On Clark-Watson's Tripartite Model of Anxiety and Depression

1997 ◽  
Vol 80 (1) ◽  
pp. 125-126 ◽  
Author(s):  
Alan Bedford
Keyword(s):  
Psychological Distress ◽  
Positive Affect ◽  
Factor Structure ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Tripartite Model ◽  
Somatic Anxiety ◽  
General Psychological Distress ◽  
Three Factor ◽  
High Positive Affect

Clark and Watson's tripartite model of anxiety and depression symptoms is reinterpreted using their data. It is suggested that a parsimonious view of the factor loadings is a three-factor structure of “general psychological distress,” “high positive affect,” and “somatic anxiety.”

scholarly journals Factor Structure of the Mood and Anxiety Symptom Questionnaire does not Generalize to an Anxious/Depressed Sample

2006 ◽  
Vol 40 (11-12) ◽  
pp. 1016-1024 ◽  
Author(s):  
Mark J Boschen ◽  
Tian P.S. Oei
Keyword(s):  
Factor Structure ◽  
Anxiety Symptom ◽  
Clinical Sample ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Tripartite Model ◽  
Unit Of Analysis ◽  
Symptom Questionnaire ◽  
Confirmatory Factor ◽  
Anxiety Depression

Objective: The tripartite model of anxiety and depression has been proposed as a representation of the structure of anxiety and depression symptoms. The Mood and Anxiety Symptom Questionnaire (MASQ) has been put forwards as a valid measure of the tripartite model of anxiety and depression symptoms. This research set out to examine the factor structure of anxiety and depression symptoms in a clinical sample to assess the MASQ's validity for use in this population. Method: The present study uses confirmatory factor analytic methods to examine the psychometric properties of the MASQ in 470 outpatients with anxiety and mood disorder. Results: The results showed that none of the previously reported two-factor, three-factor or five-factor models adequately fit the data, irrespective of whether items or subscales were used as the unit of analysis. Conclusion: It was concluded that the factor structure of the MASQ in a mixed anxiety/ depression clinical sample does not support a structure consistent with the tripartite model. This suggests that researchers using the MASQ with anxious/depressed individuals should be mindful of the instrument's psychometric limitations.

scholarly journals P106 Depressive symptoms and anxiety and their screening in IBD patients: performance of the distress thermometer in Italian IBD patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
C Canaletti ◽  
F Colombo ◽  
A Dessì ◽  
E Geccherle ◽  
A Tongiorgi ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Emotional Distress ◽  
Screening Tool ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cutoff Score ◽  
Distress Screening ◽  
Single Item ◽  
Mayo Score ◽  
Clinical Indices

Abstract Background Roughly 50% of patients with IBD have symptoms of psychological distress (Mikocka-Walus et al. 2019) but only 15.2% receive attention for their mental health although the effect on disease severity can be profound. It is necessary to have an easy-to-administer psychological distress screening tool. The distress thermometer (DT) is a single-item distress screening scale with 11-likert response widely used in oncological patients. The aim of study was to determine whether the single-item DT compared favourably with IBD clinical indices and time consuming measures currently used to screen for distress. Methods Two hundered and twenty IBD patients (51.43% male) who were recruited in eight Italian hospitals completed the DT and identified the presence or absence of 34 problems using standardised problem list (PL). They completed the 14-item Hospital Anxiety and Depression Scale (HADS) and the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ). Disease clinical indices have been collected for each patient (Mayo score, Harvey–Bradshaw Index–HBI, years of illness, and exacerbation in the last year). Using receiver operating characteristic (ROC) analyses validated the use of the DT in Italian IBD population. Results 47.6% reported anxiety and depression symptoms (HADS ≥15) and needs emotional care. Anxiety is much more associated (43.8%) than depressive problems (26.2%). Data are confirmed by responses to DT and PL: 44.5% of patients reported moderate–severe emotional distress (TD ≥ 5), 43.1% of patients report nervousness and worry, 27.1% reported depression. We observed a strong positive correlation between IBDQ and HADS (r = 0.74, p < 0.001) and DT (r = 0.58, p < 0.001), while there was a slightly smaller association with Mayo score (r = 0.46, p < 0.001) and HBI (r = 0.39, p < 0.001). There was not a statistical significant correlation between disease indices and the emotional distress as measured by HADS or DT. ROC analyses showed that a DT cutoff score of 5 or higher had optimal sensitivity (83%) and specificity (68%) relative to the HADS score as ‘gold’ standard. DT scores yielded area under the curve estimates relative to the HADS cutoff score indicative of good overall accuracy (AUC = 0.81–95% CI: 0.77–0.85). Conclusion Our study confirms that anxiety and depression symptoms are associated with IBD. This is the first study that demonstrated that DT is an easy-to-administer screening tool of psychosocial distress in IBD population. We propose that gastroenterologists use DT to identify patients with psychological distress: an early psychological support and a multidisclinar equipe can determinate a patient’s better disease course (Mawdsley et al. 2005). Our analyses indicated that using a DT’s cutoff of 5 to indicate high levels of distress.

scholarly journals Psychometric Evaluation of the Swedish Version of the Prolonged Grief Disorder-13 (PG-13) in a Bereaved Mixed Trauma Sample

2020 ◽  
Vol 11 ◽  
Author(s):  
Josefin Sveen ◽  
Kristina Bondjers ◽  
Julia Heinsoo ◽  
Filip K. Arnberg
Keyword(s):  
Psychological Distress ◽  
Psychometric Properties ◽  
Posttraumatic Stress ◽  
Factor Model ◽  
Traumatic Event ◽  
Latent Structure ◽  
Prolonged Grief ◽  
General Psychological Distress ◽  
Disability Level ◽  
Three Factor

Background: This study aimed to examine the psychometric properties of the Swedish PG-13 in a bereaved trauma exposed sample. A second aim was to examine the latent structure of prolonged grief using the PG-13.Methods: The participants were adults (n = 123) taking part in an ongoing longitudinal study regarding the effects of potentially traumatic events. Participants had experienced a potentially traumatic event in the past 5 years and had reported a death of a significant other either as their primary traumatic event or in addition to another traumatic event. Assessment included self-report of prolonged grief, posttraumatic stress, and general psychological distress. Clinical interviews were used to assess depression, posttraumatic stress disorder, and disability level. The psychometric properties of the Swedish PG-13 were examined through reliability tests and assessment of associations with symptoms of posttraumatic stress, depression, general psychological distress, and disability level. Principal component analysis (PCA) and confirmatory factor analyses (CFA) were used to assess the latent structure.Results: The internal consistency (Cronbach's α = 0.86) and test-retest (r = 0.86) reliability were good. PCA suggested a three-factor model as descriptive of the latent structure of the instrument. Therefore, the CFA used this model, as well as two models suggested in the literature. The three-factor model had the best fit to data. Support of concurrent validity of PG-13 was shown by moderate positive associations with measures of posttraumatic stress, depression, and general psychological distress.Conclusions: The Swedish PG-13 demonstrated good psychometric properties, and its use in research and practice to assess prolonged grief was supported. The factor analyses provided stronger support for models with two or three factors, as compared with a unidimensional model of prolonged grief, with the three-factor model having the best fit.

scholarly journals Network Analysis of Mindfulness Facets, Affect, Compassion, and Distress

Mindfulness ◽  
2020 ◽  
Author(s):  
Oleg N. Medvedev ◽  
Matti Cervin ◽  
Barbara Barcaccia ◽  
Richard J. Siegert ◽  
Anja Roemer ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Network Analysis ◽  
Negative Affect ◽  
Positive Affect ◽  
Experimental Studies ◽  
Well Being ◽  
Anxiety And Depression ◽  
Acting With Awareness ◽  
Mindfulness Facets ◽  
Internal Experience

Abstract Objectives Mindfulness, positive affect, and compassion may protect against psychological distress but there is lack of understanding about the ways in which these factors are linked to mental health. Network analysis is a statistical method used to investigate complex associations among constructs in a single network and is particularly suitable for this purpose. The aim of this study was to explore how mindfulness facets, affect, and compassion were linked to psychological distress using network analysis. Methods The sample (n = 400) included equal numbers from general and student populations who completed measures of five mindfulness facets, compassion, positive and negative affect, depression, anxiety, and stress. Network analysis was used to explore the direct associations between these variables. Results Compassion was directly related to positive affect, which in turn was strongly and inversely related to depression and positively related to the observing and describing facets of mindfulness. The non-judgment facet of mindfulness was strongly and inversely related to negative affect, anxiety, and depression, while non-reactivity and acting with awareness were inversely associated with stress and anxiety, respectively. Strong associations were found between all distress variables. Conclusions The present network analysis highlights the strong link between compassion and positive affect and suggests that observing and describing the world through the lens of compassion may enhance resilience to depression. Taking a non-judging and non-reacting stance toward internal experience while acting with awareness may protect against psychological distress. Applicability of these findings can be examined in experimental studies aiming to prevent distress and enhance psychological well-being.

Factorial Integrity of the Sport Anxiety Scale: A Methodological Note and Revised Scoring Recommendations

2006 ◽  
Vol 28 (1) ◽  
pp. 109-112 ◽  
Author(s):  
Ronald E. Smith ◽  
Sean P. Cumming ◽  
Frank L. Smoll
Keyword(s):  
Factor Structure ◽  
Scoring System ◽  
Cross Validation ◽  
Anxiety Scale ◽  
Present Evidence ◽  
Somatic Anxiety ◽  
Cognitive Anxiety ◽  
Anxiety Item ◽  
New Scoring ◽  
Three Factor

Results of several recent studies have called into question the factorial integrity of the Sport Anxiety Scale (SAS; Smith, Smoll, & Schutz, 1990) because two items (14 and 20) that loaded on the Concentration Disruption subscale in our validation and cross-validation samples have loaded or cross-loaded on the Worry subscale in other samples. We agree that this is a serious problem, and we evaluate proposed modifications of the SAS on both conceptual and empirical grounds. For researchers currently using the SAS, we recommend a new scoring system that deletes two troublesome Concentration Disruption items and one Somatic Anxiety item, preserving separate and factorially consistent Somatic, Worry, and Concentration Disruption subscales. We present evidence that our original Worry scale provides a better CFA fit than a suggested “cognitive anxiety” alternative that combines the two concentration disruption items with the Worry scale items. We also describe nonreplication of the SAS three-factor structure in child samples and caution researchers against computing subscale scores for child samples.

scholarly journals Identification of Anxiety and Depression Symptoms in Patients With Cancer: Comparison Between Short and Long Web-Based Questionnaires (Preprint)

2018 ◽  
Author(s):  
Susanne Mattsson ◽  
Erik Martin Gustaf Olsson ◽  
Maria Carlsson ◽  
Birgitta Beda Kristina Johansson
Keyword(s):  
Colorectal Cancer ◽  
Psychological Distress ◽  
Intervention Study ◽  
Self Report ◽  
Anxiety And Depression ◽  
The Internet ◽  
Depression Symptoms ◽  
Screening Methods ◽  
Web Based ◽  
Patients With Cancer

BACKGROUND Physicians and nurses in cancer care easily fail to detect symptoms of psychological distress because of barriers such as lack of time, training on screening methods, and knowledge about how to diagnose anxiety and depression. National guidelines in several countries recommend routine screening for emotional distress in patients with cancer, but in many clinics, this is not implemented. By inventing screening methods that are time-efficient, such as digitalized and automatized screenings with short instruments, we can alleviate the burden on patients and staff. OBJECTIVE The aim of this study was to compare Web-based versions of the ultrashort electronic Visual Analogue Scale (eVAS) anxiety and eVAS depression and the short Hospital Anxiety and Depression Scale (HADS) with Web-based versions of the longer Montgomery Åsberg Depression Rating Scale-Self-report (MADRS-S) and the State Trait Anxiety Inventory- State (STAI-S) with regard to their ability to identify symptoms of anxiety and depression in patients with cancer. METHODS Data were obtained from a consecutive sample of patients with newly diagnosed (<6 months) breast, prostate, or colorectal cancer or with recurrence of colorectal cancer (N=558). The patients were recruited at 4 hospitals in Sweden between April 2013 and September 2015, as part of an intervention study administered via the internet. All questionnaires were completed on the Web at the baseline assessment in the intervention study. RESULTS The ultrashort and short Web-based-delivered eVAS anxiety, eVAS depression and HADS were found to have an excellent ability to discriminate between persons with and without clinical levels of symptoms of anxiety and depression compared with recommended cutoffs of the longer instruments MADRS-S and STAI-S (area under the curve: 0.88-0.94). Cutoffs of >6 on HADS anxiety and >7 hundredths (hs) on eVAS anxiety identified patients with anxiety symptoms with high accuracy. For HADS depression, at a cutoff of >5 and eVAS depression at a cutoff of >7 hs, the accuracy was very high likewise. CONCLUSIONS The use of the short and ultrashort tools, eVAS and HADS, may be a suitable initial method of Web-based screening in busy clinical settings. However, there are still a proportion of patients who lack access to the internet or the ability to use it. There is a need to find solutions for this group to find all the patients with psychological distress.

Relationship between caregiver burden and psychological distress among stem cell transplant (SCT) recipients prior to transplant.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12120-12120
Author(s):  
Carlisle Topping ◽  
Ashley Nelson ◽  
Jamie M. Jacobs ◽  
Joseph A. Greer ◽  
Jennifer S. Temel ◽  
...  
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Caregiver Burden ◽  
Self Efficacy ◽  
Leisure Time ◽  
Private Life ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Caregiving Burden ◽  
Clinically Significant

12120 Background: SCT is a potentially curative therapy for patients with hematologic malignancies that involves prolonged hospitalization, intensive follow-up, and a considerable risk of morbidity and mortality. Family and friends caring for SCT recipients experience substantial caregiving burden as they prepare for SCT. Previous research demonstrates caregiver distress is highest pre-transplant and is comparable to or higher than patient-reported distress. However, the extent of this distress and its relationship to certain domains of quality of life (QOL) and caregiving burden is currently unknown. Methods: We conducted a secondary analysis of cross-sectional data from two supportive care studies focused on caregivers of SCT recipients. Caregivers completed the Hospital Anxiety and Depression Scale (HADS) and the CareGiver Oncology QOL questionnaire to assess their psychological distress and QOL prior to SCT. Scores >8 on the HADS anxiety and depression subscales indicated clinically significant symptoms. We selected eight domains from the CareGiver Oncology QOL questionnaire including social support, physical wellbeing, self-efficacy, coping, leisure time, financial stability, private life concerns, and caregiving burden. Multivariate regression models adjusted for age, sex, caregiver relationship, and SCT type were used to examine associations between these domains and caregivers’ anxiety and depression symptoms. Results: A total of 193 caregivers (age M= 57 years, 70% female, 52% allogeneic transplant) were enrolled with a majority caring for their spouse (80%), parent (8%) or child (5%). Overall 47% and 16% of caregivers reported clinically significant anxiety and depression symptoms, respectively. Low social support, physical well-being, coping and leisure time as well as high caregiver burden, private life concerns and financial distress were associated with both caregiver anxiety and depression symptoms (p < .05). Low self-efficacy was associated with higher anxiety symptoms (p < .05). Conclusions: Caregivers of SCT recipients experience substantial anxiety and depression symptoms prior to SCT. Impairments across multiple QOL domains are associated with caregiver’s psychological distress. Psychosocial interventions designed to improve coping, reduce caregiving burden, and enhance QOL are needed for caregivers prior to transplant.

Structural Validity of the Hospital Anxiety and Depression Scale Among Family Members of Critically Ill Patients

2021 ◽  
Vol 30 (3) ◽  
pp. 212-220
Author(s):  
Grant A. Pignatiello ◽  
Aloen L. Townsend ◽  
Ronald L. Hickman
Keyword(s):  
Psychological Distress ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Depression Scale ◽  
Decision Makers ◽  
Anxiety And Depression ◽  
Confirmatory Factor ◽  
General Psychological Distress ◽  
Surrogate Decision Makers ◽  
Surrogate Decision

Background The Hospital Anxiety and Depression Scale (HADS) is commonly used clinically and scientifically among surrogate decision makers for critically ill patients. The validity of the HADS has been scrutinized, but its use among surrogate decision makers has not been examined. Objective To examine the structural validity of the HADS. Methods This study was a secondary analysis of data obtained from a 3-arm randomized controlled trial of a decision support intervention. Participants were recruited from 6 intensive care units at a tertiary medical center in Northeast Ohio. Participants were adult surrogate decision makers for critically ill, cognitively impaired adults who were not expected to be discharged from the intensive care unit within the subsequent 48 hours. The fit of 2-factor, 3-factor, and bifactor structures of the HADS was tested with confirmatory factor analysis. Results The bifactor structure, possessing a general psychological distress factor and anxiety and depression group factors, showed a superior fit and met a priori thresholds for acceptable model fit. The general psychological distress factor accounted for more than 75% of the common variance in the HADS items. Conclusion Confirmatory factor analysis provided evidence supporting a bifactor structure of the HADS. In this sample, the instrument validly measures psychological distress rather than distinct symptoms of anxiety and depression. Replication of these results is encouraged, and use of alternative measures is recommended when measuring distinct symptoms of anxiety and depression among surrogate decision makers for critically ill patients.

scholarly journals Distress and Type 2 Diabetes Self-Care: Putting the Pieces Together

2020 ◽  
Author(s):  
Claire J Hoogendoorn ◽  
Clyde B Schechter ◽  
Maria M Llabre ◽  
Elizabeth A Walker ◽  
Jeffrey S Gonzalez
Keyword(s):  
Psychological Distress ◽  
Medication Adherence ◽  
Latent Variable ◽  
Self Care ◽  
Well Being ◽  
Diabetes Distress ◽  
Equation Modeling ◽  
Depression Symptoms ◽  
General Psychological Distress ◽  
Shared Variance

Abstract Background Conflicting research emphasizes depression, diabetes distress, or well-being in relation to diabetes self-care and risk for poor health outcomes. Purpose The purpose of this study was to test whether a latent variable for general psychological distress derived from shared variance of depression symptoms, diabetes distress, and well-being predicts a latent variable of diabetes self-care and to examine evidence for unique effects once shared effects are adjusted for. Methods Adults with suboptimally controlled diabetes were recruited from the South Bronx, NY, for a telephonic diabetes self-management support trial. Baseline diabetes self-care, medication adherence, depression symptoms, diabetes distress, and well-being were measured by validated self-report. Structural equation modeling specified a latent variable for general psychological distress derived from shared variance of depression symptoms, diabetes distress, and well-being. Diabetes self-care was a latent variable indicated by diet, glucose self-monitoring, and medication adherence. Results Participants (N = 627, 65% female) were predominantly ethnic minority (70% Hispanic; 45% Black) and 77% reported household income &lt;$20K/year. Mean (standard deviation) age = 56 (12) years; A1c = 9.1% (1.9%); body mass index = 32 (8) kg/m2. The latent variable for psychological distress was a robust predictor of poorer diabetes self-care (coefficient = −0.59 [confidence interval = −0.71, −0.46], p &lt; .001) with good model fit. Unique paths from depression symptoms, diabetes distress, and well-being (all ps &gt; .99) to self-care were not observed. Conclusions In this population of disadvantaged adults with suboptimally controlled diabetes, general psychological distress was strongly associated with poorer diabetes self-care and fully accounted for the effects of depression, diabetes distress, and positive well-being. This suggests that general distress may underlie previously reported associations between these constructs and diabetes self-care.

scholarly journals Association Between Psychological Distress, Cognitive Complaints, and Neuropsychological Status After a Severe COVID-19 Episode: A Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Clément Gouraud ◽  
Hugo Bottemanne ◽  
Khadija Lahlou-Laforêt ◽  
Anne Blanchard ◽  
Sven Günther ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Depression Scale ◽  
Interquartile Range ◽  
University Hospital ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Digit Symbol Substitution Test ◽  
Cognitive Complaints ◽  
Neuropsychological Status ◽  
Multivariable Analyses

Background: Cognitive complaints are frequent after COVID-19 but their clinical determinants are poorly understood. This study aimed to explore the associations of objective cognitive performances and psychological distress with cognitive complaints in COVID-19 survivors.Materials and Methods: Patients previously hospitalized for COVID-19 in a university hospital during the first wave of COVID-19 pandemic in France were followed-up at 1 month after their admission. Cognitive complaints were self-reported and standardized instruments were used to assess neuropsychological status (Digit Symbol Substitution Test, Semantic Verbal Fluency Test, Mini Mental Status Examination) and psychological distress (Hospital Anxiety and Depression Scale, HADS). Multivariable analyses were adjusted for age, sex, admission in intensive care unit (ICU) and need for oxygen and C-reactive protein.Results: One hundred patients (34% women, median age: 60 years [interquartile range: 49–72)] completed the neuropsychological assessment at follow-up. In multivariable analyses, cognitive complaints at 1-month were associated with greater HADS score (OR for one interquartile range: OR: 1.96, 95% CI: 1.08–3.57) and older age (OR: 1.05, 95% CI: 1.01–1.09) and, negatively, with admission in ICU (OR: 0.22, 95% CI: 0.05–0.90). In contrast, none of the objective neuropsychological test scores was significantly associated with cognitive complaints. Exploratory analysis showed that cognitive complaints were associated with both anxiety and depressive symptoms.Discussion: These preliminary results suggest that cognitive complaints at 1 month after a hospitalization for COVID-19 are associated with psychological distress, independently of objective neuropsychological status. Anxiety and depression symptoms should be systematically screened in patients presenting with cognitive complaints after a severe COVID-19 episode.

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