Category: Cultural Diversity / Vulnerable Populations
A substantial body of research notes the prevalence and comorbidity of depressive and anxiety disorders in adolescence. The tripartite model (Clark & Watson, 1991) has been an important theoretical framework to understand shared and differential factors associated with depression and anxiety. The model posits that depression and anxiety share a common dimension of heightened negative affect (NA) which includes several aspects of general emotional distress such as sadness, anger, and fear, whereas low positive affect (PA) or anhedonia is specific to depression, and high physiological hyperarousal (PH) is specific to anxiety. Though the model is widely validated among adult and youth, these studies primarily include middle-class samples from North America, Canada, and the UK. It is unclear if the tripartite model is supported in other parts of the world, such as Asia. Asians, compared to Americans, report less frequent positive emotions (Kitayama et al., 2000), and experience a balance of positive and negative emotions (Miyamoto & Ma, 2011), which may be adaptive in Asian countries, like India. Indian youth, compared to American youth, are more likely to report somatic complaints to express their internalizing symptoms in comparison to affective symptoms (Derasari & Shah, 1998). It is unclear what the unique role of PA and PH may be in an Indian sample. Much like other Asian countries, adolescents in India take competitive state-wide examinations that lead to high academic stress, which is associated with mental health concerns (Verma et al., 2002). Academic stress may moderate the pathways between low PA and depression, and high PH and anxiety respectively. The current study examines whether components of the tripartite model hold, and whether academic stress moderates the aforementioned paths in a community-based sample of adolescents in India. 282 high-school adolescents from Bangalore, India completed self-reports of experienced NA, PA, PH, academic stress, depression and anxiety. In line with the tripartite model, NA significantly positively correlated with both depression r = .51, p = .01 and anxiety symptoms r = .52, p = .01. However, PA significantly negatively correlated with both depression r = -.19, p = .01, and anxiety symptoms r = -.14, p = .05. Also contrary to the tripartite model, PH significantly positively correlated with both depression r = .52, p = .01, and anxiety symptoms r = .32, p = .01. There was no moderating role of high academic stress on any tripartite pathway. Regression results indicate for every one unit increase in academic stress, there is a 2.56 unit increase in depression, over and above PA, and a 1.67 unit increase in anxiety, over and above PH. Our findings suggest there are no unique symptomatic predictors of depression and anxiety in our sample, and the academic environment does not change the relationships between PA or PH and internalizing symptoms. The applicability of the tripartite model may differ depending on the context in which youth live and/or the youth’s ethnic background. Clinical and research implications are discussed.