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. 2006 Jan 6;14(2):69–81. doi: 10.1002/mpr.18

Endorsement frequencies and factor structure of DSM‐III‐R and DSM‐IV Generalized Anxiety Disorder symptoms in women: implications for future research, classification, clinical practice and comorbidity

Thomas S Kubarych 1,✉, Steven H Aggen 1, John M Hettema 1, Kenneth S Kendler 1,2, Michael C Neale 1,2
PMCID: PMC6878469  PMID: 16175876

Abstract

We investigated dimensions of liability to Generalized Anxiety Disorder (GAD) and whether evidence exists for distinct pathological versus normal clusters in the population. Structured interviews were administered to a general population sample of 2,163 female twins in a cross‐sectional design. Endorsement rates were estimated using full information maximum likelihood factor analyses of the DSM‐III‐R and DSM‐IV GAD symptoms, which provides appropriate treatment of the stem‐probe structure of the clinical interview.

Endorsement rates were highest for symptoms retained in DSM‐IV. For both DSM‐III‐R and DSM‐IV, a two‐factor model fit the data better than a single‐factor model. There was no evidence for non‐normality in the liability to GAD. For DSM‐III‐R, autonomic symptoms loaded on a factor with panic disorder, while fatiguability, difficulty concentrating and hypervigilance loaded on a factor with major depression. For DSM‐IV, all items loaded on one factor, and muscle tension also loaded on a second. Major depression, panic, phobias and alcohol dependence diagnoses also loaded on the first factor. Conclusions: future research involving structured interviews should take into account the stem‐and‐probe format and focus on common factors rather than separate disorders; GAD is not a unidimensional construct and pathological anxiety may differ only quantitatively from normal anxiety. Copyright © 2005 Whurr Publishers Ltd.

Keywords: Generalized Anxiety Disorder, factor analysis, missing data, structured interview, discriminant validity

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