Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression

Results from the EMBARC study

Joseph M. Trombello, Diego A. Pizzagalli, Myrna M. Weissman, Bruce D. Grannemann, Crystal M. Cooper, Tracy L. Greer, Ashley L. Malchow, Manish K. Jha, Thomas J. Carmody, Benji T. Kurian, Christian A. Webb, Daniel G. Dillon, Patrick J. McGrath, Gerard Bruder, Maurizio Fava, Ramin V. Parsey, Melvin G. McInnis, Phil Adams, Madhukar H. Trivedi

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)207-215
Number of pages9
JournalJournal of Psychiatric Research
Volume102
DOIs
StatePublished - Jul 1 2018

Fingerprint

Anxiety
Depression
Panic
Psychomotor Agitation
Dysthymic Disorder
Arousal
Bipolar Disorder
Self Report
Fear
Interviews
Psychology
Neuroticism

Keywords

  • Anxiety
  • Depression
  • Factor analysis
  • Flanker Task

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

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, 01.07.2018, p. 207-215.

Research output: Contribution to journalArticle

Trombello, JM, Pizzagalli, DA, Weissman, MM, Grannemann, BD, Cooper, CM, Greer, TL, Malchow, AL, Jha, MK, Carmody, TJ, Kurian, BT, Webb, CA, Dillon, DG, McGrath, PJ, Bruder, G, Fava, M, Parsey, RV, McInnis, MG, Adams, P & Trivedi, MH 2018, 'Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression: Results from the EMBARC study', Journal of Psychiatric Research, vol. 102, pp. 207-215. https://doi.org/10.1016/j.jpsychires.2018.04.003
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. / Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression : Results from the EMBARC study. In: Journal of Psychiatric Research. 2018 ; Vol. 102. pp. 207-215.
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