General and specific components of depression and anxiety in an adolescent population

Jeannette Brodbeck,Ian M Goodyer,Tim J Croudace,Rosemary A Abbott

doi:10.1186/1471-244x-11-191

Jeannette Brodbeck, Ian M Goodyer + Show 2 more

Open Access

https://doi.org/10.1186/1471-244x-11-191

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Journal: BMC Psychiatry	Publication Date: Dec 1, 2011
Citations: 70	License type: cc-by

Affiliation: University of Cambridge

Abstract

BackgroundDepressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety.MethodsAn exploratory factor analysis (EFA) and a bifactor modelling approach were used to separate a general distress continuum from more specific sub-domains of depression and anxiety in an adolescent community sample (n = 1159, age 14). The Mood and Feelings Questionnaire and the Revised Children's Manifest Anxiety Scale were used.ResultsA three-factor confirmatory factor analysis is reported which identified a) mood and social-cognitive symptoms of depression, b) worrying symptoms, and c) somatic and information-processing symptoms as distinct yet closely related constructs. Subsequent bifactor modelling supported a general distress factor which accounted for the communality of the depression and anxiety items. Specific factors for hopelessness-suicidal thoughts and restlessness-fatigue indicated distinct psychopathological constructs which account for unique information over and above the general distress factor. The general distress factor and the hopelessness-suicidal factor were more severe in females but the restlessness-fatigue factor worse in males. Measurement precision of the general distress factor was higher and spanned a wider range of the population than any of the three first-order factors.ConclusionsThe general distress factor provides the most reliable target for epidemiological analysis but specific factors may help to refine valid phenotype dimensions for aetiological research and assist in prognostic modelling of future psychiatric episodes.

Highlights

Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety
Model fit improved considerably when correlated errors were included for worded items representing identical items/item overlap in the Mood and Feelings Questionnaire (MFQ) and the Revised Children’s Manifest Anxiety Scale (RCMAS) (e.g. “It was hard for me to make up my mind“ and “I had trouble making up my mind” r = .67)
The role of aetiological factors such as genotype, early adversities, or intermediate psychoendocrine phenotypes can be investigated independently for the general and specific factors, which may improve our understanding of putative subtypes within common emotional mental illnesses

Summary

Introduction

Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety. Depressive and anxiety symptoms often co-occur across the life-course resulting in a debate about common and distinct features of depression and anxiety emotional disorders. Both can be viewed as manifestations of a broad dimension of internalizing symptoms distinct from an externalizing dimension consisting of substance abuse, ADHD, oppositional and conduct disorders [1,2,3,4,5]. Various dimensional models have been proposed in order to distinguish common and distinct features of depression and anxiety and to further investigate the components of the broad internalizing factor. While there is good evidence for a general negative affectivity factor as an explanation for the overlap of depressive and anxious symptoms the role of physiological arousal is less clear and has to date been more significantly related to panic than to other anxiety disorders [7,8,9]

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