Abstract
The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
Original language | English (US) |
---|---|
Pages (from-to) | 207-215 |
Number of pages | 9 |
Journal | Journal of Psychiatric Research |
Volume | 102 |
DOIs | |
State | Published - Jul 2018 |
Keywords
- Anxiety
- Depression
- Factor analysis
- Flanker Task
ASJC Scopus subject areas
- Psychiatry and Mental health
- Biological Psychiatry
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Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression : Results from the EMBARC study. / Trombello, Joseph M.; Pizzagalli, Diego A.; Weissman, Myrna M.; Grannemann, Bruce D.; Cooper, Crystal M.; Greer, Tracy L.; Malchow, Ashley L.; Jha, Manish K.; Carmody, Thomas J.; Kurian, Benji T.; Webb, Christian A.; Dillon, Daniel G.; McGrath, Patrick J.; Bruder, Gerard; Fava, Maurizio; Parsey, Ramin V.; McInnis, Melvin G.; Adams, Phil; Trivedi, Madhukar H.
In: Journal of Psychiatric Research, Vol. 102, 07.2018, p. 207-215.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression
T2 - Results from the EMBARC study
AU - Trombello, Joseph M.
AU - Pizzagalli, Diego A.
AU - Weissman, Myrna M.
AU - Grannemann, Bruce D.
AU - Cooper, Crystal M.
AU - Greer, Tracy L.
AU - Malchow, Ashley L.
AU - Jha, Manish K.
AU - Carmody, Thomas J.
AU - Kurian, Benji T.
AU - Webb, Christian A.
AU - Dillon, Daniel G.
AU - McGrath, Patrick J.
AU - Bruder, Gerard
AU - Fava, Maurizio
AU - Parsey, Ramin V.
AU - McInnis, Melvin G.
AU - Adams, Phil
AU - Trivedi, Madhukar H.
N1 - Funding Information: The EMBARC study was supported by the National Institute of Mental Health of the National Institutes of Health under award numbers U01MH092221 (Trivedi, M.H.) and U01MH092250 (McGrath, P.J., Parsey, R.V., Weissman, M.M.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Valeant Pharmaceuticals donated the Wellbutrin XL used in the study. This work was supported by the EMBARC National Coordinating Center at UT Southwestern Medical Center, Madhukar H. Trivedi, M.D., Coordinating PI, and the Data Center at Columbia and Stony Brook Universities. Funding Information: Bruce Grannemann, Dr. Crystal Cooper, Ashley Malchow, Dr. Manish Jha, Dr. Thomas Carmody, Dr. Christian Webb, Dr. Gerard Bruder, Dr. Ramin Parsey, Dr. Melvin McInnis and Dr. Phil Adams do not report any personal, financial or professional relationships or conflicting interests. Dr. Trombello currently owns stock in Merck and Gilead Sciences and within the past 36 months previously owned stock in Johnson & Johnson. Over the past 3 years, Dr. Diego Pizzagalli has received consulting fees from Akili Interactive Labs, BlackThorn Therapeutics, Pfizer and Posit Science, for activities unrelated to the current research. Dr. Benji Kurian has received research grant support from the following organizations: Targacept, Inc., Pfizer, Inc., Johnson & Johnson, Evotec, Rexahn, Naurex, Forest Pharmaceuticals and the National Institute of Mental Health (NIMH). Dr. Daniel Dillon has been an advisor/consultant for Pfizer Inc., on activities unrelated to the current project. Dr. Pat McGrath has received funding from the National Institute of Mental Health, New York State Department of Mental Hygiene, Research Foundation for Mental Hygiene (New York State), Forest Research Laboratories, Sunovion Pharmaceuticals, and Naurex Pharmaceuticals (now Allergan). Dr. Maurizio Fava has received research support from Abbott Laboratories; Acadia Pharmaceuticals; Alkermes, Inc.; American Cyanamid; Aspect Medical Systems; AstraZeneca; Avanir Pharmaceuticals; AXSOME Therapeutics; BioResearch; BrainCells Inc.; Bristol-Myers Squibb; CeNeRx BioPharma; Cephalon; Cerecor; Clintara, LLC; Covance; Covidien; Eli Lilly and Company; EnVivo Pharmaceuticals, Inc.; Euthymics Bioscience, Inc.; Forest Pharmaceuticals, Inc.; FORUM Pharmaceuticals; Ganeden Biotech, Inc.; GlaxoSmithKline; Harvard Clinical Research Institute; Hoffman-LaRoche; Icon Clinical Research; i3 Innovus/Ingenix; Janssen R&D, LLC; Jed Foundation; Johnson & Johnson Pharmaceutical Research & Development; Lichtwer Pharma GmbH; Lorex Pharmaceuticals; Lundbeck Inc.; MedAvante; Methylation Sciences Inc; National Alliance for Research on Schizophrenia & Depression (NARSAD); National Center for Complementary and Alternative Medicine (NCCAM);National Coordinating Center for Integrated Medicine (NiiCM); National Institute of Drug Abuse (NIDA); National Institute of Mental Health (NIMH); Neuralstem, Inc.; NeuroRx; Novartis AG; Organon Pharmaceuticals; PamLab, LLC.; Pfizer Inc.; Pharmacia-Upjohn; Pharmaceutical Research Associates., Inc.; Pharmavite® LLC; PharmoRx Therapeutics; Photothera; Reckitt Benckiser; Roche Pharmaceuticals; RCT Logic, LLC (formerly Clinical Trials Solutions, LLC); Sanofi-Aventis US LLC; Shire; Solvay Pharmaceuticals, Inc.; Stanley Medical Research Institute (SMRI); Synthelabo; Takeda Pharmaceuticals; Tal Medical; VistaGen); Wyeth-Ayerst Laboratories; he has served as advisor or consultant to Abbott Laboratories; Acadia; Affectis Pharmaceuticals AG; Alkermes, Inc.; Amarin Pharma Inc.; Aspect Medical Systems; AstraZeneca; Auspex Pharmaceuticals; Avanir Pharmaceuticals; AXSOME Therapeutics; Bayer AG; Best Practice Project Management, Inc.; Biogen; BioMarin Pharmaceuticals, Inc.; Biovail Corporation; BrainCells Inc; Bristol-Myers Squibb; CeNeRx BioPharma; Cephalon, Inc.; Cerecor; CNS Response, Inc.; Compellis Pharmaceuticals; Cypress Pharmaceutical, Inc.; DiagnoSearch Life Sciences (P) Ltd.; Dinippon Sumitomo Pharma Co. Inc.; Dov Pharmaceuticals, Inc.; Edgemont Pharmaceuticals, Inc.; Eisai Inc.; Eli Lilly and Company; EnVivo Pharmaceuticals, Inc.; ePharmaSolutions; EPIX Pharmaceuticals, Inc.; Euthymics Bioscience, Inc.; Fabre-Kramer Pharmaceuticals, Inc.; Forest Pharmaceuticals, Inc.; Forum Pharmaceuticals; GenOmind, LLC; GlaxoSmithKline; Grunenthal GmbH; Indivior; i3 Innovus/Ingenis; Intracellular; Janssen Pharmaceutica; Jazz Pharmaceuticals, Inc.; Johnson & Johnson Pharmaceutical Research & Development, LLC; Knoll Pharmaceuticals Corp.; Labopharm Inc.; Lorex Pharmaceuticals; Lundbeck Inc.; MedAvante, Inc.; Merck & Co., Inc.; MSI Methylation Sciences, Inc.; Naurex, Inc.; Nestle Health Sciences; Neuralstem, Inc.; Neuronetics, Inc.; NextWave Pharmaceuticals; Novartis AG;Nutrition 21; Orexigen Therapeutics, Inc.; Organon Pharmaceuticals; Osmotica; Otsuka Pharmaceuticals; Pamlab, LLC.; Pfizer Inc.; PharmaStar; Pharmavite® LLC.; PharmoRx Therapeutics; Precision Human Biolaboratory; Prexa Pharmaceuticals, Inc.; PPD; Puretech Ventures; PsychoGenics; Psylin Neurosciences, Inc.; RCT Logic, LLC (formerly Clinical Trials Solutions, LLC); Rexahn Pharmaceuticals, Inc.; Ridge Diagnostics, Inc.; Roche; Sanofi-Aventis US LLC.; Sepracor Inc.; Servier Laboratories; Schering-Plough Corporation; Shenox Pharmaceuticals; Solvay Pharmaceuticals, Inc.; Somaxon Pharmaceuticals, Inc.; Somerset Pharmaceuticals, Inc.; Sunovion Pharmaceuticals; Supernus Pharmaceuticals, Inc.; Synthelabo; Taisho Pharmaceutical; Takeda Pharmaceutical Company Limited; Tal Medical, Inc.; Tetragenex Pharmaceuticals, Inc.; TransForm Pharmaceuticals, Inc.; Transcept Pharmaceuticals, Inc.; Vanda Pharmaceuticals, Inc.; VistaGen; he has received speaking or publishing fees from Adamed, Co; Advanced Meeting Partners; American Psychiatric Association; American Society of Clinical Psychopharmacology; AstraZeneca; Belvoir Media Group; Boehringer Ingelheim GmbH; Bristol-Myers Squibb; Cephalon, Inc.; CME Institute/Physicians Postgraduate Press, Inc.; Eli Lilly and Company; Forest Pharmaceuticals, Inc.; GlaxoSmithKline; Imedex, LLC; MGH Psychiatry Academy/Primedia; MGH Psychiatry Academy/Reed Elsevier; Novartis AG; Organon Pharmaceuticals; Pfizer Inc.; PharmaStar; United BioSource,Corp.; Wyeth-Ayerst Laboratories; he has equity holdings in Compellis and PsyBrain, Inc.; he has a patent for Sequential Parallel Comparison Design (SPCD), which are licensed by MGH to Pharmaceutical Product Development, LLC (PPD); and patent application for a combination of Ketamine plus Scopolamine in Major Depressive Disorder (MDD), licensed by MGH to Biohaven; and he receives copyright royalties for the MGH Cognitive & Physical Functioning Questionnaire (CPFQ), Sexual Functioning Inventory (SFI), Antidepressant Treatment Response Questionnaire (ATRQ), Discontinuation-Emergent Signs & Symptoms (DESS), Symptoms of Depression Questionnaire (SDQ), and SAFER; Lippincott, Williams & Wilkins; Wolkers Kluwer; World Scientific Publishing Co. Pte.Ltd. In the past three years, Dr. Myrna Weissman received funding from the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), the National Alliance for Research on Schizophrenia and Depression (NARSAD), the Sackler Foundation, the Templeton Foundation; and receives royalties from the Oxford University Press, Perseus Press, the American Psychiatric Association Press, and MultiHealth Systems. Dr. Madhukar H. Trivedi is or has been an advisor/consultant and received fee from (lifetime disclosure): Abbott Laboratories Inc., Akzo (Organon Pharmaceuticals Inc.), Allergan Sales LLC, Alkermes, Arcadia Pharmaceuticals Inc., AstraZeneca, Axon Advisors, Brintellix, Bristol-Myers Squibb Company, Cephalon Inc., Cerecor, Eli Lilly & Company, Evotec, Fabre Kramer Pharmaceuticals Inc., Forest Pharmaceuticals, GlaxoSmithKline, Global Medical Education Inc., Health Research Associates, Johnson & Johnson, Lundbeck, MedAvante Medscape, Medtronic, Merck, Mitsubishi Tanabe Pharma Development America Inc., MSI Methylation Sciences Inc., Nestle Health Science-PamLab Inc., Naurex, Neuronetics, One Carbon Therapeutics Ltd., Otsuka Pharmaceuticals, Pamlab, Parke-Davis Pharmaceuticals Inc., Pfizer Inc., PgxHealth, Phoenix Marketing Solutions, Rexahn Pharmaceuticals, Ridge Diagnostics, Roche Products Ltd., Sepracor, SHIRE Development, Sierra, SK Life and Science, Sunovion, Takeda, Tal Medical/Puretech Venture, Targacept, Transcept, VantagePoint, Vivus, and Wyeth-Ayerst Laboratories. In addition, he has received grants/research support from: Agency for Healthcare Research and Quality, Cyberonics Inc., National Alliance for Research in Schizophrenia and Depression, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases, Johnson & Johnson; and he receives royalties from Janssen Research and Development LLC. All authors have approved this manuscript. Funding Information: Bruce Grannemann, Dr. Crystal Cooper, Ashley Malchow, Dr. Manish Jha, Dr. Thomas Carmody, Dr. Christian Webb, Dr. Gerard Bruder, Dr. Ramin Parsey, Dr. Melvin McInnis and Dr. Phil Adams do not report any personal, financial or professional relationships or conflicting interests. Dr. Trombello currently owns stock in Merck and Gilead Sciences and within the past 36 months previously owned stock in Johnson & Johnson. Over the past 3 years, Dr. Diego Pizzagalli has received consulting fees from Akili Interactive Labs, BlackThorn Therapeutics, Pfizer and Posit Science, for activities unrelated to the current research. Dr. Benji Kurian has received research grant support from the following organizations: Targacept, Inc ., Pfizer, Inc ., Johnson & Johnson , Evotec , Rexahn , Naurex , Forest Pharmaceuticals and the National Institute of Mental Health (NIMH) . Dr. Daniel Dillon has been an advisor/consultant for Pfizer Inc., on activities unrelated to the current project. Dr. Pat McGrath has received funding from the National Institute of Mental Health , New York State Department of Mental Hygiene , Research Foundation for Mental Hygiene (New York State) , Forest Research Laboratories , Sunovion Pharmaceuticals, and Naurex Pharmaceuticals (now Allergan). Dr. Maurizio Fava has received research support from Abbott Laboratories ; Acadia Pharmaceuticals ; Alkermes, Inc .; American Cyanamid ; Aspect Medical Systems ; AstraZeneca ; Avanir Pharmaceuticals ; AXSOME Therapeutics ; BioResearch ; BrainCells Inc .; Bristol-Myers Squibb ; CeNeRx BioPharma ; Cephalon ; Cerecor ; Clintara, LLC ; Covance ; Covidien ; Eli Lilly and Company ; EnVivo Pharmaceuticals, Inc .; Euthymics Bioscience, Inc .; Forest Pharmaceuticals, Inc .; FORUM Pharmaceuticals ; Ganeden Biotech, Inc .; GlaxoSmithKline ; Harvard Clinical Research Institute ; Hoffman-LaRoche ; Icon Clinical Research ; i3 Innovus/Ingenix ; Janssen R&D, LLC ; Jed Foundation ; Johnson & Johnson Pharmaceutical Research & Development ; Lichtwer Pharma GmbH ; Lorex Pharmaceuticals ; Lundbeck Inc .; MedAvante ; Methylation Sciences Inc ; National Alliance for Research on Schizophrenia & Depression (NARSAD) ; National Center for Complementary and Alternative Medicine (NCCAM) ; National Coordinating Center for Integrated Medicine (NiiCM) ; National Institute of Drug Abuse (NIDA) ; National Institute of Mental Health (NIMH) ; Neuralstem, Inc .; NeuroRx ; Novartis AG ; Organon Pharmaceuticals ; PamLab, LLC .; Pfizer Inc .; Pharmacia-Upjohn ; Pharmaceutical Research Associates., Inc .; Pharmavite ® LLC ; PharmoRx Therapeutics ; Photothera ; Reckitt Benckiser ; Roche Pharmaceuticals ; RCT Logic, LLC (formerly Clinical Trials Solutions, LLC); Sanofi-Aventis US LLC ; Shire ; Solvay Pharmaceuticals, Inc .; Stanley Medical Research Institute (SMRI) ; Synthelabo ; Takeda Pharmaceuticals ; Tal Medical ; VistaGen); Wyeth-Ayerst Laboratories ; he has served as advisor or consultant to Abbott Laboratories; Acadia; Affectis Pharmaceuticals AG; Alkermes, Inc.; Amarin Pharma Inc.; Aspect Medical Systems; AstraZeneca; Auspex Pharmaceuticals; Avanir Pharmaceuticals; AXSOME Therapeutics; Bayer AG; Best Practice Project Management, Inc.; Biogen; BioMarin Pharmaceuticals, Inc.; Biovail Corporation; BrainCells Inc; Bristol-Myers Squibb; CeNeRx BioPharma; Cephalon, Inc.; Cerecor; CNS Response, Inc.; Compellis Pharmaceuticals; Cypress Pharmaceutical, Inc.; DiagnoSearch Life Sciences (P) Ltd.; Dinippon Sumitomo Pharma Co. Inc.; Dov Pharmaceuticals, Inc.; Edgemont Pharmaceuticals, Inc.; Eisai Inc.; Eli Lilly and Company; EnVivo Pharmaceuticals, Inc.; ePharmaSolutions; EPIX Pharmaceuticals, Inc.; Euthymics Bioscience, Inc.; Fabre-Kramer Pharmaceuticals, Inc.; Forest Pharmaceuticals, Inc.; Forum Pharmaceuticals; GenOmind, LLC; GlaxoSmithKline; Grunenthal GmbH; Indivior; i3 Innovus/Ingenis; Intracellular; Janssen Pharmaceutica; Jazz Pharmaceuticals, Inc.; Johnson & Johnson Pharmaceutical Research & Development, LLC; Knoll Pharmaceuticals Corp.; Labopharm Inc.; Lorex Pharmaceuticals; Lundbeck Inc.; MedAvante, Inc.; Merck & Co., Inc.; MSI Methylation Sciences, Inc.; Naurex, Inc.; Nestle Health Sciences; Neuralstem, Inc.; Neuronetics, Inc.; NextWave Pharmaceuticals; Novartis AG;Nutrition 21; Orexigen Therapeutics, Inc.; Organon Pharmaceuticals; Osmotica; Otsuka Pharmaceuticals; Pamlab, LLC.; Pfizer Inc.; PharmaStar; Pharmavite ® LLC.; PharmoRx Therapeutics; Precision Human Biolaboratory; Prexa Pharmaceuticals, Inc.; PPD; Puretech Ventures; PsychoGenics; Psylin Neurosciences, Inc.; RCT Logic, LLC ( formerly Clinical Trials Solutions, LLC); Rexahn Pharmaceuticals, Inc.; Ridge Diagnostics, Inc.; Roche; Sanofi-Aventis US LLC.; Sepracor Inc.; Servier Laboratories; Schering-Plough Corporation; Shenox Pharmaceuticals; Solvay Pharmaceuticals, Inc.; Somaxon Pharmaceuticals, Inc.; Somerset Pharmaceuticals, Inc.; Sunovion Pharmaceuticals; Supernus Pharmaceuticals, Inc.; Synthelabo; Taisho Pharmaceutical; Takeda Pharmaceutical Company Limited; Tal Medical, Inc.; Tetragenex Pharmaceuticals, Inc.; TransForm Pharmaceuticals, Inc.; Transcept Pharmaceuticals, Inc.; Vanda Pharmaceuticals, Inc.; VistaGen; he has received speaking or publishing fees from Adamed, Co ; Advanced Meeting Partners ; American Psychiatric Association; American Society of Clinical Psychopharmacology ; AstraZeneca ; Belvoir Media Group ; Boehringer Ingelheim GmbH ; Bristol-Myers Squibb ; Cephalon, Inc .; CME Institute/Physicians Postgraduate Press, Inc .; Eli Lilly and Company ; Forest Pharmaceuticals, Inc .; GlaxoSmithKline ; Imedex, LLC ; MGH Psychiatry Academy/Primedia ; MGH Psychiatry Academy/Reed Elsevier ; Novartis AG ; Organon Pharmaceuticals ; Pfizer Inc .; PharmaStar ; United BioSource,Corp .; Wyeth-Ayerst Laboratories ; he has equity holdings in Compellis and PsyBrain, Inc.; he has a patent for Sequential Parallel Comparison Design (SPCD), which are licensed by MGH to Pharmaceutical Product Development, LLC (PPD); and patent application for a combination of Ketamine plus Scopolamine in Major Depressive Disorder (MDD), licensed by MGH to Biohaven; and he receives copyright royalties for the MGH Cognitive & Physical Functioning Questionnaire (CPFQ), Sexual Functioning Inventory (SFI), Antidepressant Treatment Response Questionnaire (ATRQ), Discontinuation-Emergent Signs & Symptoms (DESS), Symptoms of Depression Questionnaire (SDQ), and SAFER; Lippincott, Williams & Wilkins; Wolkers Kluwer; World Scientific Publishing Co. Pte.Ltd. In the past three years, Dr. Myrna Weissman received funding from the National Institute of Mental Health (NIMH) , the National Institute on Drug Abuse (NIDA) , the National Alliance for Research on Schizophrenia and Depression (NARSAD) , the Sackler Foundation , the Templeton Foundation ; and receives royalties from the Oxford University Press, Perseus Press, the American Psychiatric Association Press, and MultiHealth Systems. Dr. Madhukar H. Trivedi is or has been an advisor/consultant and received fee from (lifetime disclosure): Abbott Laboratories Inc ., Akzo (Organon Pharmaceuticals Inc.) , Allergan Sales LLC , Alkermes, Arcadia Pharmaceuticals Inc ., AstraZeneca , Axon Advisors, Brintellix , Bristol-Myers Squibb Company , Cephalon Inc ., Cerecor , Eli Lilly & Company , Evotec , Fabre Kramer Pharmaceuticals Inc ., Forest Pharmaceuticals , GlaxoSmithKline , Global Medical Education Inc ., Health Research Associates , Johnson & Johnson , Lundbeck, MedAvante Medscape , Medtronic, Merck, Mitsubishi Tanabe Pharma Development America Inc ., MSI Methylation Sciences Inc ., Nestle Health Science-PamLab Inc ., Naurex, Neuronetics, One Carbon Therapeutics Ltd ., Otsuka Pharmaceuticals, Pamlab, Parke-Davis Pharmaceuticals Inc ., Pfizer Inc ., PgxHealth , Phoenix Marketing Solutions , Rexahn Pharmaceuticals , Ridge Diagnostics , Roche Products Ltd ., Sepracor , SHIRE Development , Sierra, SK Life and Science , Sunovion, Takeda , Tal Medical/Puretech Venture , Targacept, Transcept, VantagePoint, Vivus, and Wyeth-Ayerst Laboratories . In addition, he has received grants/research support from: Agency for Healthcare Research and Quality , Cyberonics Inc ., National Alliance for Research in Schizophrenia and Depression , National Institute of Mental Health , National Institute on Drug Abuse , National Institute of Diabetes and Digestive and Kidney Diseases , Johnson & Johnson ; and he receives royalties from Janssen Research and Development LLC. All authors have approved this manuscript. Publisher Copyright: © 2018 Elsevier Ltd
PY - 2018/7
Y1 - 2018/7
N2 - The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
AB - The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
KW - Anxiety
KW - Depression
KW - Factor analysis
KW - Flanker Task
UR - http://www.scopus.com/inward/record.url?scp=85046014135&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046014135&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychires.2018.04.003
DO - 10.1016/j.jpsychires.2018.04.003
M3 - Article
C2 - 29689518
AN - SCOPUS:85046014135
VL - 102
SP - 207
EP - 215
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
SN - 0022-3956
ER -