































Graduate Student Journal of Psychology          Copyright 2012 by the Department of Counseling and Clinical Psychology 
2012, Vol. 14               Teachers College, Columbia University 

37 

 
The Tripartite Model of Anxiety and Depression: 

Function and Utility in a Youth Community Sample 
 

Ruifan Zeng, Shauna Kushner, and Jennifer L. Tackett 
University of Toronto 

 
The current study examined the application of Clark & Watson’s (1991) tripartite model of the 
internalizing disorders (i.e., anxiety and depression) in non-clinical youth as research is lacking on 
its functionality in youth compared to adult populations.  We attempted to replicate the tripartite 
constructs (Negative Affect, Positive Affect, and Somatic Problems as an approximation of 
Physiological Hyperarousal) in a community sample of youth aged between 6 and 17 years.  
Consistent with the tripartite model, the results showed that NA was highly correlated with anxiety 
and depression symptoms, while low positive affect was related to depression but not anxiety.  
Somatic problems were found to be correlated with both anxiety and depression, which 
corroborates recent trends in the adult literature indicating that physiological hyperarousal does not 
uniquely distinguish depression from anxiety.  Implications and limitations of the current study are 
discussed.  

 
 

Depressive and anxious disorders affect both adult and 
youth populations.  Twelve-month prevalence of major 
depressive disorder (MDD) in adults is approximately 6.7%, 
and lifetime prevalence of MDD in children and adolescents 
is as high as 11.2 –13.0% (National Institute of Mental Health 
[NIMH], 2011).  For anxiety disorders, 12-month prevalence 
in adults is 18.2%, and lifetime prevalence in youth is 15% 
(NIMH, 2011).  Many people suffer from both disorders and 
the intercorrelations between self-report measures of anxiety 
and depression are particularly high in youth populations 
(Stark & Laurent, 2001).  This points to a considerable 
degree of symptom overlap between anxiety and depressive 
disorders, and there are indeed notable similarities in the way 
the two are manifested.   

According to the Diagnostic and Statistical Manual of 
Mental Disorders (4th ed., text rev; DSM-IV-TR; American 
Psychiatric Association, 2000) anxiety and depression are 
both characterized by high subjective distress, poor 
concentration, and somatic symptoms.  Instead of separating 
anxiety and depression into conceptually distinct disorders, 
Clark and Watson (1991) proposed a tripartite model to 
account for both the unique and shared variances of anxiety 
and depressive symptoms.  The tripartite model has found 
support in adult populations.  However, research on its utility 
in youth samples is scarce (Anderson & Hope, 2008).  The 
current investigation extended this line of research by 

                                                 
 Ruifan Zeng, M.A., and Shauna Kushner, M.A., Department 

of Psychology, University of Toronto; Jennifer L. Tackett, Ph.D., 
Department of Psychology, University of Toronto.  

Ruifan Zeng is now at the Department of Counseling and 
Clinical Psychology, Teachers College, Columbia University. 
Jennifer L. Tackett is now at the Department of Psychology, 
University of Houston. 

Correspondence concerning this article should be addressed to 
Ruifan Zeng at 235 E. 40 Street 8I, New York, NY 10016. Email: 
rrz2103@columbia.edu. 

examining the relevance of the tripartite model in explaining 
anxiety and depression symptoms in a community sample of 
non-clinical youths. 

 
Anxiety and Depression: Overview 

Past research has demonstrated the considerable overlap 
between self-report measures of anxiety and depressive 
symptoms in youth (for a detailed review, see Brady & 
Kendall, 1992).  This high overlap in symptomatology and 
poor discriminant validity of measures is problematic, as 
anxiety and depression have traditionally been categorized as 
distinct diagnostic classes and theoretical constructs (Akiskal, 
1985).  High symptom overlap in self-report measures has 
made it difficult to identify pure groups of depressed and 
anxious youth and to compare them to non-clinical youth in a 
valid way (Laurent & Ettelson, 2001).  Rates of comorbid 
anxiety and depression diagnoses are approximately 28% to 
62% in clinically-diagnosed samples (Brady & Kendall, 
1992).  In fact, the highest comorbidity rates between anxiety 
and depression exist not among adults, but among adolescents 
(Ollendick, Shortt, & Sander, 2005).  Comorbid anxiety and 
depression has also been associated with increased rates of 
suicidal ideation, suicide attempts, and completed suicide 
among clinical and community samples (Mineka, Watson, & 
Clark, 1998).  This increased risk denotes the augmented 
severity of comorbid cases, and calls for further research into 
the causes of such high rates of diagnostic overlap. 

It remains unclear whether depressive and anxious 
disorders should be conceptualized as distinct.  Further, 
research is needed to determine how different disorder 
conceptualizations might affect treatment strategies.  Clearly, 
there are both theoretical and clinical implications for 
enhancing our understanding of the dimensional versus 
discrete nature of anxiety and depression.   

There is some evidence suggesting that anxiety disorders 
in fact may lead to the onset of concurrent depression 



ZENG, KUSHNER, & TACKETT 
 

38 

(Anderson & Hope, 2008; Brady & Kendall, 1992; Chorpita 
& Daleiden, 2002; Finch, Lipovsky, & Casat, 1989).  It is 
unclear whether this co-occurrence reflects the fact that 
anxiety and depression are distinct constructs yet strongly 
inter-related, or rather are different manifestations of the same 
disorder represented by a single underlying dimension 
(Feldman, 1993).   

Recent research has shown that subfactors of 
internalizing symptoms were not differentiated in middle 
childhood, but that personality factors may distinguish 
anxiety/fear from depression/distress symptoms, suggesting 
some differentiation within childhood psychopathology 
(Kushner, Tackett, & Bagby, 2011).  The seminal tripartite 
model proposed by Clark and Watson (1991) has formed the 
basis for subsequent dimensional models of anxiety and 
depression, which can better explain the disorders’ underlying 
nature.   
 
Clark & Watson’s Tripartite Model 

Clark and Watson (1991) developed a tripartite model to 
explain both the similarity and distinctiveness of depressive 
and anxiety disorders.  The tripartite model is a dimensional 
approach which posits that there are both shared components 
of the two disorders, as well as distinguishing factors that can 
separate comorbid diagnoses.  Clark and Watson (1991) 
examined mood as well as anxious symptoms in both clinical 
and non-clinical adult samples, and suggested that a 
nonspecific distress factor, Negative Affect (NA), forms the 
core component of both syndromes (Clark & Watson, 1991).  
NA refers to the extent to which a person feels unpleasantly 
engaged or upset, and includes negative mood states such as 
“angry,” “guilty,” “sad,” “disgusted,” and “worried.” Absence 
of NA is characterized by “calm” and “peaceful” mood states. 

In contrast, Positive Affect (PA) is best defined by the 
degree to which a person feels enthusiasm, pleasurable 
engagement, and energy.  This positive affectivity is captured 
by descriptors such as “active,” “delighted,” “proud,” and 
“enthusiastic.” A deficiency in PA is also characterized by 
somatic terms, such as “sluggish” (Clark & Watson, 1991).  
Positive Affect and NA are not opposites and function 
independently of each other: PA is related to measures of 
social activity and pleasant events, while NA is correlated 
with health complaints, stress, and unpleasant events.  Clark 
and Watson (1991) also cite Tellegen’s (1985) factor analysis 
of self-report measures of PA, NA, anxiety, and depression, 
which demonstrated that anxiety was more highly associated 
with NA, while low PA best characterized depression. 

The third construct in the tripartite model is 
Physiological Hyperarousal (PH).  This construct reflects 
somatic symptoms and autonomic arousal, such as muscle 
tension, shortness of breath, dizziness, lightheadedness, and 
indigestion (Clark & Watson, 1991).  Clark and Watson 
(1991) found that the items on the Hamilton Rating Scale of 
Anxiety (Hamilton, 1959) that best differentiated depressed 
patients from those with panic attacks were physiologically 
based.  These items included measures of cardiovascular, 
autonomic, and respiratory symptoms.  They noted that the 

physiological hyperarousal associated with generalized 
anxiety disorder (GAD) and panic attacks seemed to be 
specific to anxiety,.  Overall, Clark and Watson (1991) 
concluded that high levels of NA persist in both anxious and 
depressed patients and act as an indicator of these disorders, 
yet they offer little in the way of discerning between the two.  
Positive Affect and PH may play a pivotal role as factors 
distinguishing between depressive and anxious disorders. 

Though substantial empirical support has been found for 
PA as relatively unique to youth depression and NA as a 
shared component, (for a detailed review, see Anderson & 
Hope, 2008), results from research on PH has been rather 
mixed in terms of whether it is unique to anxious or to 
depressive symptoms (Chorpita & Daleiden, 2002; Jacques & 
Mash, 2004; Laurent et al., 2004).  Due to the model’s origins 
in clinical adult populations, further research on the tripartite 
constructs in youth is necessary to determine its applicability 
with a younger population. 
 
Applicability of the Tripartite Model in Youth 
Populations 

Research so far on the tripartite model has supported its 
utility in differentiating between anxiety and depression in a 
variety of populations (Anderson & Hope, 2008).  In a non-
clinical sample of undergraduate students, factor analyses 
showed that anxiety and depression symptoms were best 
separated using a three-factor solution including PA, NA, and 
PH (Joiner, 1996).  In otherwise non-clinical substance 
abusers, symptoms of anxiety and depression were better 
discriminated by measures of PA and PH, consistent with the 
tripartite model (Watson et al., 1995).  The application of the 
tripartite model to community samples demonstrates its 
efficacy at discerning between anxious and depressive 
symptoms, even when these symptoms do not reach clinical 
levels. 

 Though the model was originally developed to account 
for adult populations, a number of studies with child and 
adolescent samples have since demonstrated its application in 
differentiating anxiety and depression symptoms among 
youths.  Lonigan and colleagues (1994) showed that low PA 
distinguished children with depressive disorders from those 
with anxiety disorders in a clinical sample, as measured by 
the Children’s Depression Inventory (CDI; Kovacs, 1980, 
1981) and the Revised Children’s Manifest Anxiety Scale 
(RCMAS; Reynolds & Richmond, 1985).  Research with 
non-clinical children and adolescents has also established the 
utility of a three-factor model for children in grades three, six, 
and nine, as measured by items selected from the CDI and 
RCMAS (Turner & Barrett, 2003).  Overall, there is support 
for the tripartite constructs in youth populations despite the 
fact that considerably less research has thus far been 
conducted with children and adolescents in comparison to 
that with adult populations (Anderson & Hope, 2008). 

On the other hand, there have been debates over whether 
there is a developmental change in the differentiation between 
anxious and depressive disorders.  Cole et al. (1997) found 
that a single factor model (anxiety-depression) fit data from 



TRIPARTITE MODEL OF ANXIETY AND DEPRESSION 
 

39 

third-grade students equally as well as a two-factor model 
(anxiety and depression), but that a two-factor model was a 
better fit for data from sixth graders.  However, in a separate 
study, Turner and Barrett (2003) found no differences in 
terms of model fit between the grade 3, 6, and 9 groups, with 
a three-factor model best characterizing the data for all 
groups.  Researchers also concluded that within a combined 
sample of general population and clinically-referred 8-14 year 
olds, there is a dual-construct distinction between anxiety and 
depression across the whole age range (De Bolle, Decuyper, 
De Clercq, & De Fruyt, 2010).  Cannon and Weems’ (2006) 
study also found no support for gradual developmental 
differentiation, and found that a three-factor model was the 
best fit for both groups of 6-11 year olds and 12-17 year olds.  
They did, however, note that there may be differences in the 
predominance of anxious versus depressive symptoms across 
development, as opposed to the separation of a single 
syndrome (Cannon & Weems, 2006). 

Unlike the affective factors (i.e., PA and NA) of the 
tripartite model which have received ample support, the 
somatic factor, (PH) has not been given adequate empirical 
attention (Anderson & Hope, 2008).  Three-factor structures 
consistent with the tripartite model seem to operate in child 
and adolescent samples as originally outlined in adult samples 
(Chorpita & Daleiden, 2002).  It has also been suggested that 
PH may not be evenly related to all anxiety disorders.  For 
instance, studies of adult outpatients suggest that PH is 
positively related to symptoms of panic disorder, but not to 
other anxiety disorders (Brown, Chorpita & Barlow, 1998).  
This observation is contrary to the tripartite model’s 
supposition that PH is common to various anxiety disorders.   

Empirical results of the discriminatory power of PH have 
been mixed: One study showed that although PH was 
correlated with depression, it had no incremental predictive 
value for depressive symptoms after accounting for the effect 
of PA and NA in a non-clinical youth sample (Laurent, 
Catanzaro, & Joiner, 2004).  In addition, PH scales were 
found to be negatively correlated with PA scales in both 
parent- and child-reports suggesting the two factors may not 
be independent as proposed by the tripartite model (Clark & 
Watson, 1991).  On the other hand, a study of outpatient 
adolescents showed that the relationship between PH and 
anxiety is stronger than the relationship between low PA and 
depression, suggesting that PH may indeed be a better 
construct for differentiating anxiety and depression (Dia, 
Harrington, & Silverman, 2010). 
 
The Current Investigation 

The current study aimed to expand the literature on the 
applicability of the tripartite model in youth populations 
(Anderson & Hope, 2008).  We examined the relationships 
between the tripartite model constructs and 
depression/anxiety symptoms, in a community sample of 
children and adolescents.  Further, we also examined whether 
the constructs function differently in children (6-11 years old) 
versus adolescents (11-17 years old).  The comparison of 
younger versus older youth would help explore whether 

anxiety and depression differentiate from a unitary construct 
over time (e.g., Cole, 1997; Turner & Barrett, 2003).  Further 
validation of the tripartite model in youth populations would 
support a shift toward a dimensional approach to child and 
adolescent psychopathology similar to the shift in 
conceptualizations of adult pathology, especially with the 
advent of the DSM-5.   

Several studies have also found that there are 
discrepancies between child and parent reports in the 
correlations of depression, anxiety and the tripartite factors.  
For example, Chorpita and Daleiden (2002) found that 
children reported more concurrent anxiety and depression 
symptoms than observed by their parents.  There is also 
evidence that parent reports of anxiety and depression in their 
children were often not associated with the children’s own 
endorsements of NA (Philips, Lonigan, Driscoll, & Hooe, 
2002).  Explanations for convergence and discrepancies in 
cross-informant reports of PH remain unclear.  If children do 
not vocalize particular somatic complaints such as headaches, 
the measures of PH would be likely lower in parent reports 
than those in child report.  Such differences could account for 
discrepancies in parent and child ratings of PH levels in 
relation to the child’s anxious/depressive symptoms.  In the 
current study, both self- and parent-reports were obtained 
about the same individual, in order to obtain a better 
understanding of the nature of the tripartite factors.   

We used trait measures of PA and NA instead of 
generally used state measures, such as the Positive and 
Negative Affect Scale for Children (PANAS-C; Laurent et 
al., 1999).  We believed that trait measurement scales would 
serve a better instrument in capturing affective functioning in 
non-clinical samples such as the one used in the current study.   

We also focused on PH, which has consistently shown 
associations with anxiety, depression, and the other tripartite 
factors that are relatively contrary to the original model.  
Somatic Problems (SP) scales were used as a measure of PH 
(see Measures for details).  Overall, the elucidation of these 
relationships through the current study can advance our 
understanding of the syndromes in general, as well as reduce 
the risk of artificial diagnostic ‘splitting’ when assessing 
patient populations so that the comorbidity, or possible 
unitary nature of anxiety and depression, can be properly 
addressed in both diagnosis and treatment.   

 
Method 

 
We attempted to replicate the tripartite model in a youth 

population.  We hypothesized that: (1) PA and NA would be 
negatively correlated (though not independent constructs, low 
PA is expected to be unique to depression which is also 
characterized by high NA); (2) SP would be positively 
correlated with NA and not correlated with PA; (3) SP would 
be positively correlated with anxiety symptoms but not 
depression symptoms; (4) NA would be positively correlated 
with both anxiety and depression; and (5) PA would be 
negatively correlated with depression, but not anxiety.  In 
general, we expected that similar patterns of correlations 



ZENG, KUSHNER, & TACKETT 
 

40 

would be found in both self-reports and parent reports, but 
that correlations between the constructs would be higher for 
youth self-reports than for parent reports. 

 
Participants 

Participants were a community sample of 153 youth aged 
between 6 and 17 years.  Adult caregivers completed 
measures of mood and behavior for all participants.  Self-
reports were obtained from participants aged 11 and older.  In 
total, we collected 153 parent reports, 55 of which were 
paired with youth reports (for those children who were 11-17 
years old).  Participants were not pre-screened for clinical 
disorders (i.e., previous or current diagnoses of mood/anxiety 
disorders) in order to include a wide range of possible 
symptomatology and severity.  Exclusion criteria were lack of 
fluency in English and the presence of developmental 
disorders (such as autism and Down’s syndrome), which we 
assessed by asking the child’s parent during phone 
screenings.   
 
Measures  

Parents completed the 51-item Inventory of Children’s 
Individual Differences (ICID; Halverson et al., 2003).  The 
Positive Emotions subscale was used as a measure of PA, 
which includes items such as “is a joy to be with,” “is sweet,” 
and “is loving.” The ICID’s Negative Affect subscale was 
used to measure NA, which includes items such as “is 
irritable”, “is quick-tempered”, and “gets angry easily”. 

Parents also completed the Child Behavior Checklist 
(CBCL; Achenbach, 1991), a measure of their children’s 
observed social behaviors and competencies.  Anxiety 
symptoms were measured by the Anxious/Depressed scale, 
which included items such as, “Fears going to school”, 
“nervous, highstrung, or tense”, and “worries”.  Symptoms of 
depression were assessed by the CBCL Withdrawn/Depressed 
scale.  Items include descriptions such as, “there is very little 
he/she enjoys,” “underactive, slow moving, or lacks energy,” 
and “unhappy, sad, or depressed.” Finally, our measure of PH 
was approximated by the CBCL Somatic Problems (SP) 
scale.  This scale was used due to the measures being 
administered as part of a larger study which did not include a 
specific measure of PH.  The CBCL SP scale includes items 
such as “feels dizzy or lightheaded,” “overtired without good 
reason,” and “nausea, feels sick.” Although these items do not 
assess the autonomic arousal component of PH, it is parallel 
with the somatic tension associated with PH (i.e., items 
assessing nausea, dizziness, chronic aches).   

Children’s self-report consisted of ratings on the Youth 
Self-Report (YSR; Achenbach, 1991).  Items on the 
questionnaire are analagous to those on the CBCL, and 
participants completed the Anxious/Depressed scale, 
Withdrawn/Depressed scale, and the Somatic Problems scale. 
 
Procedure 

Youth and adult participants were recruited by phone 
from a database of families that had previously expressed 
interest in participating in psychological studies.  Some 

participants were also recruited by flyers posted in the 
metropolitan and Greater Toronto area, as well as 
advertisements in local newspapers.  Participants were mailed 
a package containing the questionnaires, and were asked to 
send them back in separate, sealed envelopes in order to 
ensure confidentiality.  Parents with children under the age of 
11 were asked to fill out a set of questionnaires about their 
child.  Parents with children over the age of 11 were asked if 
their child would be willing to fill out a set of questionnaires 
about themselves, and these parents were also asked to 
complete a corresponding set of questionnaires about their 
child.  The current investigation included data from families 
in which one primary caregiver had completed the CBCL & 
ICID and their child over the age of 11 had completed the 
YSR.  In 6-17 year old youth, we examined data from all 
parents who had completed the CBCL and ICID about their 
child.  Upon receipt of the completed questionnaires each 
participant was compensated with a small honorarium (e.g., 
$10 gift-certificate).   

 
Results 

 
Youth Self- and Parent-Report 

Results of correlational analyses (Pearson’s r) using 
SPSS statistical software of 55 parent and youth dyads (youth 
11 years and older) are depicted in Tables 1 and 2.  We 
compared parent-reported NA, PA, & SP to parent- and 
youth-reported anxiety and depression.  In both youth- and 
parent-reports, the tripartite constructs NA and PA were 
significantly negatively correlated, and SP was not 
significantly correlated with PA (p > .05).  Also in both 
youth- and parent-reports, SP was significantly positively 
correlated with Withdrawn/Depressed scores and 
Anxious/Depressed scores.  However, the youth self-reports 
indicated that anxiety was more highly correlated with SP 
than was depression.  Negative Affect was not associated 
with youth-reported Anxious/Depressed or 
Withdrawn/Depressed scores, while low PA was significantly 
correlated with parent- but not youth-reported 
Anxious/Depressed scores.   
 
 
Table 1 

  

 
Correlations between Tripartite Constructs on Parent & Youth Self-
Report Measures 
 

Tripartite Constructs 
Positive  
Affect  

(Parent) 

Negative  
Affect  

(Parent) 

Somatic Problems (Parent) -.260 .288* 

Somatic Problems (Youth) -.008 .103 

Positive Affect (Parent) 1 -.470** 

 
Note. N = 55. Data from youth 11 and older.  
*p < .05, two-tailed. **p < .01, two-tailed. 



TRIPARTITE MODEL OF ANXIETY AND DEPRESSION 
 

41 

 
 
 
Table 3 

  

 
Correlations between Tripartite Constructs on Parent 
Report Measures 
 

Tripartite Constructs PA (Parent) NA (Parent) 

SP (Parent) -.110 271** 

PA (Parent) 1 -.394** 

 
Note. N = 153. Data from youth aged 6-17. 
*p<.05, two tailed. **p<.01, two-tailed. 
 
 
Parent-Report Only 

Results of correlational analyses of 153 parent reports of 
their children aged 6-17 are depicted in Tables 3 and 4. 
Negative Affect was significantly negatively correlated with 
PA and significantly positively correlated with SP.  Negative 
Affect was also significantly positively correlated with both 
anxiety and depression.  Somatic Problems was significantly 
positively correlated with both anxiety and depression, and 
PA was significantly negatively correlated with depression.  
We observed PA to be negatively correlated with anxiety but 
it was not statistically significant (p > .05). 
 

Discussion 
 

The aim of this study was to examine the conflicting literature 
surrounding the function of the tripartite model in youth.  We 
investigated the application of the tripartite constructs in 
differentiating anxious and depressive symptoms in a non-

clinical child and adolescent sample.  We found that NA was 
significantly correlated with both anxious and depressive 
symptoms and the amount of variance it explained in both 
disorders was comparable.  This is consistent with previous 
findings of the relationship between NA and the two disorders 
(Anderson & Hope, 2008), lending further support to the 
proposition of the tripartite model that NA is an underlying, 
shared component of anxiety and depression (Clark & 
Watson, 1991).  However, SP was found to be associated with 
both anxiety and depression, which challenges the 
discriminant validity of SP (and possibly PH) in predicting 
anxiety, as proposed by the model.  Indeed, previous studies 
on the association between PH and internalizing disorders 
have been mixed (e.g., Chorpita & Daleiden, 2002; Jacques & 
Mash, 2004; Laurent et al., 2004)  
 Surprisingly, we found no significant correlations 
between NA and anxious or depressive symptoms reported by 
adolescents themselves.  This is contrary to the abundance of 
past literature demonstrating that negative affect strongly 
characterizes both anxiety and depression.  The current 
findings may be due in part to the cross-informant issue.  That 
is, for the older youth in the sample, ratings of NA were 
obtained from parents only, and these ratings were compared 
against the youth’s own ratings of depressive and anxious 
symptoms.   

It is possible that children’s negative affectivity may be 
less apparent to parents.  Negative Affect is characterized by  
more internal unpleasant engagement as opposed to the 
obvious, outward expressions of energy characteristic of PA 
(Clark & Watson, 1991), so parents may simply have less 
knowledge of their child’s feelings of sadness.  There is also 
evidence that children and adolescents’ ability to verbalize 
their emotions are not well developed, and thus tend to 
present negative emotions as somatic symptoms (Mahoney, 
Kennard, & Mayes, 2011). Furthermore, for older adolescents 
beginning to assert their independence, displays of NA 
towards their parents might not be evident in other domains 
of their lives.  In the current study, parents might have rated  

 
 
Table 4 

 
Correlations between Tripartite Constructs and Depressive 
and Anxious Symptoms on Parent and Youth Self-Report 
Measures 
 

Tripartite 
Constructs 

Depression 
(Parent) 

Anxiety 
(Parent) 

SP (Parent) .506** .498** 

PA (Parent) -.250** -.034 

NA (Parent) .308** .350** 

 
Note. N = 153. Data from youth aged 6-17. 
*p<.05, two tailed. **p<.01, two-tailed. 

Table 2 
 
Correlations between Tripartite Constructs and Depressive 
and Anxious Symptoms on Parent and Youth Self-Report 
 

Tripartite 
Constructs 

Depression 
(Parent & Youth) 

Anxiety  
(Parent & Youth) 

SP (Parent) P: .433** P: .412** 

SP (Youth) Y: .472** Y: .757** 

PA (Parent) P: -.480** P: -.081 

 Y: -.053 Y: .049 

NA (Parent) P:.380** P: .488** 

 Y: -.080 Y: .019 

 
Note. N = 55. Data from youth 11 and older.  
*p < .05, two-tailed, **p < .01, two-tailed. 



ZENG, KUSHNER, & TACKETT 
 

42 

their teenagers highly on NA based on their behavior 
displayed at home but may have little knowledge of their 
behavior in other settings.  These negative behaviors at home 
might not be representative of their genuine feelings, leading 
to the observed lack of correlation between NA and 
depression or anxiety.   

We found that PA was negatively correlated with 
depression in parent reports, but was not correlated with 
anxiety symptoms in both youth and parent reports.  These 
results are consistent with the prediction of the tripartite 
model that PA is a factor unique to depression (Clark & 
Watson, 1991).  Some studies, however, have reported the 
negative association between PA and anxiety symptoms (e.g., 
Jacques & Mash, 2004).  It has been suggested that the 
absence of positive emotions might be the most prominent in 
social phobia among anxiety disorders (Watson et al., 2005).  
The anxiety measure used in the current study (i.e., CBCL) 
does not include symptoms of social phobia, which may have 
obscured this negative association. 

The SP measure included in the current study captured 
the somatic tension component of the PH construct, and was 
found to be positively correlated with both measures of 
anxiety and depression in both parent and youth reports.  
These results suggest that somatic tension problems are not 
exclusive to anxiety, which invalidates predictions of the 
tripartite model.  Though we were unable to measure and 
distinguish between specific anxiety disorders in the current 
study, perhaps PH is more highly correlated with panic 
disorder in youth populations.  There is some evidence among 
adult outpatients that PH is positively correlated with panic 
symptoms, but not the other anxiety disorders (Brown, 
Chorpita & Barlow, 1998).  Clark & Watson (1991) noted 
that NA comprised a component of psychosomatic distress, 
and as our current measure of PH focused on somatic 
complaints and tension, the similarity in correlations between 
our measure of PH and anxiety/depression may be a reflection 
of negative affect-related somatization.  Therefore, this can 
help identify, at the symptom level, which components of PH 
(i.e., autonomic arousal vs.  chronic somatic tension) are more 
relevant to different types of anxiety disorders in the future.  
For example, autonomic arousal measures have been 
consistently shown to be more highly correlated with panic 
than any other anxiety disorder (Anderson & Hope, 2008), 
while generalized anxiety disorder reflects some similar 
somatic symptoms as depression (e.g., muscle tension, aches 
and pains; American Psychiatric Association, 2000). 

Interestingly, in the older youth sample, the positive 
correlation between SP and anxiety appeared to be larger than 
that between SP and depression (although we did not test if 
this difference was statistically significant).  However, this 
difference was not observed in the analyses that included the 
full age range of youth.  Perhaps in older adolescents, chronic 
aches and pains are more salient whereas younger children 
(for whom we only obtained parent report) are not able to 
adequately express or identify their physical complaints.  
Alternatively, perhaps somatic complaints simply become 

more relevant to anxiety disorders than they are to depression 
as children grow up.   
 
Future Directions and Limitations 

Based on the findings discussed above, we proposed 
several directions for future research.  It is important to 
address the validity of parent reports when investigating the 
affective components of the tripartite model, as they may not 
fully capture the child’s internal perspective.  It is also 
necessary to investigate the relevance of PH in differentiating 
anxiety and depression, as the construct did not seem to 
adequately distinguish the two in the current study.  Because 
we used SP to approximate PH, future studies should include 
more items measuring the autonomic arousal component in 
order to better represent Clark and Watson’s (1991) original 
conception of PH.  Although SP did not separate the two 
syndromes in our study, such physiological symptoms 
appeared to be more highly correlated with anxiety compared 
to depression in youth.  Future research can examine age 
differences in the utility of somatic complaints as a 
distinguishing feature of anxiety and depression, and how 
different classes of symptoms may characterize subtypes of 
anxiety disorder. 

In the current study, we utilized trait measures of positive 
affect and negative affect, as opposed to the more commonly 
used state measures, and found trait affectivity to be as 
effective as state affectivity in predicting anxiety and 
depression.  McCrae and John (1992) proposed that NA is 
related to Big Five personality traits such as neuroticism and 
PA is related to extraversion.  Our results appear to support 
the connection of affect and personality in relation to anxiety 
and depression.  Some researchers have suggested a 
temperamental basis for both personality and 
psychopathology, with temperamental domains of negative 
affectivity and positive affectivity (Clark, 2005).  Future 
studies can examine the relationships between affective 
dimensions in personality and anxiety/depression, and a 
closer exploration of trait versus state affectivity will enhance 
our understanding of how each functions in the two disorders.  
Our study was limited by the fact that the sample was drawn 
from a community sample, and the nature of clinically 
significant anxiety and depression may be 
phenomenologically different from subclinical symptoms.  
Further replication in a clinical population would be 
beneficial to advancing our understanding of the difference 
between clinical and subclinical anxiety and depression in 
terms of whether they differ in severity or presentation of 
symptoms. 

Despite the methodological constraints, our study has 
shown that anxiety and depression are both characterized by 
NA, and PA distinguishes the two groups of symptoms – 
findings which are consistent with predictions of the tripartite 
model.  Our results, however, do not support the model 
prediction that PH is uniquely assoicated with anxiety.  Our 
results support the utility of the tripartite model in 
understanding anxiety and depression in children and 



TRIPARTITE MODEL OF ANXIETY AND DEPRESSION 
 

43 

adolescents, and also provide direction for further 
validation/modification of the model. 

Finally, the tripartite model is a dimensional model of 
psychopathology that corresponds to the current shift towards 
an integration of categorical and dimensional models in 
DSM-5.  For example, Watson (2005) has proposed 
empirically based structures of psychopathology that reflect 
similarities among disorders instead of separating them into 
different categories.  Watson posits that disorders with a 
primary distress component such as major depression and 
generalized anxiety belong in one class, while panic disorder 
and social phobia cluster in a separate class, therefore 
dividing anxiety disorders (i.e., panic and GAD) which had 
been traditionally conceptualized within one category.  
Alternatively, Lahey et al. (2004) found that social phobia in 
children clustered with the distress disorders.  This again 
demonstrates the need for further investigation into 
dimensional models of youth psychopathology or, as we have 
attempted to do with the tripartite model, further extensions 
of adult models to children.   

Given the shift toward dimensional diagnoses of adult 
psychopathology, it is important to define highly comorbid 
disorders such as anxiety and depression (and their respective 
subtypes) in terms of the factors which they share and do not 
share.  The tripartite model represents one such way of 
addressing the issues of comorbidity between anxiety and 
depression by positing a shared underlying component (NA) 
and unique constructs (PA, PH) instead of splitting the two 
syndromes.  The current study highlighted the importance of 
further illuminating the dimensional nature of anxiety and 
depression in youth populations in order to advance tools for 
assessment and treatment, as well as our overall 
understanding of the two syndromes. 

 
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