Distinguishing between anxiety and depression using the Mood and Anxiety Symptoms Questionnaire (MASQ) (original) (raw)
Related papers
Distinguishing between depression and anxiety: A proposal for an extension of the tripartite model
European Psychiatry, 2010
The aim of the current study was to develop scales that assess symptoms of depression and anxiety and can adequately differentiate between depression and anxiety disorders, and also can distinguish within anxiety disorders. As point of departure, we used the tripartite model of Clark and Watson that discerns three dimensions: negative affect, positive affect and physiological hyperarousal. Methods: Analyses were performed on the data of 1449 patients, who completed the Mood and Anxiety Symptoms Questionnaire (MASQ) and the Brief Symptom Inventory (BSI). From this, 1434 patients were assessed with a standardized diagnostic interview. Results: A model with five dimensions was found: depressed mood, lack of positive affect, somatic arousal, phobic fear and hostility. The scales appear capable to differentiate between patients with a mood and with an anxiety disorder. Within the anxiety disorders, somatic arousal was specific for patients with panic disorder. Phobic fear was associated with panic disorder, simple phobia and social anxiety disorder, but not with generalized anxiety disorder. Conclusions: We present a five-factor model as an extension of the tripartite model. Through the addition of phobic fear, anxiety is better represented than in the tripartite model. The new scales are capable to accurately differentiate between depression and anxiety disorders, as well as between several anxiety disorders. #
Journal of Abnormal …, 1995
- proposed a tripartite model that groups symptoms of depression and anxiety into 3 subtypes: symptoms of general distress that are largely nonspecific, manifestations of somatic tension and arousal that are relatively unique to anxiety, and symptoms of anhedonia and low Positive Affect that are specific to depression. This model was tested in 5 samples (3 student, 1 adult, and 1 patient sample) using the Mood and Anxiety Symptom Questionnaire (MASQ; D. Watson & L. A. Clark, 1991), which was designed to assess the hypothesized symptom groups, together with other symptom and cognition measures. Consistent with the tripartite model, the MASQ Anxious Arousal and Anhedonic Depression scales both differentiated anxiety and depression well and also showed excellent convergent validity. Thus, differentiation of these constructs can be improved by focusing on symptoms that are relatively unique to each.
The tripartite model of anxiety and depression: A new look at theory and measurement
The relationship between anxiety and depression remains unclear, despite ongoing revision of diagnostic concepts over the last sixty years. Various proposals have been suggested which attempt to explain this relationship. Some have suggested that anxiety and depression are distinct disorders, with different etiologies, symptoms, natural courses, and response to treatment (the pluralist position). Others have suggested that anxiety and depression are a single disorder, or at least different manifestations of the same underlying pathology (the unitary position). Clark & Watson (1991) proposed an alternative model in which anxiety and depression symptoms are divided into three clusters-a specific set of symptoms for each, as well as a shared set of non-specific symptoms seen in both disorders. They suggested that such a tripartite model of anxiety and depression symptoms provided the best description of the manifestation of anxiety and depression symptoms. Clark & Watson (1991) further suggested that by focusing on the specific symptoms of anxiety and depression, the discriminant validity of psychometric assessments of the two could be improved. The current research reviews the literature in support of unitary, pluralist and tripartite models of anxiety and depression symptoms, and concludes that a tripartite model is the most consistently supported by the literature, including studies of symptoms, course, treatment, etiology, family patterns and genetics in both. It examines in detail the research into the tripartite structure of anxiety and depression symptoms, and concludes that previous research also supports a three-factor structure of anxiety and depression symptoms in existing self-report measures. The Mood and Anxiety Symptom Questionnaire (MASQ) is reviewed as the only existing clinical symptom measure based on the tripartite model. Although previous authors have reported broad support for the MASQ, the present research uniquely used a sample of anxious and depressed patients and confirmatory factor analytic methods, and failed to support the MASQ as a valid tripartite measure. Specifically, there was no support at the item or subscale level for any of the two-factor or three-factor models tested. Furthermore, the MASQ subscales did not show the expected differences when compared between anxious and depression patients, and the instrument was found to be inadequate in discriminating between those diagnosed with anxiety versus those diagnosed with depression. In response to the psychometric inadequacy of the MASQ, the Tripartite Clinical Symptom Inventory (TCSI) was proposed as a measure based on the tripartite model which would be clinically useful, as well as showing strong reliability and validity. It was also proposed that the TCSI would further validate several aspects of the tripartite theory of anxiety and depression symptoms. The original 45-item set was reduced over a series of exploratory factor analyses, designed to yield a core subset of symptoms that were reliably and stably associated with
Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications
Journal of Abnormal Psychology, 1991
We review psychometric and other evidence relevant to mixed anxiety-depression. Properties of anxiety and depression measures, including the convergent and discriminant validity of self-and clinical ratings, and interrater reliability, are examined in patient and normal samples. Results suggest that anxiety and depression can be reliably and validly assessed; moreover, although these disorders share a substantial component of general affective distress, they can be differentiated on the basis of factors specific to each syndrome. We also review evidence for these specific factors, examining the influence of context and scale content on ratings, factor analytic studies, and the role of low positive affect in depression. With these data, we argue for a tripartite structure consisting of general distress, physiological hyperarousal (specific anxiety), and anhedonia (specific depression), and we propose a diagnosis of mixed anxiety-depression.
The authors conducted three studies to construct and examine the psychometric properties of a 27-item version of the Mood and Anxiety Symptom Questionnaire-90 (MASQ-90; Watson & Clark, 1991a). The Anxiety Depression Distress Inventory-27 (ADDI-27) contains three empirically derived scales: Positive Affect, Somatic Anxiety, and General Distress, which are relevant dimensions of the tripartite model of affect. Each scale is composed of nine items, and the estimate of scale reliability for each scale score was Z.80 across the three studies. Results of exploratory and confirmatory factor analyses provided adequate support for a 3-factor model. Additional estimates of concurrent validity documented the ADDI-27 scales' convergent and discriminant validity. We also identified three construct relevant correlates for each scale score. Overall, the ADDI-27 appears to be a content valid, reliable, and multidimensional measure of the tripartite model of affect. Concerns regarding the nature and structure of depression and anxiety have received extensive attention in the extant literature (Watson proposed the tripartite model of affect to address some of the concerns regarding the high overlap between anxiety and depression in self-report and clinical data. In particular, the domains of the tripartite model are characterized by symptoms of internalizing disorders: positive affect, negative affect, and anxious-arousal (i.e., physiological hyperarousal). Clinically, low positive affect responses (i.e., the absence of positive affect symptoms such as felt happy, felt optimistic, and felt good) are indicative of depression, and high-level anxious arousal responses (e.g., felt dizzy, hands were shaky, and trouble swallowing) are indicative of anxiety. High-level negative affect responses (e.g., worry, fear, and irritability) account for most of the shared (nonspecific) or overlapping symptoms of anxiety and depression. In terms of measurement, self-report instruments composed of positive affect and anxious arousal components are expected to have low to moderate negative correlations (i.e., rs typically range from À.35 to À.50; Cohen, 1988) among the derived scale scores (Keogh & Reidy, 2000). Furthermore, scores on self-report instruments composed of predominantly negative affect components are expected to be associated substantially (rs 5 .45 to .75) with scores on instruments designed to assess a range of mixed depression and anxiety responses, as
Psychiatry Research, 2010
The original Mood and Anxiety Symptoms Questionnaire (MASQ) is a 90-item self-report, designed to measure the dimensions of Clark and Watson's tripartite model. We developed and validated a 30-item short adaptation of the MASQ: the MASQ-D30, which is more suitable for large-scale psychopathology research and has a clearer factor structure. The MASQ-D30 was developed through a process of item reduction and grouping of the appropriate subscales in a sample of 489 psychiatric outpatients, using a validated Dutch translation, based on the original English MASQ, as a starting point. Validation was done in two other large samples of 1461 and 2471 subjects, respectively, with an anxiety, somatoform and/or depression diagnosis or no psychiatric diagnosis. Psychometric properties were investigated and compared between the MASQ-D30 and the full (adapted) MASQ. A three-dimensional model (negative affect, positive affect and somatic arousal) was found to represent the data well, indicating good construct validity. The scales of the MASQ-D30 showed good internal consistency (all alphas N 0.87) in patient samples. Correlations of the subscales with other instruments indicated acceptable convergent validity. Psychometric properties were similar for the MASQ-D30 and the full questionnaire. In conclusion, the MASQ-D30 is a valid instrument to assess dimensional aspects of depression and anxiety and can easily be implemented in psychopathology studies.
Differentiating anxiety and depression: the State-Trait Anxiety-Depression Inventory
Cognition & Emotion, 2016
The differentiation of trait anxiety and depression in nonclinical and clinical populations is addressed. Following the tripartite model, it is assumed that anxiety and depression share a large portion of negative affectivity (NA), but differ with respect to bodily hyperarousal (specific to anxiety) and anhedonia (lack of positive affect; specific to depression). In contrast to the tripartite model, NA is subdivided into worry (characteristic for anxiety) and dysthymia (characteristic for depression), which leads to a four-variable model of anxiety and depression encompassing emotionality, worry, dysthymia, and anhedonia. Item-level confirmatory factor analyses and latent class cluster analysis based on a large nationwide representative German sample (N = 3150) substantiate the construct validity of the model. Further evidence concerning convergent and discriminant validity with respect to related constructs is obtained in two smaller nonclinical and clinical samples. Factors influencing the association between components of anxiety and depression are discussed.
Frontiers in Psychology
The present paper is addressed to (1) the validation of a recently proposed typology of anxiety and depression, and (2) the presentation of a new tool-the Anxiety and Depression Questionnaire (ADQ)-based on this typology. Empirical data collected across two stages-construction and validation-allowed us to offer the final form of the ADQ, designed to measure arousal anxiety, apprehension anxiety, valence depression, anhedonic depression, and mixed types of anxiety and depression. The results support the proposed typology of anxiety and depression and provide evidence that the ADQ is a reliable and valid self-rating measure of affective types, and accordingly its use in scientific research is recommended.