title: Perceived and physiological arousal during a stress task: can they differentiate between anxiety and depression?
abstract: BACKGROUND
  Anxiety and depression might be two different valid constructs that often co-occur, or they could be different manifestations of the same underlying vulnerability. A theoretical framework to address this question is the tripartite model, by Clark and Watson, which hypothesizes that physiological hyperarousal (PH) is specific for anxiety. Knowledge about the relationship between PH, psychophysiological measures, perceived arousal, and anxiety would increase our understanding of the validity of the PH construct in this model. Our objective was to assess whether (a) hypothalamic-pituitary-adrenocortical (HPA) axis functioning, and (b) perceived arousal before, during and after stress can differentiate anxious from depressive children.
  
  
  METHODS
  In a general population sample of 225 children aged 8-12 years, self-reported anxiety and depressive symptoms were assessed using the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI). Perceived arousal was assessed using a self-report questionnaire before, during and after a stress task. Basal and reactive HPA-axis functioning were used as indices for psychophysiological arousal.
  
  
  RESULTS
  Our data showed that the relation between perceived arousal and anxiety problems is stronger than the relation with depressive problems. Reactive HPA-axis functioning is reduced in children with depressive problems.
  
  
  CONCLUSIONS
  Some evidence was found in support of the tripartite model. Our findings indicate that perceived arousal to a challenge might be a useful tool to assess the PH component of the tripartite model. Reactive HPA-axis functioning might be able to differentiate between anxiety and depressive problems in children in a general population sample, but effect sizes are small and replication is needed.
authors.affiliation: Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Department of Child & Adolescent Psychiatry, Rotterdam, The Netherlands. g.dieleman@erasmusmc.nl
authors.forename: Gwendolyn C
authors.initials: GC
authors.lastname: Dieleman
authors.forename: Jan
authors.initials: J
authors.lastname: van der Ende
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Anja C
authors.initials: AC
authors.lastname: Huizink
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001007:Anxiety / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D001143:Arousal / Q000502:physiology*; D002648:Child; D003863:Depression / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism; D016014:Linear Models; D008297:Male; D008962:Models, Theoretical; D010465:Perception / Q000502:physiology*; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
chemical_list: D006854:Hydrocortisone