Burns D D, Eidelson R J
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA.
J Consult Clin Psychol. 1998 Jun;66(3):461-73. doi: 10.1037//0022-006x.66.3.461.
L. A. Clark and D. Watson's (1991) tripartite model groups the symptoms of depression and anxiety into 3 components: nonspecific symptoms of general distress, which do not distinguish depression and anxiety; physiologic arousal, which is relatively unique to anxiety; and anhedonia (or low positive affect), which is unique to depression. Structural equation modeling was used to test this model with self-report data from 3 different samples: outpatients seeking treatment for mood disorder, anxiety disorder, or both (n = 483) outpatients seeking treatment for substance abuse (n = 453), and college students (n = 516). The tripartite model did not fit any of the sample covariance matrices, because the nonspecific symptoms of depression and anxiety could not be adequately represented by a single General Distress factor. An alternative model, in which the Anhedonia and Nonspecific Depression factors loaded on a second-order Depression factor, while the Somatic Arousal and Nonspecific Anxiety factors loaded on a second-order Anxiety factor, produced an excellent fit in all the groups. The Nonspecific Depression and Nonspecific Anxiety factors were the most valid and specific indicators of depression and anxiety, respectively. Anhedonia and Somatic Arousal were significantly less valid measures of depression and anxiety. The implications of these findings are discussed.
L. A. 克拉克和D. 沃森（1991年）的三方模型将抑郁和焦虑症状分为三个成分：一般痛苦的非特异性症状，它无法区分抑郁和焦虑；生理唤醒，这相对是焦虑所特有的；以及快感缺失（或积极情感低落），这是抑郁所特有的。结构方程模型被用于用来自三个不同样本的自我报告数据来检验这个模型：寻求治疗情绪障碍、焦虑障碍或两者的门诊患者（n = 483），寻求治疗物质滥用的门诊患者（n = 453），以及大学生（n = 516）。三方模型与任何一个样本协方差矩阵都不拟合，因为抑郁和焦虑的非特异性症状无法由单一的一般痛苦因子充分表征。一个替代模型，其中快感缺失和非特异性抑郁因子加载在一个二阶抑郁因子上，而躯体唤醒和非特异性焦虑因子加载在一个二阶焦虑因子上，在所有组中都产生了极佳的拟合。非特异性抑郁和非特异性焦虑因子分别是抑郁和焦虑最有效且最具特异性的指标。快感缺失和躯体唤醒作为抑郁和焦虑的测量指标有效性显著较低。讨论了这些发现的意义。
