Testing a hierarchical model of anxiety and depression in adolescents: a tri-level model.

The present study examined the structural relationships among anxiety and depressive symptoms in a sample of high school juniors. The best-fitting structural representation was a tri-level hierarchical arrangement with a broad general factor (general distress), two factors of intermediate breadth (anxious-misery and fears), and five conceptually meaningful, narrow group factors. In accord with the integrative hierarchical model of anxiety and depression, the results supported a structure with a symptom factor central to major depression, and other symptom factors specific to particular anxiety disorders. These group factors displayed significant, unique associations with clinician severity ratings (CSRs) for their respective DSM diagnoses. The hierarchical arrangement demonstrated temporal invariance over a one-year period and configural and partial metric invariance in females and males. Implications for DSM classification and arrangement of anxiety and depressive disorders are discussed as is how present findings help bridge existing research conducted at symptom and diagnostic levels.