Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors.

ABSTRACT

BACKGROUND: Dependent (self-generated) stress is a strong risk factor for depression and anxiety, but perceptions of stress can alter its impact. Appraisals of dependent stress controllability and severity additionally relate to depression and anxiety over and above stress exposure. Due to the high comorbidity of depression and anxiety, it is unclear whether dependent stress frequency and appraisals relate specifically to depression or anxiety or are transdiagnostically associated shared aspects of internalizing disorders. Consistent with the tripartite model, the current study represented internalizing symptoms with three latent factors - depression-specific, anxiety-specific, and common internalizing - and tested how dependent stress frequency and appraisals of controllability and severity were associated with these factors. METHODS: Bifactor modeling was used to create the latent internalizing factors in a treatment-seeking sample of emerging adults (n = 356). Structural equation models tested dependent stress frequency and appraisals of controllability and severity as predictors of these latent factors. RESULTS: Dependent stress frequency was associated with common internalizing while perceived controllability was associated uniquely with depression-specific variance. Continuous stress severity was not associated with latent factors, but high-severity stressors were associated with anxiety-specific variance. LIMITATIONS: Without longitudinal data conclusions regarding temporal directionality cannot be made. Participants' appraisals of stressors could not be compared to expert ratings. CONCLUSIONS: Dependent stress frequency, controllability appraisals, and high-severity stressful events have distinct links with different dimensions of internalizing psychopathology. This suggests there may be several distinct mediating mechanisms between stress constructs and psychopathology, which have potential to serve as targets for intervention.