Journal of Abnormal Psychology
1988, Vol. 97, No. 3, 346-333
Copyright 1988 by the American Psychological Association. Inc.
Positive and Negative Affectivity and Their Relation
to Anxiety and Depressive Disorders
David Watson and Lee Anna Clark
Southern Methodist University
Institute for Behavioral Genetics, University of Colorado
Distinguishing between depression and anxiety has been a matter of concern and controversy for
some time. Studies in normal samples have suggested, however, that assessment of two broad mood
factors—Negative Aflect (NA) and Positive Affect (PA)—may improve their differentiation. The
present study extends these findings to a clinical sample. As part of an ongoing twin study, 90 inpa-
tient probands and 60 cotwins were interviewed with the anxiety and depression sections of the
Diagnostic Interview Schedule (DIS; Robins, Helzer, Croughan, & Ratcliff, 1981). Respondents also
completed trait NA and PA scales. Consistent with previous research, NA was broadly correlated
with symptoms and diagnoses of both anxiety and depression, and acted as a general predictor of
psychiatric disorder. In contrast, PA was consistently related (negatively) only to symptoms and
diagnoses of depression, indicating that the loss of pleasurable engagement is a distinctive feature of
depression. The results suggest that strengthening the PA component in depression measures may
enhance their discriminative power.
Oinicians have long been concerned by the conceptual and
empirical overlap between anxiety and depression, and have re-
cently devoted considerable attention to their differentiation
(e.g., Akiskal, 1985; Breier, Charney, & Heninger. 1985). Al-
though the association is strong enough to suggest to some re-
searchers that they are variants of a single disorder, most clini-
cians and researchers in the area continue to believe that the
basic distinction is valid (e.g., Akiskal, 1985;Foa&Foa, 1982).
A complete discussion of this literature is beyond the scope of
our article, but we will present evidence illustrating the magni-
tude of the problem.
Numerous studies have demonstrated that self-report anxiety
and depression scales are highly correlated, typically in the
range of .40 to .70. This finding is, moreover, both robust and
general: Such correlations have been reported in college stu-
dents (Dobson, 1985; Gotlib, 1984;Nezu,Nezu,&Nezu, 1986;
Tanaka-Matsumi & Kameoka, 1986), children (Blumberg &
Izard, 1986; Wolfe et al., 1987), normal adults (Orme, Reis, &
Herz, 1986), and diverse patient samples (Bouman & Luteijn,
1986; Mendels, Weinstein, & Cochrane, 1972; Zurawski &
Smith, 1987). The correlations are often high enough to suggest
that they tap a single construct. In fact, different measures of
anxiety and depression are as highly correlated with each other
This research was supported in part by National Institute of Mental
Health Grant MH14677.
We are deeply indebted to Irving I. Gottesman, Codirector of the
Washington University Twin Series, for his help in securing the data
used in this study.
Correspondence concerning this article should be addressed to David
Watson, Department of Psychology, Southern Methodist University,
Dallas, Texas 75275.
as they are among themselves, and thus often load on a single,
undifferentiated factor, together with measures of hostility and
anger, neuroticism, physical complaints, repression-sensitiza-
tion, irrational beliefs, and (on the opposite pole) with ego
strength and social desirability (e.g., Dobson, 1985; Gotlib,
1984; Mendels et al., 1972; Tanaka-Matsumi & Kameoka,
1986). Many investigators have concluded that all of these mea-
sures tap a common, underlying construct of Negative Affectiv-
ity, Neuroticism, or General Psychological Distress (Eysenck,
1970; Gotlib, 1984; Watson & Clark, 1984; Zurawski & Smith,
These findings obviously cause interpretive problems for re-
search involving self-report scales and suggest that they offer
little help in differential diagnosis. Indeed, "anxiety" scales
have been found to correlate as highly with clinical ratings of
depression as they do with anxiety; and conversely, "depres-
sion" scales are as strongly correlated with clinically rated anxi-
ety as depression (e.g., Deluty, Deluty, & Carver, 1986; Zucker-
man, Persky, Eckman, & Hopkins, 1967). It would be a mistake,
however, to conclude that these data simply reflect the limita-
tions of self-report. Clinicians' and teachers' ratings of anxiety
and depression are also strongly correlated (Deluty et al., 1986;
Foa et al., 1983; Lipman, Rickels, Covi, Derogatis, & Uhlen-
huth, 1969; Wolfe etal., 1987;Zuckermanetal., 1967), anxious
and depressive symptoms co-occur in many patients (Dero-
gatis, Klerman, & Lipman, 1972; Roth, Guraey, Garside, &
Kerr, 1972), and comorbidity of the full clinical syndromes oc-
curs in about half of all patients with anxiety or depressive diag-
noses (e.g., Breier, Charney, & Heninger, 1986; Woodruff, Guze,
& Clayton, 1972; for reviews, see Breier et al., 1985; Clark, in
press; Gersh & Fowles, 1979).
Taken together, these data demonstrate a substantial degree
POSITIVE AND NEGATIVE AFFECTIVITY
of overlap between anxiety and depression, regardless of the
level considered. However, the data by no means imply that a
distinction between anxiety and depression cannot be made.
Correlations in the .40 to .70 range leave much variance unac-
counted for, and half of all patients with anxiety or depressive
disorders show relatively pure syndromes. Furthermore, one
can point to distinct subgroups of patients within each class,
and to subjective and physiological correlates that are unique
to each type of disorder (e.g., the disturbance of rapid eye move-
ment [REM] sleep in depression, but not anxiety; see Akiskal,
1985; Kupfer et al., 1983). Even proponents of differentiability,
however, recognize the aforementioned problems, and agree on
the need for ftirther research to identify factors that will im-
prove their distinction.
In this article we will report on one such factor. Specifically,
we will relate symptoms and diagnoses of anxiety and depres-
sion to two general mood-based personality factors, Positive
Affectivity and Negative Affectivity. We will show that Positive
Affectivity—but not Negative Affectivity—can be clinically
useful in distinguishing these two classes of disorder.
Positive and Negative Affect
Extensive evidence demonstrates that two broad mood fac-
tors—Positive Affect and Negative Affect—are the dominant
dimensions in self-reported mood (Watson, Clark, & Tellegen,
1984; Watson & Tellegen, 1985). Although their names might
suggest that they are opposite poles of the same dimension, Pos-
itive and Negative Affect are in fact highly distinctive dimen-
sions that can be meaningfully represented as orthogonal (un-
correlated) factors. Both mood factors can be measured either
as a state (i.e., transient fluctuations in mood) or as a trait (i.e.,
stable individual differences in general affective tone). Our arti-
cle will focus on the traits, which Tellegen (1982) has termed
Negative Affectivity (NA) and Positive Affectivity (PA).
Negative Affect is a general factor of subjective distress, and
subsumes a broad range of negative mood states, including fear,
anxiety, hostility, scorn, and disgust. Mood states related to de-
pression such as sadness and loneliness also have substantial
loadings on this factor. At the trait level, NA is a broad and
pervasive predisposition to experience negative emotions that
has further influences on cognition, self-concept, and world
view (Watson & Clark, 1984). In contrast, PA is a dimension
reflecting one's level of pleasurable engagement with the envi-
ronment. High PA is composed of terms reflecting one's enthu-
siasm, energy level, mental alertness, interest, joy, and determi-
nation, whereas low PA is best denned by descriptors reflecting
lethargy and fatigue. It is noteworthy that states of sadness and
loneliness also have relatively strong loadings on the low end of
this factor (Watson & Tellegen, 1985). Trait PA is a correspond-
ing predisposition conducive to positive emotional experience;
it reflects a generalized sense of well-being and competence, and
of effective interpersonal engagement.
Putting these data together, we have the following pattern:
Anxiety is essentially a state of high NA, and has no significant
relation with PA, but depression is a mixed state of high NA
and low PA. Tellegen (1985) specifically tested this model by
factor analyzing measures of anxiety, depression, NA, and PA.
The results were generally consistent with the model. As ex-
pected, the NA and PA scales each defined a factor. The anxiety
and depression scales had significant loadings on both factors;
however, the anxiety scale loaded more strongly on the NA fac-
tor, whereas the depression scale was a much better marker of
low PA. Similarly, Blumberg and Izard (1986) used self-report
mood scales to predict scores on measures of depression and
anxiety. Several of the negative emotion scales (most notably
Sadness and Fear) contributed to the prediction of both mea-
sures, but the positive emotion scales (Joy and Interest) added
significantly only to the prediction of depression. The mood
data therefore suggest that PA may be an important factor in
differentiating anxiety from depression (Tellegen, 1985; Watson
& Tellegen, 1985).
These studies, however, were conducted with normal subjects
and did not involve trait measures. Two studies have reported
supportive results using clinical samples. First, Hall (1977) ob-
tained diagnostic data and clinicians'ratings of anxiety and de-
pression on a sample of 108 male outpatients. She found ratings
and diagnoses of anxiety to be significantly correlated with NA,
but not PA, whereas ratings and diagnoses of depression were
more highly related to (low) PA than NA. Second, Bouman and
Luteijn (1986) examined three groups of patients: (a) major de-
pressives, (b) dysthymics, and (c) nondepressives. Scores on a
number of mood and personality scales were factor analyzed,
and two factors were extracted and interpreted as NA and PA.
Consistent with the model outlined earlier, the major depres-
sives had significantly lower PA scores than the dysphoric pa-
tients, who were, in turn, lower on PA than the nondepressed
group. The latter data do not permit any comparison between
anxiety and depression, however.
Our study provides the most comprehensive test of the model
to date. We examined the relation of trait PA and NA scores to
symptoms and diagnoses of depression and anxiety in a clinical
patient population. On the basis of the data we have reviewed,
we predicted that NA scores would be significantly correlated
with both anxiety and depression, whereas PA scores would be
associated only with the latter.
Subjects were twins and their cotwins contacted as part of the Wash-
ington University Twin Series, a large-scale study of the heritability of
psychiatric disorders. Most (90%) of the proband twins were admitted
to in- and outpatient psychiatric units staffed by personnel from the
Washington University School of Medicine Department of Psychiatry;
an additional 10% were ascertained through private treatment facilities
for substance abuse not affiliated with Washington University. Cooper-
ating probands and their cotwins were administered a battery of inter-
views, and were then given several self-report measures to complete.
In many cases these were returned by mail, and on the average were
completed within 3 weeks of the interview. AD probands (« - 90) who
completed both the interviews and self-report measures by July 1984
were included in our analyses. Of the cotwins, we included only those
(n = 60) who also received either a computer-generated Diagnostic In-
terview Schedule diagnosis for an anxiety or depressive disorder, or a
Diagnostic and Statistical Manual of Mental Disorders (3rd edition;
DSM-1II: American Psychiatric Association, 1980) diagnosis for any
disorder by a consensus of the research staff. Thus, the final sample
D. WATSON, L. CLARK, AND G. CAREY
consisted of 150 patients with a mean age of 46.6 (SD =13.1). Of these,
84 (56%) were female.
Trait NA and PA scales. Trait NA and PA were assessed using scales
from the Multidimensional Personality Questionnaire (MPQ; Tellegen,
in press, formerly called the Differential Personality Questionnaire), a
300-item general true-false inventory designed to measure normal-
range personality. For Trait NA, we used the 14-item Negative Emotion-
ality (NEM) Scale, which is particularly well-suited for our purposes in
that it focuses specifically on the experience of negative affect and does
not directly assess psychiatric problems and complaints. Thus, its corre-
lations with psychiatric symptoms and diagnoses do not simply reflect
content overlap. High NEM scorers describe themselves as nervous,
worrying, irritable, overly sensitive, and emotionally labile. For exam-
ple, high NEM scorers report that they often are irritated by small an-
noyances, and that their feelings are easily hurt. NEM is internally con-
sistent (coefficient alpha = .82, n = 872) and stable over time (12-week
retestr=.72,n = 109; Watson &Pennebaker, in press). The mean NEM
score in this sample was 8.2 (SD = 4.3), significantly higher than that
found in a normal adult sample (M = 6.5, SD = 3.8), J(311) = 3.6, p <
.01 (Watson & Pennebaker, 1988).
Trait PA was assessed by using the 11-item Positive Emotionality
(PEM) Scale. High PEM scorers describe themselves as happy and en-
thusiastic, as having a lot of energy, and as leading an interesting and
exciting life. For example, high PEM scorers report that they often feel
happy and content for no special reason, and that they do some fun
things nearly every day. PEM is also homogeneous (coefficient alpha =
.80) and stable (12-week retest r = .77; Watson & Pennebaker, in press).
The mean PEM score in this sample was 6.5 (SD = 3.2), significantly
lower than that reported for normal adults (M = 8.4, SD = 2.5),
/(3ll) = 5.7,p<.OI (Watson & Pennebaker, 1988).
Across several samples, we have found NEM and PEM to be reason-
ably independent of one another, with an average correlation of approxi-
mately -.30 (Watson, 1988; Watson & Pennebaker, in press). In the
current sample they have a correlation of —.37. NEM and PEM also
show good convergent and discriminant validity when related to mood
scales and other variables (e.g., Watson, 1988; Watson & Pennebaker, in
Diagnostic interview schedule. The interview schedule used for the
assessment of anxiety and depression was based on Version 3.0 of the
Diagnostic Interview Schedule (DIS; Robins, Helzer, Croughan, & Rat-
cliff, 1981) and was administered by trained psychiatrists, psychologists,
or research technicians. Although we do not have data regarding the
reliability of the DIS with these raters, the interview itself has been
shown to be highly reliable (Hesselbrock, Stabenau, Hesselbrock, Mir-
kin, & Meyer, 1982). As for its validity, the results have been mixed, but
studies have generally supported its use as a diagnostic measure, even
with lay interviewers (Anthony et al., 1985; Helzer et al., 1985; Robins
et al., 1981; Wittchen, Semler, & von Zerssen, 1985. For a general dis-
cussion of the DIS as a diagnostic measure, see Robins, 198 5). As many
of our interviews were conducted by clinicians, the overall validity
should be as high as that of other current methods.
Responses to relevant items were scored as absent, suhcli nically pres-
ent, or clinically present. These trichotomized scores were used for the
correlational analyses to be reported, but only symptoms rated as clini-
cally present were used in creating the DSM-III diagnoses. Nonhierar-
chical lifetime diagnoses were computer generated using DSM-III cri-
teria; thus, patients were considered to have obsessive-compulsive disor-
der if they met the appropriate inclusion criteria, regardless of whether
they also met the criteria for another syndrome, such as major depres-
sion. (See Boyd et al., 1984, and Leckman, Merikangas, Pauls, Prusoff,
& Weissman, 1983, for discussions of the validity of exclusion criteria.)
We will consider the relation between the NA and PA scales and anxi-
ety and depression byusing five DSM-III diagnostic groups and their
associated symptoms (numbers in parentheses indicate the number of
patients receiving each diagnosis): major depression (n = 77) and dys-
thymic disorder (n = 33) represent the depressive spectrum, whereas
simple phobia (n = 52), social phobia (n = 21), obsessive-compulsive
disorder (n = 30), panic disorder (n = 9) and agoraphobia (« = 3) com-
prise the anxiety spectrum. The latter two diagnoses are not considered
separately because of their low frequency in this sample. Finally, neither
generalized anxiety disorder nor posttraumatic stress disorder are in-
cluded because they cannot be scored from Version 3.0 of the DIS.
Altogether, 31 (21%) of the subjects received a single DIS diagnosis,
68 (45%) met the criteria for more than one DIS diagnosis, and 51 (34%)
did not receive any DIS diagnosis (the majority of these had a staff con-
sensus diagnosis of substance abuse or personality disorder). Consistent
with other patient samples reported in the literature, slightly over half
(57%) of the 99 subjects who met criteria for at least one DIS diagnosis
had both a depressive and an anxiety diagnosis, 19% had only a depres-
sive disorder, and 24% met criteria only for anxiety disorder. In analyz-
ing these data, patients are included in a diagnostic group if they meet
criteria for that disorder regardless of any other diagnoses they may
have. We consider the effect of overlapping diagnoses elsewhere (Clark,
in press; Clark & Watson, in press).
Correlations between NEM and PEM and the anxiety symp-
toms are presented in Table 1; corresponding correlations with
the depressive complaints are given in Table 2. In addition to
analyzing the individual items, we created four indexes of prob-
lem severity by calculating the number of clinically present
complaints in each symptom class. The Ms and SDs for these
indexes were: Panic symptoms, M = 1.4, SD = 2.6; phobias,
M = \.1,SD= 1.9; obsessive-compulsive symptoms, M = .43,
SD = .75; depressive symptoms, M - 6.5, SD = 4.7. Corre-
lations between these severity indexes and NEM and PEM are
also displayed in Tables 1 and 2. Because of the number of cor-
relations involved, for these analyses only we will use a stringent
p < .01 cutoff in discussing the statistical significance of the
coefficients (although correlations significant at the p < .05 level
are also noted in the Tables). Also included in these tables are
the numbers of patients reporting clinical and subclinical levels
of each symptom.
We predicted that NA would be significantly related to both
anxiety and depression, but that PA would be correlated only
with the latter. The symptom correlations generally support
these predictions. Looking first at NA, Tables 1 and 2 demon-
strate that NEM is related to a very broad array of complaints,
and is significantly associated with most symptoms of both anx-
iety and depression. Specifically, it is significantly related to 18
of the 33 anxiety complaints (55%; median r = .22); within the
anxiety disorders, NEM is most strongly related to symptoms
of panic, with 86% of these coefficients reaching significance
(median r = .28). The NEM scale also correlates significantly
with 19 of the 20 depressive symptoms (95%; median r = .33).
Many of the correlations, moreover, are as high as can reason-
ably be expected (i.e., in the .30 to .50 range), given the unreli-
ability of single items. NEM is also significantly related to all
four severity indexes, with the correlations ranging from .25
POSITIVE AND NEGATIVE AFFECTIVITY
Correlations Between Negative and Positive Emotionality
(NEM and PEM) Scales and Anxiety Symptoms
No. of patients
Symptoms of panic disorder
Shortness of breath
Felt dizzy or light-headed
Tingling in fingers or feet
Tightness or pain in chest
Choking or smothering
Hot or cold flashes
Things seemed unreal
Feared dying or acting
No. of panic
Being in a crowd
Eating in public
Speaking in public
Speaking to strangers
Going out of the house
Being on transportation
Being in a closed place
Tunnels or bridges
Spiders, hugs, mice, snakes,
Being near a harmless
Being in water
No. of phobias
Thoughts of harming a
Obsessions about dirt and
Unable to resist counting
No. of obsessive-
(phobias) to .57 (depression). Clearly, NA represents a very gen-
eral dimension of subjective distress that subsumes both anx-
ious and depressive complaints; thus, these sections of the
DIS—like other psychometric instruments of anxiety and de-
pression—are strongly correlated with this broad and pervasive
personality factor (Watson & Clark, 1984).
Turning now to PA, Tables 1 and 2 indicate that, as expected,
PEM is much more strongly and consistently related to depres-
sion than anxiety. The PEM scale is significantly related to only
3 of the 33 anxiety symptoms (9%; median r = -.10), and the
highest coefficient is only -.25 (with nervousness). Moreover, it
is unrelated to all three anxiety severity indexes. In contrast,
PEM is significantly associated with 11 of the 20 depression
symptoms (55%; median r = —.25), and correlates —.40 with
the total number of depressive complaints. An inspection of the
individual item coefficients indicates that PEM is especially re-
lated to anhedonia and depressed affect, suicidal ideation, feel-
ings of hopelessness and worthlessness, and insomnia/fatigue.
Correlations between NEM and PEM and the DIS-derived
diagnoses are shown in Table 3. Consistent with the symptom
data, NA is related to both the anxiety and depressive disorders,
whereas PA is consistently related only to the latter. The NEM
scale is, in fact, significantly related to every diagnosis, with co-
efficients ranging from. 16 with simple phobia to .50 with major
depression. The PEM scale is also significantly correlated with
both major depression and dysthymic disorder, however, among
the anxiety disorders it is related only to social phobia.
The finding that PEM is related to social phobia, though not
specifically predicted, is quite congruent with other evidence
regarding this mood factor. The PA factor (but not NA) has
consistently been found to be significantly correlated with di-
verse indexes of social behavior, including frequency of contact
and satisfaction with friends and relatives, making new ac-
quaintances, involvement in social organizations, and trait
measures of sociability or extraversion (Clark & Watson, 1986,
1988; Costa & McCrae, 1980; Watson, 1988). Thus, it is not
surprising that this particular anxiety disorder—which reflects
fear and distress in settings of interpersonal scrutiny—is related
to PA as well as NA.
Finally, to assess the combined contributions of NA and PA
to the prediction of these disorders, we performed stepwise mul-
tiple regression analyses (with forward inclusion) using NEM
and PEM as predictors. These analyses were restricted to the
three diagnoses (major depression, dysthymic disorder, and so-
cial phobia) that were significantly correlated with both scales.
The results are presented in Table 4.
Perhaps the most important result emerging from these anal-
yses is the demonstration that NEM and PEM each contribute
to the prediction of the depressive disorders. In the case of major
depression, the two predictors together account for 31% of the
criterion variance, with PEM contributing an additional 6%
over that possible from NEM alone. Similarly, NEM and PEM
account for 22% of the variance in dysthymic disorder, with the
latter again contributing an additional 6%. Interestingly, how-
ever, NEM did not add significantly to the prediction of social
phobia, despite the fact that it had a significant zero-order cor-
D. WATSON, L. CLARK, AND G. CAREY
Correlations Between Negative and Positive Emotionality
(NEM and PEM) Scales and Depressive Symptoms
No. of patients
Felt sad, blue, depressed,
or lost all interest
Depressed, sad for at least
Felt worthless, sinful,
Felt that life was hopeless
Thought a lot about death
Wanted to die
Thought of committing
Felt tired all the time
Inability to concentrate
Loss of sexual interest
Loss of appetite
No. of depressive
*p<. 05. **/><. 01.
relation with this diagnosis (see Table 3). This finding reflects
the significant relation (r - -.37) between NEM and PEM in
our patient sample; once PEM's influence is partialed out,
NEM is no longer significantly correlated with social phobia
(partial r=. 12).
The results generally support our predictions, and are consis-
tent with previous research in this area. The data regarding NA
are congruent with its conceptualization as a general dimension
of psychological distress: NA was consistently correlated with a
broad range of anxious and depressive symptoms and diagno-
ses. In contrast, PA was consistently related only to depressive
symptoms and diagnoses, suggesting that the loss of pleasurable
engagement (low PA) may be a critical factor in distinguishing
depression from anxiety.
One might argue that these results simply reflect content
overlap between the PA/NA scales and the psychiatric data. The
NA construct, as we have denned it (see also Watson & Clark,
1984), is clearly a concept that is closely related to anxiety (and,
by extrapolation, to the DSM-III anxiety disorders). For exam-
ple, both involve component states of nervousness, apprehen-
sion, and fearfulness. Similarly, depression, as it is set forth in
Correlations Between Negative and Positive Emotionality
(NEM and PEM) Scales and Diagnostic Interview
Schedule Diagnoses of the Anxiety
and Depressive Disorders
Any anxiety diagnosis
Any depressive diagnosis
Note. All diagnoses are scored dichotomously (0 = absent, 1 = present).
DSM-III, may be interpreted as a disorder involving both high
NA (dysphoria) and low PA (loss of pleasure). Moreover, one
can point to specific NEM and PEM items that overlap with
various diagnostic criteria. For example, the NEM item (para-
phrased) "I often have trouble sleeping because of my worries"
is conceptually related to the "insomnia" criterion for major
depressive disorder, whereas the PEM item (paraphrased) "On
most days I have some feelings of real joy" seems to be an oppo-
site expression of the DSM-III criterion of prominent and per-
sistent depressed mood.
However, NEM and PEM are also correlated with many indi-
vidual symptoms (and their respective diagnoses) that do not
involve any overlapping content. For example, almost all of the
symptoms of panic disorder—which mostly involve physiologi-
cal manifestations of extreme anxiety— were significantly cor-
related with NEM, even though none of the NEM items refer
to somatic complaints. (These results are consistent with other
research showing that NEM is significantly related to a broad
range of physical symptoms; Watson & Pennebaker, in press.)
Regressions of Negative and Positive Emotionality (NEM and
PEM) Scales on Major Depression. Dysthymic
Disorder, and Social Phobia
* Standardized regression coefficient.
POSITIVE AND NEGATIVE AFFECTIVITY
Similarly, NEM contains no items specifically referring to pho-
bias, and yet it was significantly correlated with most of the DIS
As for the depressive symptoms, neither the NEM nor PEM
items refer directly to fatigue, suicidal tendencies, appetite dis-
turbance, or difficulty concentrating, and yet these symptoms
are significantly correlated with scores on both scales. Thus,
while a few of the individual correlations may reflect content
overlap, such considerations alone cannot explain the overall
pattern of results.
The Role of NA and PA in Anxiety and Depression
As expected, NA was broadly correlated with symptoms and
diagnoses of both anxiety and depression, confirming earlier
findings that it is an important general correlate of psychiatric
disorder (Watson & Clark, 1984). By the same token, however,
the pervasiveness of its relation to psychiatric complaints sug-
gests that NA will not prove very useful in differential diagnosis.
That is, NA is a diffuse index of psychological distress that can
be expected to differentiate most patient groups from normals,
but that will not effectively distinguish specific types of psychi-
atric disorder from one another. Thus, the substantial overlap
between anxiety and depression described earlier may derive
from the fact that they share NA as a common underlying con-
struct. In this view, a major component of both depression and
anxiety is a fundamental predisposition to experience a wide
variety of negative emotional states, and correlations between
measures of depression and anxiety may largely reflect the fact
that both assess specific facets of NA.
The PA factor, in contrast, was related primarily to symptoms
and diagnoses of depression. Although PA's contribution to the
prediction of the depressive diagnoses was smaller than that of
NA, at the symptom level, NA and PA were comparably related
to depression (median rs = .33 and -.25, respectively). These
and other data thus indicate that the differential measurement
of depression might be improved if the PA component were
weighted more heavily. Currently, most self-report depression
scales largely tap NA, but also include a more modest PA com-
ponent (see Tellegen, 1985; Watson & Clark, 1984; Watson,
Clark, & Tellegen, 1988). In terms of convergent validity, this is
a good strategy because depression appears to be an affectively
complex combination of high NA and low PA. However, this
high NA component is also prominent in anxiety, and so will
produce high correlations among depression and anxiety mea-
sures. Because low PA is a more important factor in depression
than anxiety, strengthening this component in depression mea-
sures should improve their discrimination from anxiety scales.
One important consideration is how best to assess this PA
component. Psychiatric research has traditionally emphasized
dichotomous measurement: A given symptom such as anhedo-
nia is recorded as present or absent. However, extensive recent
evidence indicates that PA is a normally distributed dimension
of both inter- and intraindividual differences (e.g., Clark & Wat-
son, 1988; Costa & McCrae, 1980; Watson, 1988; Watson et al.,
1988 ; Watson & Tellegen, 1985). That is, people differ greatly
in their characteristic PA levels, and a given individual's PA
fluctuates widely from day to day and from moment to moment.
Rather than simply assessing the presence/absence of positive
emotional experiences, it seems desirable to adopt a measure-
ment strategy that allows these finer gradations to be identified
and studied. In particular, the dimensional approach seems bet-
ter suited to the study of factors (both biological and environ-
mental) that influence positive emotionality.
It might also be useful to focus more on the measurement of
high PA. Our experience in mood assessment indicates that
there are many more descriptors of high than low PA and, fur-
thermore, that the high PA terms tend to be purer markers of the
underlying factor(e.g., Watson et al., 1988; Watson & Tellegen,
1985). Thus, the best measurement approach may be to assess
the degree to which respondents report various high PA experi-
ences. Depressive symptoms can then be inferred from the rela-
tive absence of any such experiences.
Finally, we should also note some limitations of our study.
First, although the results are very orderly and generally sup-
portive of our model, it is clearly important that they be repli-
cated. Moreover, as noted earlier, the form of the DIS used in
this study (Version 3.0) did not permit the assessment of either
generalized anxiety disorder or posttraumatic stress disorder.
Given their current conceptualization, we suspect that these
disorders will be strongly related to trait NA, but this obviously
requires empirical confirmation. Thus, it is important that sub-
sequent studies examine the full range of anxiety disorders.
It would also be interesting to examine how anxiety and de-
pression relate to different types of trait NA and trait PA mea-
sures. For example, as was discussed previously, PEM and NEM
are moderately correlated. This poses no theoretical problem
(because the underlying factors themselves may be modestly
correlated), but the resulting lack of statistical independence
does create some interpretive problems for the multiple regres-
sion analyses involving the depressive diagnoses (see Table 4).
Because NEM and PEM are correlated, and because NEM was
entered into the regression equations first (so that its influence
is partialed out), these analyses may underestimate PA's true
contribution to the prediction of depression. However, this is
impossible to determine without further data. We are in the
process of validating a new, longer (22-item) trait PA scale that
was designed to be more clearly independent of trait NA; it will
be interesting to examine how this scale relates to the depressive
In summary, the findings of the present study indicate that
the shared element of NA may underlie the consistently strong
correlation between measures of anxiety and depression; how-
ever, the data also demonstrate that PA is more specifically re-
lated to depression. On the basis of the data we have presented,
we believe that researchers of anxiety and depression would
profit from an improved understanding of the extensive litera-
ture on the nature and correlates of NA and PA. Conversely,
research into the causes and treatment of anxiety and depres-
sion will likely enhance our understanding of the basic mecha-
nisms underlying the experience of NA and PA. At the very
least, we hope that this article will stimulate an increased level
of interaction between these research traditions.
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Received August 3, 1987
Revision received February 4, 1988
Accepted February 9, 1988 •
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