Cover image of the article: Vulnerability factors of generalized anxiety disorder based on triple vulnerability model

Image Credit:Koomesh

Vulnerability factors of generalized anxiety disorder based on triple vulnerability model

Authors

hamid Poursharifi, Jalil Babapour, hossein karsazi,*
*Corresponding Author: Email: hosseinkarsazi@gmail.com

Koomesh:Vol. 18, issue 1; 51-61
Published online:Sep 28, 2016
Article type:Research Article
Received:Dec 01, 2015
Accepted:May 01, 2016
How to Cite:Poursharifi H, Babapour J, karsazi H. Vulnerability factors of generalized anxiety disorder based on triple vulnerability model. koomesh. 2016;18(1):e151145. doi:

Abstract

Introduction: Triple vulnerability model focuses on the interaction of three types of vulnerabilities in development and maintenance of emotional disorders. Despite the prominence of this model, there is not enough research done to assess its experimental validity. The aim of this study was to evaluate vulnerability factors of generalized anxiety disorder based on triple vulnerability model. Materials and Methods: For this purpose, 320 students from Tabriz University (Iran) were selected by cluster sampling and responses to NEO Five-Factor Inventory, Anxiety Control Questionnaire-revised, Intolerance of Uncertainty Scale and Generalized Anxiety Disorders Questionnaire-IV. Analysis was performed using structural equation modeling. Results: Evaluation of hypothetical model using fit indices showed that the hypothetical model fitted with the measurement model. The results showed that neuroticism and extroversion have significant effect on generalized anxiety disorder by mediation of lack of perceived control and intolerance of uncertainty. In addition, hypothetical model was a better fit in compare to the alternative models. Conclusion: our result, along with the support of triple vulnerability model for generalized anxiety disorder, proposes a suitable framework for the etiology of this disorder

Highlights

References

  • 1.
    Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety 2002; 16: 162-171.
  • 2.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5nd Ed.Washington, DC: Author; 2013.
  • 3.
    Barlow DH. Anxiety and its disorders: The nature and treatment of anxiety and panic. 2nd Ed. New York: Guilford Press; 2002.
  • 4.
    Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Life time prevalence and age of onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005; 62: 593-602.
  • 5.
    Clark LA, Watson D, Mineka S. Temperament, personality, and the mood andanxiety disorders. J Abnorm Psychol 1994; 103:103-116.
  • 6.
    Smoller JW, Rosenbaum J, Biederman JK, Dai D, Racette SR, Laird NM, et al. Association of a genetic marker at the corticotrophin-releasing hormone locus with behavioral inhibition. Biol Psychiatry 2003; 54: 1376-1381.
  • 7.
    Bienvenu OJ, Hettema JM, Neale MC, Prescott CA, Kendler KS. Low extraversion and high neuroticism as indices of genetic and environmental risk for social phobia, agoraphobia, and animal phobia. Am J Psychiatry 2007; 164: 1714-1721.
  • 8.
    Hettema JM, Neale MC, Myers JM, Prescott CA, Kendler KS. A population based twin study of the relationship between neuroticism and internalizing disorders. Am J Psychiatry 2006; 163: 857-864.
  • 9.
    Gershuny BS, Sher KJ. The relation between personality and anxiety: Findings from a 3-year prospective study. J Abnorm Psychol 1998; 107: 252-262.
  • 10.
    Hettema, JM, Prescott CA, Myers JM, Neale MC, Kendler KS. The structure of genetic and environmental risk factors for anxiety disorders in men and women. Arch Gen Psychiatry 2005; 62: 182-189.
  • 11.
    Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, et al. Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science 2003; 301: 386-389.
  • 12.
    Chorpita BF, Barlow DH. The development of anxiety: The role of control in the early environment. Psychol Bull 1998; 124: 3-21.
  • 13.
    Treat AT, Bootzin RR, Baker TB. Psychological clinical science. New York: Psychology Press; 2007.
  • 14.
    Genetes EL, Ruscio AM. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive compulsive disorder. Clin Psychol Rev 2011; 31: 923-933.
  • 15.
    Kline RB. Principles and practice of structural equation modeling. 3nd Ed. New York: Guilford; 2011.
  • 16.
    Furukawa T, Hori S, Yoshida S, Tsuji M, Nakanishi M, hamanaka T. Premorbid personality traits of patients with organic, schizophrenic, mood, and neurotic disorders according to the five-factor model of personality. Psychiatry Res 1998; 78: 179-187.
  • 17.
    Brown TA, White KS, Forsyth JP, Barlow DH. The structure of perceive emotional control: Psychometric properties of a revised anxiety control questionnaire. Behav Ther 2004; 35: 75-99.
  • 18.
    Buhr K, Dugas MJ. The intolerance of uncertainty scale: psychometric properties of the English version. Behav Res Ther 2002; 40: 931-945.
  • 19.
    Newman MG, Zuellig AR, Kachin KE, Constantino MJ, Przeworski A, Erickson T, et al. Preliminary reliability and validity of the GAD-Q-IV: A revised self-report diagnostic measure of generalized anxiety disorder. Behav Ther 2002; 33: 215-233.
  • 20.
    Abdi R , Bakhshipour Roodsari A , Mahmood Alilou M , Farnam A , Efficacy evaluation of unified transdiagnostic treatment in Patients with generalized anxiety disorder. J Res Behave Sci 2014; 11: 245-251. (Persian).
  • 21.
    Anderson JC, Gerbing DW. Structural equation modeling in practice: A review and recommended two-step approach. Psychol Bull 1988; 103: 411-423.
  • 22.
    Flora DB, Curran PJ. An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods 2004; 9: 466-491.
  • 23.
    Hu L, Bentler PM. Fit indices in covariance structure analysis: Sensitivity to underparameterized model misspecification. Psychol Methods 1998; 3: 424-453.
  • 24.
    Yu C. Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcome. Doctoral Dissertation: University of California; 2002.
  • 25.
    Chou CP, Bentler PM. Estimates and tests in structural equation modeling. In: RH. Hoyle, Structural equation modeling: Concepts, issues and applications. California: Sage. 1995.
  • 26.
    Bentler P. Kurtosis, residuals, fit indices. Message posted to SEMNET discussion list. 1998, March 10. Available from http://bama.ua.edu/archives/semnet.html.
  • 27.
    Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40: 879-891.
  • 28.
    Nelson BD, ShankmanSA. Does intolerance of uncertainty predict anticipatory startle responses to uncertain threat? Int J Psychophysiol 2011; 81: 107-115.
  • 29.
    Kenny DA, Kaniskan B, McCoach, DB. The performance of RMSEA in models with small degrees of freedom. Sociol Methods Res 2015; 44: 486-507.
  • 30.
    Mineka S, Zinbarg R. A contemporary learning theory perspective on the etiological of anxiety disorders. Am Psychol 2006; 61: 10-26.
  • 31.
    Barefoot JC, Beckham JC. Peterson BL, HaneyTL, Williams RB Jr. Measures of neuroticism and disease status in coronary angiography patients. J Consult Clin Psychol 1992; 60: 127-132.
  • 32.
    Horner KL. Locus of control, neuroticism, and stressors: Combined influences on reported physical illness. Pers Individ Dif 1996; 21: 195-204.
  • 33.
    Rapee RM, Craske MG, Brown TA, Barlow DH. Measurement of perceived control over anxiety-related events. Behav Ther 1996; 27: 279-293.
  • 34.
    Heckhausen J, Schulz R. A life span theory of control. Psychol Rev 1995; 102: 284-304.
  • 35.
    Boswell JF, Thompson-Hollands J, Farchione TJ, Barlow DH. Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol 2013; 69: 1-16.
  • 36.
    Elliot AJ, Thrash TM. Approachavoidance motivation in personality: Approach and avoidance temperaments and goals. J Pers Soc Psychol 2002; 82: 804-818.
  • 37.
    Sellbom M, Ben-Porath YS, Bagby RM. On the hierarchical structure of moo and anxiety disorders: confirmatory evidence and an elaborated model of temperament markers. J Abnorm Psychol 2008; 117: 576-590.##.

Copyright

© 2016, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.

Similar Articles

27
Dec
2019
Comparison of modular cognitive-behavioral therapy and behavioral activation on the intolerance of uncertainty in students with generalized anxiety disorder

Comparison of modular cognitive-behavioral therapy and behavioral activation on the intolerance of uncertainty in students with generalized anxiety disorder

Elahe Beheshtian,
Hasan Toozandehjani,
Mohammad Reza Saffarian Tousi

Beheshtian E, Toozandehjani H, Saffarian Tousi MR. Comparison of modular cognitive-behavioral therapy and behavioral activation on the intolerance of uncertainty in students with generalized anxiety disorder. J Nurs Midwifery Sci. 2020;7(1):e140807. doi: https://doi.org/10.4103/jnms.jnms_29_19

4
Jan
2026
Developing a Pathological Model of Social Anxiety Based on Attachment Styles, Mentalization Capacity, and Ego Strength Among Adolescents in Qazvin: A Path Analysis Approach

Developing a Pathological Model of Social Anxiety Based on Attachment Styles, Mentalization Capacity, and Ego Strength Among Adolescents in Qazvin: A Path Analysis Approach

Mahmoud Bahramkhani,
Masoumeh Isazadeh

Bahramkhani M, Isazadeh M. Developing a Pathological Model of Social Anxiety Based on Attachment Styles, Mentalization Capacity, and Ego Strength Among Adolescents in Qazvin: A Path Analysis Approach. Iran J Psychiatry Behav Sci. 2026;20(1):e162436. doi: https://doi.org/10.5812/ijpbs-162436

31
May
2019
The mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias

The mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias

Alireza Sangani,
Paria Jangi,
Nahid Ramak,
Aniseh Ahmadi

Sangani A, Jangi P, Ramak N, Ahmadi A. The mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias. J Nurs Midwifery Sci. 2019;6(2):e141129. doi: https://doi.org/10.4103/jnms.jnms_7_19

28
Oct
2012
Predicting Obsessive-Compulsive Disorder on the Basis of Emotion Regulation and Anxiety Sensitivity

Predicting Obsessive-Compulsive Disorder on the Basis of Emotion Regulation and Anxiety Sensitivity

Abdollah Ghasempour,
Ebrahim Akbari,
Zeinab Azimi,
Reza Ilbeygi,
Shahnaz Hassanzadeh

Ghasempour A, Akbari E, Azimi Z, Ilbeygi R, Hassanzadeh S. Predicting Obsessive-Compulsive Disorder on the Basis of Emotion Regulation and Anxiety Sensitivity. Zahedan J Res Med Sci. 2013;15(2):e93122. doi:

17
Oct
2016
The Mediating Role of Repetitive Negative Thinking in Relationship Between Negative Perfectionism and Severity of Anxiety Symptoms

The Mediating Role of Repetitive Negative Thinking in Relationship Between Negative Perfectionism and Severity of Anxiety Symptoms

Reza Abdi,
Gholamreza Chalabianloo,
Afsaneh Joorbonyan

Abdi R, Chalabianloo G, Joorbonyan A. The Mediating Role of Repetitive Negative Thinking in Relationship Between Negative Perfectionism and Severity of Anxiety Symptoms. Iran J Psychiatry Behav Sci. 2016;10(4):e5308. doi: https://doi.org/10.17795/ijpbs-5308

More by these authors

hamid PoursharifiPubMedScholar
Jalil BabapourPubMedScholar
hossein karsaziPubMedScholar
Share
Cited by
Metrics