title: Anxiety, depression and hopelessness in adolescents: a structural equation model.
abstract: OBJECTIVE
  This study tested a structural model, examining the relationship between a latent variable termed demoralization and measured variables (anxiety, depression and hopelessness) in a community sample of Canadian youth.
  
  
  METHODS
  The combined sample consisted of data collected from four independent studies from 2001 to 2005. Nine hundred and seventy one (n=971) participants were high school students (grades 10-12) from three geographic locations: Calgary, Saskatchewan and Lethbridge. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory-Revised (BDI-II), Beck Hopelessness Scale (BHS), and demographic survey. Structural equation modeling was used for statistical analysis.
  
  
  RESULTS
  The analysis revealed that the final model, including depression, anxiety and hopelessness and one latent variable demoralization, fit the data (chi-square value, X(2) (2) = 7.25, p< .001, goodness of fit indices (CFI=0.99, NFI=0.98) and standardized error (0.05). Overall, the findings suggest that close relationships exist among depression, anxiety, hopelessness and demoralization that is stable across demographic variables. Further, the model explains the relationship between sub-clinical anxiety, depression and hopelessness.
  
  
  CONCLUSIONS
  These findings contribute to a theoretical framework, which has implications for educational and clinical intervention. The present findings will help guide further preventative research on examining demoralization as a precursor to sub-clinical anxiety and depression.
authors.affiliation: Foothills Medical Centre, Calgary, Alberta. shaylyn.cunningham@calgaryhealthregion.ca
authors.forename: Shaylyn
authors.initials: S
authors.lastname: Cunningham
authors.forename: Thelma
authors.initials: T
authors.lastname: Gunn
authors.forename: Assen
authors.initials: A
authors.lastname: Alladin
authors.forename: David
authors.initials: D
authors.lastname: Cawthorpe