Abstract
BackgroundThe overlap between Depression and Anxiety has led some researchers to conclude that they are manifestations of a broad, non-specific neurotic disorder. However, others believe that they can be distinguished despite sharing symptoms of general distress. The Tripartite Model of Affect proposes an anxiety-specific, a depression-specific and a shared symptoms factor. Watson and Clark developed the Mood and Anxiety Symptom Questionnaire (MASQ) to specifically measure these Tripartite constructs. Early research showed that the MASQ distinguished between dimensions of Depression and Anxiety in non-clinical samples. However, two recent studies have cautioned that the MASQ may show limited validity in clinical populations. The present study investigated the clinical utility of the MASQ in a clinical sample of adolescents and young adults.MethodsA total of 204 Young people consecutively referred to a specialist public mental health service in Melbourne, Australia were approached and 150 consented to participate. From this, 136 participants completed both a diagnostic interview and the MASQ.ResultsThe majority of the sample rated for an Axis-I disorder, with Mood and Anxiety disorders most prevalent. The disorder-specific scales of the MASQ significantly discriminated Anxiety (61.0%) and Mood Disorders (72.8%), however, the predictive accuracy for presence of Anxiety Disorders was very low (29.8%). From ROC analyses, a proposed cut-off of 76 was proposed for the depression scale to indicate 'caseness' for Mood Disorders. The resulting sensitivity/specificity was superior to that of the CES-D.ConclusionIt was concluded that the depression-specific scale of the MASQ showed good clinical utility, but that the anxiety-specific scale showed poor discriminant validity.
Highlights
The overlap between Depression and Anxiety has led some researchers to conclude that they are manifestations of a broad, non-specific neurotic disorder
Physiological Hyperarousal (PH) may only be related to Panic Disorder and, to a lesser extent, Generalised Anxiety Disorder
A recent study employed confirmatory factor analysis with depressed and anxious patients and reported that the structure of the tripartite model was not confirmed in this clinical sample [15]
Summary
Characteristics of the sample Two hundred and four people met the study criteria during the recruiting phase. AA:AD was only moderately correlated in the no Anxiety/Mood group (r = 0.35, p = 0.01) When examining those participants without any current diagnoses (N = 27), AA:AD were uncorrelated (r = 0.18, p = 0.36). By visually inspecting the ROC for the largest area under the curve and by manually comparing various true positive and true negative rates, it was determined that an AD cut-off of 76 best reflected caseness (sensitivity = 85%, specificity = 65%). These figures were compared to CES-D (cut-off = 24). Further analyses with AA were not run as this scale demonstrated poor discriminant validity (see above) (Figures 1 and 2)
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