Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors
Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors
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DOI：
10.1016/j.jad.2019.09.053
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发表时间：
2020-01-01
影响因子：
6.6
通讯作者：
Snyder, Hannah R.
中科院分区：
文献类型：
--
作者：
Fassett-Carman, Alyssa N.;DiDomenico, Grace E.;Snyder, Hannah R.
背景：依赖(自身产生的)压力是抑郁和焦虑的强烈风险因素，但对压力的感知可以改变其影响。对依赖压力、可控性和严重程度的评估还与压力暴露以上的抑郁和焦虑有关。由于抑郁和焦虑的高共患率，目前尚不清楚依赖应激频率和评估是否具体与抑郁或焦虑有关，或者是否与内化性障碍的跨诊断相关。与三方模型一致，本研究用三个潜在因素--抑郁症特有的、焦虑特有的和共同的内化--来表示内化症状，并测试依赖压力频率以及对可控性和严重性的评估与这些因素之间的关系。方法：采用双因素模型在356名寻求治疗的新兴成年人样本中建立潜在内化因素。结构方程模型检验了依赖应激频率以及对可控性和严重性的评价作为这些潜在因素的预测因子。结果：依赖应激频率与共同内化相关，而感知可控性与抑郁特有的方差唯一相关。持续应激严重程度与潜在因素无关，但严重程度高的应激源与焦虑特有的变量有关。限制：没有纵向数据，就不能得出关于时间方向性的结论。结论：依赖应激频度、可控性评价和高严重性应激事件与内化精神病理学的不同维度有明显的联系。这表明，在压力结构和精神病理学之间可能存在几种不同的中介机制，这些机制有可能成为干预的目标。
Background: Dependent (self-generated) stress is a strong risk factor for depression and anxiety, but perceptions of stress can alter its impact. Appraisals of dependent stress controllability and severity additionally relate to depression and anxiety over and above stress exposure. Due to the high comorbidity of depression and anxiety, it is unclear whether dependent stress frequency and appraisals relate specifically to depression or anxiety or are transdiagnostically associated shared aspects of internalizing disorders. Consistent with the tripartite model, the current study represented internalizing symptoms with three latent factors - depression-specific, anxiety-specific, and common internalizing - and tested how dependent stress frequency and appraisals of controllability and severity were associated with these factors.Methods: Bifactor modeling was used to create the latent internalizing factors in a treatment-seeking sample of emerging adults (n = 356). Structural equation models tested dependent stress frequency and appraisals of controllability and severity as predictors of these latent factors.Results: Dependent stress frequency was associated with common internalizing while perceived controllability was associated uniquely with depression-specific variance. Continuous stress severity was not associated with latent factors, but high-severity stressors were associated with anxiety-specific variance.Limitations: Without longitudinal data conclusions regarding temporal directionality cannot be made. Participants' appraisals of stressors could not be compared to expert ratings.Conclusions: Dependent stress frequency, controllability appraisals, and high-severity stressful events have distinct links with different dimensions of internalizing psychopathology. This suggests there may be several distinct mediating mechanisms between stress constructs and psychopathology, which have potential to serve as targets for intervention.