.004
  2. ^ a b c Clark, L., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316-336. doi:10.1037/0021-843X.100.3.316
  3. ^ Brown, T., Chorpita, B., & Barlow, D. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107(2), 179-192. doi:10.1037/0021-843X.107.2.179
  4. ^ a b Watson, D., Clark, L., & Carey, G. (1988). Positive and negative affectivity and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97(3), 346-353. doi:10.1037/0021-843X.97.3.346
  5. ^ Watson, D., Weber, K., Assenheimer, J., & Clark, L. (1995). Testing a tripartite model: I. evaluating the convergent and discriminant validity of anxiety and depression symptom scales. Journal of Abnormal Psychology, 104(1), 3-14. doi:10.1037/0021-843X.104.1.3(Watson et al., 1995)
  6. ^ a b Watson, D., Clark, L., Weber, K., & Assenheimer, J. (1995). Testing a tripartite model: II. exploring the symptom structure of anxiety and depression in student, adult, and patient samples. Journal of Abnormal Psychology, 104(1), 15-25. doi:10.1037/0021-843X.104.1.15
  7. ^ Clark, D., Steer, R., & Beck, A. (1994). Common and specific dimensions of self-reported anxiety and depression: Implications for the cognitive and tripartite models. Journal of Abnormal Psychology, 103(4), 645-654. doi:10.1037/0021-843X.103.4.645
  8. ^ Laurent, J., Catanzaro, S., Joiner, T., Rudolph, K., Potter, K., Lambert, S., . . . Gathright, T. (1999). A measure of positive and negative affect for children: Scale development and preliminary validation. Psychological Assessment, 11(3), 326-338. doi:10.1037/1040-3590.11.3.326
  9. ^ a b Hughes, A., & Kendall, P. (2009). Psychometric properties of the positive and negative affect scale for children (PANAS-C) in children with anxiety disorders. Child Psychiatry Human Development, 40(3), 343-352. doi:10.1007/s10578-009-0130-4
  10. ^ Chorpita, B. (2002). The tripartite model and dimensions of anxiety and depression: An examination of structure in a large school sample. Journal of Abnormal Child Psychology, 30(2), 177-190. doi:10.1023/A:1014709417132
  11. ^ Gencoz, F. (2000). Physiological hyperarousal as a specific correlate of symptoms of anxiety among young psychiatric inpatients. Social Behavior and Personality, 28(4), 409. doi:10.2224/sbp.2000.28.4.409
  12. ^ Laurent, J., Catanzaro, S., & Joiner, T. (2004). Development and preliminary validation of the physiological hyperarousal scale for children. Psychological Assessment, 16(4), 373-380. doi:10.1037/1040-3590.16.4.373
  13. ^ a b Chorpita, B., Daleiden, E., Moffitt, C., Yim, L., & Umemoto, L. (2000). Assessment of tripartite factors of emotion in children and adolescents I: Structural validity and normative data of an affect and arousal scale. Journal of Psychopathology and Behavioral Assessment, 22(2), 141-160. doi:10.1023/A:1007584423617
  14. ^ Joiner, T., Steer, R., Beck, A., Schmidt, N., Rudd, M. D., & Catanzaro, S. (1999). Physiological hyperarousal: Construct validity of a central aspect of the tripartite model of depression and anxiety. Journal of Abnormal Psychology, 108(2), 290-298. doi:10.1037/0021-843X.108.2.290
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