Cognitive symptoms link anxiety and depression within a validation of the German State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA)

Background: In the present study we aimed to develop a German version of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and evaluate the psychometric properties. Associations of cognitive and somatic anxiety with other measures of anxiety, depression, and stress, elucidating possible underlying functional connections, were also examined, as symptoms of anxiety, depression and stress often overlap. Method: Two samples (n1 = 301; n2 = 303) were collected online and in the lab, respectively. Dynamic connections between somatic and cognitive anxiety, other measures of anxiety, depression, and stress, were analyzed using a network approach. Psychometric analyses were conducted using exploratory and confirmatory factor analyses. Results: We replicated and validated the two-factorial structure of the STICSA with the German translation. Network analyses revealed cognitive trait anxiety as the most central node, bridging anxiety and depression. Somatic trait anxiety exhibited the highest discriminant validity for distinguishing anxiety from depression. Conclusion: The central role of cognitive symptoms in these dynamic interactions suggests an overlap of these symptoms between anxiety and depression and that differential diagnostics should focus more on anxious somatic symptoms than on cognitive symptoms. The STICSA could therefore be useful in delineating differences between anxiety and depression and for differential assessment of mood and anxiety symptoms. Additional understanding of both cognitive and somatic aspects of anxiety might prove useful for therapeutic interventions.