A review of the tripartite model for understanding the link between anxiety and depression in youth

Abstract

Although research from numerous investigations indicates that there is substantial overlap in anxiety and depressive symptoms and comorbid diagnoses in youth, these constructs can be adequately differentiated. Clark and Watson [Clark, L. A. & Watson, D., (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336] proposed a tripartite model to account for the symptom overlap and diagnostic comorbidity between anxiety and depression. This tripartite model posits that anxiety and depression share a common component of negative affect, but can be differentiated by low positive affect associated with depression and high physiological hyperarousal associated with anxiety. The present article reviews initial research which has supported the utility of the tripartite model for explaining the association between anxiety and depression in adult and youth samples. Following that review, more recent investigations which have called into question the applicability of the tripartite constructs for youth are presented. Finally, the paper reviews evidence suggesting that the tripartite factors may not function similarly across all anxiety and depressive disorders. This article concludes by suggesting that more research is necessary with children and adolescents in order to determine the functioning of tripartite constructs across anxiety disorders in youth.

Depression and Social Anxiety in Children: Differential Links with Coping Strategies

“…Thus, recent theoretical and empirical work, as well as the need to recognise more effective treatments, has challenged us to investigate the convergences and divergences between the two disorders (see Anderson and Hope 2008;Zahn-Waxler et al 2000). We propose that studies of children's strategies for coping with stressors-a core aspect of socio-emotional development-can provide valuable insight into key areas of distinction between social anxiety and depression.…”

“…Although recommended treatments for social anxiety and depression commonly have a focus on coping strategies (Lewisohn et al 1994;Spence et al 2002), differentiated coping profiles would suggest that it may be more effective to target each disorder in distinct and specific ways. This would of course be important when only one of the disorders is present, but even where there is high comorbidity (see Chavira et al 2004), targeting the different coping strategies associated with social anxiety and depression may be crucial for successful clinical outcomes.Thus, recent theoretical and empirical work, as well as the need to recognise more effective treatments, has challenged us to investigate the convergences and divergences between the two disorders (see Anderson and Hope 2008;Zahn-Waxler et al 2000). We propose that studies of children's strategies for coping with stressors-a core aspect of socio-emotional development-can provide valuable insight into key areas of distinction between social anxiety and depression.…”

An Evaluation of the Applicability of the Tripartite Constructs to Social Anxiety in Adolescents

“…However, less research has examined the tripartite constructs in children and adolescents with social phobia, and thus further evaluation is warranted (Anderson & Hope, 2008). Adolescence is an ideal developmental time frame in which to examine the tripartite constructs in relation to social phobia, because onset typically occurs during this period.…”

Self-forgiveness in Japanese adolescents.

“…However, the assessment of depression and anxiety is complicated due to common symptoms, especially for children and youths (Anderson & Hope, 2008 Consistent with this, according to Brady and Kendall's (1992) review of studies of children and adolescents, 15.9% to 61.9% of children and youths identified as depressed or anxious had a comorbid depression and anxiety. Clark and Watson (1991) proposed the tripartite model of anxiety and depression to explain this existing overlap between depressive and anxiety symptoms and to differentiate one from another.…”

“…Lonigan, Hooe, David, and Kistner (1999) found that in their regression models, both positive affect and negative affect were significant, unique predictors of CDI and RCMAS scores in adolescents. After reviewing the tripartite literature in children and youths, Anderson and Hope (2008) suggested that the tripartite model was useful in explaining the association between anxiety and depressive symptoms in a community sample of adolescents.…”