Dimension Of General Distress Research Articles

Neuroticism and the longitudinal trajectories of anxiety and depressive symptoms in older adolescents.

Adolescence is a developmental period characterized by remarkable volatility and comorbidity in internalizing disorders. Delineating internalizing symptom change in a manner that accounts for symptoms' shared versus distinctive features is imperative to an understanding of their development. An additional question concerns how vulnerabilities for internalizing disorders relate to development of internalizing symptoms. Cross-sectional and prospective associations between neuroticism and internalizing psychopathology are well-established, yet conclusive evidence on neuroticism's relation to the progression of symptom dimensions relevant to internalizing disorders remains absent. In this investigation, we used latent growth curve modeling to characterize the trajectories of tri-level model internalizing dimensions (General Distress, Anhedonia-Apprehension, Fears, Anxious Arousal, Fears of Specific Stimuli, Social Fears, Narrow Depression, Interoceptive/Agoraphobic Fears) and examined whether a general neuroticism factor predicted their growth. We used anxiety and depressive symptom data spanning 6 years, collected from 606 high school juniors mostly vulnerable for internalizing disorders. We observed a pattern of results that varied by symptom dimension. Only Anhedonia-Apprehension showed a distinct increasing trend, on average. Neuroticism predicted an adverse symptom course for the dimension of General Distress. Our results reinforce the notion that neuroticism confers substantial risk for internalizing symptom maintenance and extend past findings by demonstrating that neuroticism forecasts a poor symptom course for General Distress but not narrower dimensions of internalizing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Neuroticism and interpretive bias as risk factors for anxiety and depression.

Neuroticism has been associated with depression and anxiety both cross-sectionally and longitudinally. Interpretive bias has been associated with depression and anxiety, primarily in cross-sectional and bias induction studies. The purpose of the current study was to examine the role of interpretive bias as a prospective risk factor and a mediator of the relation between neuroticism and depressive and anxious symptoms in young adults assessed longitudinally. Neuroticism significantly predicted a broad general distress dimension, but not intermediate fears and anhedonia-apprehension dimensions, nor a narrow social fears dimension. Neuroticism also significantly predicted negative interpretive bias for social scenarios. Negative interpretive bias for social scenarios did not significantly predict dimension scores, nor did it mediate the relation between neuroticism and general distress or social fears. These results suggest that although neuroticism relates to negative interpretive bias, its risk for symptoms of depression and anxiety is at most weakly conferred through negative interpretive bias.

Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory.

Depression is commonly seen in survivors of conflict and disaster across the world. There is a dearth of research on the validity of commonly used measures of depression in these populations. Measurements of depression that are used in multiple contexts need to meet measurement equivalence, i.e., the instrument measures the same construct in the same manner across different groups. The Beck Depression Inventory (BDI) was administered to female trauma survivors in the United States (n = 268) and female survivors of war in Sri Lanka (n = 149). Three metrics of measurement equivalence—structural, metric, and scalar—were examined. Two- and three-factor structures of the BDI that have been identified in other populations did not provide a good fit for our data. However, a bifactor model revealed a similar general distress dimension across populations, but dissimilar secondary dimensions or subfactors. The Sri Lankan subfactor comprised of predominantly somatic symptoms and the United States subfactor comprised of cognitive and somatic symptoms. While intercepts of individual BDI items differed, their differences seem to be offsetting. Total BDI scores across these two populations are roughly comparable, although caution is recommended when interpreting them. Making comparisons on subscales is not recommended.

Posttraumatic Stress Disorder Symptom Clusters, Depression, Alcohol Abuse, and General Stress Among Hispanic Male Firefighters

This study examined the association of the four posttraumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, dysphoria, and hyperarousal) included in the Dysphoria factor model to depression, substance abuse, and general stress among 551 male, Hispanic firefighters in a large metropolitan city in the United States. Approximately 11% of the participants demonstrated elevated PTSD compared with a 7% PTSD prevalence rate in the U.S. Hispanic population. Results of bivariate correlations and regression analyses indicated that, as expected, the dysphoria cluster captured a general distress dimension common to other affective disorders, whereas re-experiencing, avoidance, and hyperarousal symptoms demonstrated stronger specificity to depression than to substance abuse or general stress. Findings suggest that treatment approaches to PTSD with Hispanics should include interventions such as behavioral activation, which are designed to address non-specific distress.

Distinguishing between emotional distress and psychiatric disorder in primary care attenders: A cross sectional study of the four-dimensional symptom questionnaire (4DSQ)

BackgroundDetection of psychiatric disorder in primary care is a complex issue. Distinctions between ‘normal’ emotional distress and psychiatric disorder depend on how disorder is conceptualized. Our aim was to explore two different conceptualizations by examining patients' scores on one-dimensional depression measures and scores on the Four Dimensional Symptom Questionnaire (4DSQ), a measure that uniquely has separate dimensions for general distress and depressive disorder. MethodsThis was a cross sectional study of 487 primary care patients attending general clinics in Hampshire, UK. Patients completed the 4DSQ, Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12) and the Hospital Anxiety and Depression Scale (HADS) whilst in the waiting room. ResultsThe 4DSQ classified 26% (126/485) of patients as having heightened distress levels and 8% (38/468) as possible cases of depressive disorder. Casesness was consistently higher across the one-dimensional measures (PHQ-9: 16%, GHQ-12: 28%, HADS-D: 13%). Of those patients deemed possible cases by the PHQ-9 (≥10), the 4DSQ classified 91% (71/78) as having heightened distress and 44% (32/72) as possible cases of depressive disorder. LimitationsThe sample was predominately older and white, which may limit generalizability of the findings to more diverse patient groups. There are limits to self-report measures in the assessment of complex diagnostic issues. ConclusionsInclusion of a distinct general distress dimension alongside a dimension focusing on specific depression symptomatology lowered the number of primary care patients classified as possible cases of disorder. This view of symptoms may have implications for the targeting of existing treatments, and may be useful in guiding the development of novel self-management interventions.

Operating characteristics of depression and anxiety disorder phenotype dimensions and trait neuroticism: A theoretical examination of the fear and distress disorders from the Netherlands study of depression and anxiety

BackgroundThe receiver operating characteristics (ROC) of anhedonic depression and anxious arousal to detect the distress- (major depression, dysthymia, generalized anxiety disorder) and fear-disorder clusters (i.e. panic disorder, agoraphobia, social phobia) have not been reported in a large sample. MethodsA sample of 2981 persons underwent structured psychiatric interview; n=652 were without lifetime depression and anxiety disorder history. Participants also completed a neuroticism scale (Revised NEO Five Factor Inventory [NEO-FFI]), and the 30-item short adaptation of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30) measuring anhedonic depression, anxious arousal and general distress. Maximal sensitivity and specificity was determined by the Youden Index and the area-under-the-curve (AUC) in ROC analysis. ResultsA total of 2624 completed all measures (age M=42.4 years±13.1, 1760 females [67.1%]), including 1060 (40.4%) persons who met criteria for a distress-disorder, and 973 (37.1%) who met criteria for a fear-disorder. The general distress dimension provided the highest ROC values in the detection of the distress-disorders (AUC=.814, sensitivity=71.95%, specificity=76.34%, positive predictive value=67.33, negative predictive value=80.07). None of the measures provided suitable operating characteristics in the detection of the fear-disorders with specificity values <75%. LimitationsOver sampling of depression and anxiety disorders may lead to inflated positive- and negative predictive values. ConclusionsThe MASQ-D30 general distress dimension showed clinically suitable operating characteristics in the detection of distress-disorders. Neither neuroticism nor the MASQ-D30 dimensions provided suitable operating characteristics in the detection of the fear-disorders.

Relations among positive and negative affect, dysphoria and anxiety1

According to Tellegen et al.'s Two-factor model, commonalities between depression and anxiety are due to their shared variance with Negative affect (NA), a broad dimension of general distress. Low Positive affect (PA), a dimension of pleasurable emotions, is believed to be uniquely related to depression. In this study, we tested these basic assumptions. A sample of 141 students at the Faculty of Philosophy in Novi Sad filled out a state measure of PA, NA, and basic emotions (SIAB-PANAS), a depression scale (BDI-II), and a state anxiety scale (STAI-S). Hierarchical regression analyses were conducted to estimate the unique contributions of PA, NA, and basic emotions in the prediction of dysphoria and anxiety. The hypothesis that NA is a general dimension related to both dysphoria and anxiety was supported. Sadness and fear added incrementally to the prediction of both criteria. However, contrary to our hypothesis, PA was related to both dysphoria and anxiety. Joviality, attentiveness, and self-assurance were better predictors of anxiety than dysphoria. Methodological and clinical implications of the results were discussed.

An evaluation of positive affectivity, negative affectivity, and hyperarousal as markers for assessing between syndrome relationships

Clark and Watson (1991) have proposed that anxiety and depression share a relation with a general distress dimension (negative affectivity), but that each syndrome is also defined by its unique relation to a syndrome specific dimension. Depression is characterized by low positive affectivity and anxiety is characterized by hyperarousal. These relations were assessed with self-report symptom data obtained from 162 adult psychiatric outpatients. Factor analysis of symptom, mood, and other clinical measures resulted in two factors corresponding to previous descriptions of negative and positive affectivity; only depression and positive affect/cognition measures had non-trivial loadings on the positive affectivity factor. Positive affectivity made a significant contribution to the prediction of an independent measure of depression, but not anxiety. A second factor analysis which included additional symptom variables resulted in a three-factor solution. The extra factor (factor 1 in this analysis) was highly correlated with the negative affectivity factor; it was primarily defined by variables incorporating somatic symptoms. This factor was not specific to anxiety; although it made a significant contribution to predicting two self-report general anxiety measures, it also predicted self-report symptoms of ‘psychosis’ and ‘paranoia’. The extra factor was also the only factor to make a contribution to the prediction of ‘neurotic’ depression scores; the positive and negative affectivity factors each made a significant contribution to the prediction of ‘endogenous’ depression scores.