The Beck Anxiety Inventory: A psychometric analysis.

Provides information on the Beck Anxiety Inventory (BAI) with respect to psychometric properties, gender differences, and relation to depression. A sample of 291 psychiatric patients (mean age 36.9 yrs) completed the BAI, and a subsample of 251 completed the Beck Depression Inventory (BDI). The results from factor analyses demonstrated that the BAI has 2 factors, corresponding to cognitive and somatic symptoms. Although men and women did not differ in terms of factor structures, they did differ on mean levels of cognitive and somatic symptom scores and on total BAI scores. Finally, it was found that BAI items were distinguishable from BDI items, suggesting that the symptoms measured in the 2 scales are not entirely overlapping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal analysis of anxiety and depressive symptoms.

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age?=?60.9 years, SD?=?13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of depression in aging contexts: General considerations when working with older adults.

Popular assertions portray depression as an inevitable outcome of aging, a widespread image embraced by many health professionals. Although epidemiological data contradict the prevalent image that depressive syndromes increase with age, the prognosis becomes more negative as one grows older. An early thorough assessment is vital to identify depressive symptoms in older adults, thus promoting the development of tailored interventions and improved recovery rates. The main problems associated with the assessment of depressive symptoms in older adults include a lack of knowledge about changes in the pattern of symptoms, the inadequacy of techniques developed for other age cohorts, the misuse of psychometric instruments, and deficits in additional areas of assessment. The underlying goal of this article is to analyze the obstacles to a successful assessment of depression symptoms in older adults, suggesting strategies to overcome them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aspects of dysphoria and symptoms of schizophrenia

BACKGROUND: In the past it has been postulated that dysphoric emotions may be related to positive and/or negative symptoms in schizophrenia. The results of several recent studies have suggested that composite dysphoria indices are more strongly related to positive than negative symptoms. In the current study we use part correlation techniques to examine the possible unique contributions of two aspects of dysphoria--depression and anxiety--to three syndromes of symptoms (reality distortion, disorganization and psychomotor poverty) within schizophrenia. METHODS: Data were obtained from 60 patients with a DSM-III-R diagnosis of schizophrenia. Symptoms of schizophrenia were assessed using the SAPS and SANS and dysphoria was assessed using both self-report (BDI and BAI) and observer ratings (HRSD and HARS). Assessment of schizophrenia symptoms and ratings of depression and anxiety were completed by different observers. In addition, drug induced extrapyramidal side effects were rated. RESULTS: Part correlations showed that unique aspects of anxiety (particularly physiological arousal) were correlated with reality distortion while unique aspects of depression (including psychomotor slowing and loss of social interest) were related to psychomotor poverty. At least part of the latter relationship may be due to extrapyramidal side effects of neuroleptic medication. CONCLUSIONS: Although there is considerable overlap between anxiety and depression, it appears that the unique arousing or activating aspects of anxiety are related to the experience of reality distortion symptoms in schizophrenia and the unique slowing and withdrawal aspects of depression are particularly related to psychomotor poverty. Possible reasons for these relationships are discussed.     

Aging and symptoms of anxiety and depression: Structural invariance of the tripartite model.

Negative affect measures were evaluated in a cross-sectional community sample of adults aged 18-93 (N = 335) to examine the structure of neuroticism, anxiety, and depressive symptoms in young, middle, and older adult cohorts. Structural equation modeling was used to contrast 3 nested models: a 1-factor general distress model; a 2-factor high negative-low positive affect model; and a 3-factor "tripartite model" reflecting a higher order Negative Affect factor that is common to depression and anxiety problems and 2 lower order factors, Low Positive Affect (mostly specific to depression) and Arousal (specific to anxiety/panic). As expected, the tripartite model fit best for all age groups. Further, multigroup analyses indicated age invariance for the tripartite model, suggesting the model can be effectively applied with older populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An inventory for measuring clinical anxiety: Psychometric properties.

The development of a 21-item self-report inventory for measuring the severity of anxiety in psychiatric populations is described. The initial item pool of 86 items were drawn from three preexisting scales: the Anxiety Checklist, the Physician's Desk Reference Checklist, and the Situational Anxiety Checklist. A series of analyses was usd to reduce the item pool. The resulting Beck Anxiety Inventory (BAI) is a 21-item scale that showed high internal consistency (α?=?.92) and test–retest reliability over 1 week, r(81)?=?.75. The BAI discriminated anxious diagnostic groups (panic disorder, generalized anxiety disorder, etc.) from nonanxious diagnostic groups (major depression, dysthymic disorder, etc.). In addition, the BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale, r(150)?=?.51, and was only mildly correlated with the revised Hamilton Depression Rating Scale, r(153)?=?.25. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Test of the Tripartite Model of Depression and Anxiety in Older Adult Psychiatric Outpatients.

This study examined the tripartite model of depression and anxiety in 131 psychiatric outpatients, ages 55-87. Confirmatory factor analyses revealed that a 3-factor model provided an adequate fit to the observed data, that the 3-factor model was empirically superior to 1- or 2-factor models, and that the 3-factor structure obtained in the current sample of older adult outpatients converged with that obtained on a separate, younger 'sample. Negative affect was significantly related to depression and anxiety symptoms and syndromes, and positive affect was more highly related to depression than anxiety symptoms and syndromes. Ways for taking into account possible age-associated differences in emotion in older adults and thus improving the conceptual model of anxiety and depression are briefly noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain-specific angiogenesis inhibitor 1 expression is inversely correlated with vascularity and distant metastasis of colorectal cancer

Brain-specific angiogenesis inhibitor (BAI) 1 was recently isolated as a novel p53 inducible gene. BAI1 has been suggested to play a significant role in angiostasis. We studied the expression of BAI1 in 49 colorectal cancer specimens by RT-PCR. BAI1 expression was significantly reduced in colorectal cancers as compared to the extraneoplastic tissues (X(2) test, p=0.041). BAI1 expression was inversely correlated with vascular invasion and metastasis (Fisher's exact test, p 0.045). Moreover, vascularity in the colorectal cancer was inversely correlated with BAI1 gene expression (Mann-Whitney U-test, p=0.0003). These observations suggested that BAI1 expression might inhibit angiogenesis and metastasis of colorectal cancer.     

Comorbidity of anxiety and depression in children and adolescents.

Anxiety and depression in children and adolescents are reviewed, including differential diagnosis, assessment of symptoms, family history data, developmental features, and clinical correlates. Findings indicate that 15.9% to 61.9% of children identified as anxious or depressed have comorbid anxiety and depressive disorders and that measures of anxiety and depression are highly correlated. Family history data are inconclusive. Differences emerged among children with anxiety, depression, or both disorders. Anxious children were distinguishable from the other 2 groups in that they showed less depressive symptomatology and tended to be younger. The concurrently depressed and anxious group tended to be older and more symptomatic. In this group, the anxiety symptoms tended to predate the depressive symptoms. Findings are discussed in the context of a proposed developmental sequence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia

Psychometric properties of the Beck Anxiety Inventory (BAI) (Beck and Steer, 1990) were investigated in a sample of 82 patients suffering from panic disorder with agoraphobia. Before and after brief treatment, patients completed a battery of questionnaires and, for 2-week periods, kept a daily panic diary in which they recorded panic attacks, fear of panic, and average anxiety. The BAI demonstrated excellent internal consistency and good test-retest reliability over a 5-week interval. A partial multitrait, multimethod correlation matrix provided evidence of convergent validity with other measures of anxiety and of divergent validity vis á vis measures of depression. Factor analyses of pretest scores and residual gain scores used to address criticism that the BAI is excessively panic-centric yielded mixed results. In one analysis, the BAI was loaded with multimethod measures of panic and anxiety and, in the other, with questionnaire methods of assessing anxiety and depression. However, the BAI was clearly distinguished from measures of fear of fear, a central construct in panic disorder, and agoraphobic avoidance. Finally, the BAI proved sensitive to change with treatment, yielding effect sizes for improvement comparable to those of other anxiety measures.     

The two-factor structure of sleep complaints and its relation to depression and anxiety.

Although sleep complaints are common in depression and anxiety, there is little agreement as to how they should be organized and assessed. It is also unclear whether sleep complaints show specificity with certain disorders or whether they are nonspecific symptoms. The authors examined the structure of sleep complaints and the relations of these complaints to depression and anxiety in 3 samples: college students, older adults, and psychiatric patients. Exploratory and confirmatory factor analyses indicated that sleep complaints consistently defined 2 distinct dimensions: Insomnia and Lassitude. The Insomnia factor included indicators of early, middle, and late insomnia, as well as poor sleep quality. The Lassitude factor included measures of hypersomnia, fatigue, and sleepiness. Both factors were significantly related to symptoms and diagnoses of depression and anxiety. However, Lassitude was more strongly related to symptoms of depression and anxiety than was Insomnia. In addition, Lassitude showed specificity to measures and diagnoses of depression compared with anxiety disorders. This specificity can be explained by Lassitude's relation with negative and positive emotionality, both of which are components of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic and environmental contributions to depression symptomatology: Evidence from Danish twins 75 years of age and older.

The heritability symptoms of depression were investigated in a sample of 406 same-sex Danish twin pairs 75 years of age and older. Twins completed an interview assessment that included symptoms of depression, which were scored on the following 3 scales: Somatic, Affect, and Total. Heritability estimates (h–2) for the Total (h–2?=?.34), Somatic (h–2?=?.31), and Affect (h–2?=?.27) scales were all moderate and statistically significant. For not one of the scales did h–2 vary significantly over the age range sampled, and although the observed twin correlations were substantially smaller among men as compared with women, none of the sex differences in heritability were statistically significant. Multivariate analyses indicated that all of the heritable effects on the Affect and Somatic subscales could be attributed to a single genetic factor. Depression symptoms in older adults may thus be more heritable than indicated in previous studies, although nonshared environmental factors clearly account for a majority of the variance. The implications of these findings for understanding the nature of late-life depression symptomatology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences in stimulus intensity modulation and its relationship to two styles of depression in older adults.

Research comparing depressive persons with and without manic symptoms shows striking parallels with differences between augmenters and reducers on the Kinesthetic Aftereffect (KAE) task (A. Petrie, 1967). Twenty-three community-dwelling older adults identified by the Minnesota Multiphasic Personality Inventory (S. R. Hathaway & J. C. McKinley, 1951) as depressive without manic symptoms were compared with 24 older adults with manic symptoms on the KAE, the NEO Personality Inventory (NEO-PI; P. T. Costa & R. R. McCrae, 1985), and Strelau (J. Strelau, 1983) Temperament Inventory. As hypothesized, augmentation was related to depression without manic symptoms, and reduction was related to depression with manic symptoms. Stepwise discriminant analyses indicated that the KAE is a potent discriminator between the 2 types of depression. Three characteristics of Strelau's "strength of nervous system"—excitation, and inhibition and mobility—discriminate significantly between the 2 groups as well as NEO extraversion and conscientiousness. Results suggest that older depressive persons with and without manic symptoms may benefit from different therapeutic interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decline in self-reported dysphoria after treatment entry in inner-city cocaine addicts.

This study examined self-reported dysphoria in 82 consecutive admissions to intensive outpatient treatment for cocaine abuse on whom data for the Beck scales for depression, anxiety, and hopelessness were available for intake and 4 subsequent weeks with no more than 1 missing data point. Mean scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) decreased significantly between intake and Week 1, with no further significant changes from Weeks 1–4. Similar drops in the rate of clinically significant BDI and BAI scores also were observed. Scores on the Beck Hopelessness Scale (BHS) showed no significant changes. By Week 4, rates of clinically significant depression, anxiety, and hopelessness were similar (17%, 13%, and 16%, respectively) . These findings suggest that assessing depression and anxiety using the BDI and BAI in this population should be postponed for at least 1 week after intake and that intake levels of self-reported mood may be inappropriate baseline measures for evaluating treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between symptoms of anxiety and depression in children: A multitrait-multimethod-multigroup assessment.

Teacher, parent, peer, and self-ratings of depression and anxiety symptoms were obtained from 280 3rd-grade and 211 6th-grade children. Confirmatory factor analysis of these multitrait-multimethod data for 3rd graders revealed low but statistically significant levels of convergent validity, high levels of method variance, and an extremely high correlation between the depression and anxiety factors, even after controlling for shared method variance. Similar analyses of 6th graders revealed slightly higher levels of convergent validity and a somewhat smaller correlation between the depression and anxiety factors. The data support a unified construct model for younger children and are consistent with either a dual factor or a tripartite model of depression and anxiety in older children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of physical disease and functional impairment to depression in older people.

Physical disease is commonly considered a risk factor for depression among older adults. However, this pattern is not consistently supported, and a theoretical framework for understanding such a relationship has not been articulated. P. M. Lewinsohn, H. Hoberman, L. Teri, and M. Hautzinger's (1985) integrative model of depression predicts that disease will be a risk factor for depression only when disease results in functional impairment, and that impairment in the absence of disease is also a risk factor for depression. The authors tested these predictions in a community-based sample of older adults followed longitudinally and found that functional impairment was a significant risk factor for depression, regardless of disease status. Disease was not a significant predictor of major depression, nor did it interact with impairment to predict depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and specific dimensions of self-reported anxiety and depression: Implications for the cognitive and tripartite models.

The common and specific symptom dimensions of anxiety and depression proposed by the tripartite (L. A. Clark and D. Watson, see record 1991-32000-001) and cognitive (A. T. Beck, 1976; see also PA, Vol 74:33248) models were investigated in 844 psychiatric outpatients and 420 undergraduates. Principal-factor analyses with oblique rotations performed on the 42 items of the Beck Depression Inventory and Beck Anxiety Inventory for both samples revealed that there were 2 correlated factors, Depression and Anxiety. Second-order factor analyses of the interfactor correlation matrices indicated a large general distress or negative affect factor underlying the relationship between the 2 first-order factors. Specific depression and anxiety dimensions were apparent even after controlling for negative affect. The results were consistent with both the tripartite and cognitive models, with the cognitive and motivational symptoms specific to depression and the physiological arousal symptoms unique to anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Platelet serotonin markers and depressive symptomatology

Dysfunction of brain serotonergic symptoms may be a factor in the mood and behavioral disturbances associated with depression. Platelet serotonin measures represent indirect but easily obtainable indices of brain serotonin function. To examine the specificity of relationships between cognitive and vegetative symptom groupings and platelet serotonin measures, we assessed 35 depressed outpatients using the Hamilton Rating Scale for Depression and collected platelets after a minimum 3-week drug-free period. Platelets were also collected from 14 controls. The results showed that depressed patients had lower platelet serotonin (5-HT) uptake site density values than controls and that 5-HT uptake site density values were inversely correlated with the severity of cognitive symptoms of depression. Platelet 5-HT2 receptor density values were higher in depressed patients than controls, and there was a trend toward a direct correlation between the cognitive symptoms of depression and 5-HT2 receptor density values. Neither platelet measure showed any relationship with the severity of the vegetative symptoms of depression.     

Depressive symptoms and lymphocyte proliferation in older adults.

In an 18-month prospective study, community-dwelling older adults, including both spousal caregivers of dementia patients and noncaregiving controls, were examined. Participants were selected on the basis of the presence or absence of chronic depressive symptoms that exceeded a cutoff score for clinically relevant depressive symptoms on a self-report symptom measure. Compared with nondepressed older adults, those with chronic, mild depressive symptoms had poorer T cell responses to 2 mitogens from baseline to follow-up. Additionally, among individuals with depressive symptoms, older age was associated with the poorest blastogenic response to the mitogens at follow-up. These findings extend the association between depression and immune function to community-dwelling older adults with chronic, mild depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of attention problems on depression: Developmental, academic, and cognitive pathways.

The present study investigated developmental pathways between inattention and depression, particularly the roles of school maladjustment and child cognitions. Additionally, a measure of conduct problems was included in all analyses to test competing theories about the emergence of depressive symptoms. Results supported the hypothesized path models from inattention to depression for younger and older children. Consistent with developmental theories, only an environmental variable, school maladjustment, was needed to explain the relationship between inattention and depression for the younger group (under 8 years old). For children in the middle group (8-9 years old), school maladjustment continued to uniquely account for part of the path to child depressive symptoms, but a cognitive variable, control-related beliefs, emerged as a significant mediator as well. For older children (10 years and older), control-related beliefs fully mediated the effects of school maladjustment on depressive symptoms. The hypothesized paths from conduct problems to depression, however, were not supported. Implications for designing interventions and prevention strategies for children with inattention and conduct problems are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)