A comparison of one, two and three-factor models of depression and anxiety in a community-based sample of African Americans
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Given the frequent co-occurrence of symptoms of depression and anxiety, their debilitating course, problems with differential diagnosis, and related problems with accurate diagnosis in African Americans, additional work is required to examine the adequacy of current models of co-morbidity and classification for African Americans. Given the importance of race-related stressors for the well-being of many African Americans, it is also important to examine the impact of race-related stressors on the occurrence and co-occurrence of anxious and depressive symptoms among African Americans. Examination of the differential association of symptom clusters with race-related stressors will provide potential insights about the utility of different facets of structural models of anxiety and depression in capturing response to salient environmental causes. Our sample consisted of 245 African American adults between the ages of 18 and 60-years-old from low-income communities. Participants completed a demographics form, a self-report measure of race-related stress, and self-report measures of depressive and anxious symptoms. Results of the study indicated that a modified two-factor solution using the Beck Depression Inventory-II and Beck Anxiety Inventory to assess symptoms of depression and anxiety showed better fit to the data than a one (i.e., general distress) or a three (i.e., tripartite) factor model. Furthermore, we found differential association between the three different dimensions of race-related stress on the two identified factors. Specifically, we found that the institutional racism dimension was associated only with the anxiety factor, while the individual racism dimension was associated only with the depression factor. The cultural racism dimension was not significantly associated with either factor. Future directions and implications for research are discussed.