Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Department of Child & Adolescent Psychiatry, Rotterdam, The Netherlands.
Psychoneuroendocrinology. 2010 Sep;35(8):1223-34. doi: 10.1016/j.psyneuen.2010.02.012. Epub 2010 Mar 12.
Anxiety and depression might be two different valid constructs that often co-occur, or they could be different manifestations of the same underlying vulnerability. A theoretical framework to address this question is the tripartite model, by Clark and Watson, which hypothesizes that physiological hyperarousal (PH) is specific for anxiety. Knowledge about the relationship between PH, psychophysiological measures, perceived arousal, and anxiety would increase our understanding of the validity of the PH construct in this model. Our objective was to assess whether (a) hypothalamic-pituitary-adrenocortical (HPA) axis functioning, and (b) perceived arousal before, during and after stress can differentiate anxious from depressive children.
In a general population sample of 225 children aged 8-12 years, self-reported anxiety and depressive symptoms were assessed using the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI). Perceived arousal was assessed using a self-report questionnaire before, during and after a stress task. Basal and reactive HPA-axis functioning were used as indices for psychophysiological arousal.
Our data showed that the relation between perceived arousal and anxiety problems is stronger than the relation with depressive problems. Reactive HPA-axis functioning is reduced in children with depressive problems.
Some evidence was found in support of the tripartite model. Our findings indicate that perceived arousal to a challenge might be a useful tool to assess the PH component of the tripartite model. Reactive HPA-axis functioning might be able to differentiate between anxiety and depressive problems in children in a general population sample, but effect sizes are small and replication is needed.
焦虑和抑郁可能是两个不同的有效结构，它们经常同时发生，或者它们可能是同一潜在弱点的不同表现。解决这个问题的一个理论框架是克拉克和沃森的三分模型，该模型假设生理过度唤醒（PH）是焦虑的特异性表现。关于 PH、心理生理测量、感知唤醒和焦虑之间关系的知识将增加我们对该模型中 PH 结构有效性的理解。我们的目的是评估（a）下丘脑-垂体-肾上腺皮质（HPA）轴功能，以及（b）在压力前、期间和之后感知的唤醒是否可以区分焦虑和抑郁的儿童。
在一个 225 名 8-12 岁儿童的一般人群样本中，使用多维焦虑量表儿童版（MASC）和儿童抑郁量表（CDI）评估自我报告的焦虑和抑郁症状。在压力任务之前、期间和之后使用自我报告问卷评估感知唤醒。基础和反应性 HPA 轴功能被用作心理生理唤醒的指标。
我们的数据表明，感知唤醒与焦虑问题的关系比与抑郁问题的关系更强。有抑郁问题的儿童的反应性 HPA 轴功能降低。
有一些证据支持三分模型。我们的研究结果表明，对挑战的感知唤醒可能是评估三分模型 PH 成分的有用工具。反应性 HPA 轴功能可能能够区分一般人群样本中的焦虑和抑郁问题，但效应大小较小，需要复制。
