Cargando…
Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury
Background: The dimensionality of depression and anxiety instruments have recently been a source of controversy. Objectives and Design: In a European-wide sample of patients after Traumatic Brain Injury (TBI), we aim to examine the factorial structure, validity, and association of the Patient Health...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141536/ https://www.ncbi.nlm.nih.gov/pubmed/32210017 http://dx.doi.org/10.3390/jcm9030873 |
_version_ | 1783519214573715456 |
---|---|
author | Teymoori, Ali Gorbunova, Anastasia Haghish, Fardzadeh E. Real, Ruben Zeldovich, Marina Wu, Yi-Jhen Polinder, Suzanne Asendorf, Thomas Menon, David v. Steinbüchel, Nicole |
author_facet | Teymoori, Ali Gorbunova, Anastasia Haghish, Fardzadeh E. Real, Ruben Zeldovich, Marina Wu, Yi-Jhen Polinder, Suzanne Asendorf, Thomas Menon, David v. Steinbüchel, Nicole |
author_sort | Teymoori, Ali |
collection | PubMed |
description | Background: The dimensionality of depression and anxiety instruments have recently been a source of controversy. Objectives and Design: In a European-wide sample of patients after Traumatic Brain Injury (TBI), we aim to examine the factorial structure, validity, and association of the Patient Health Questionnaire for depression (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) instruments. This study is based on longitudinal observational data. We conducted analyses of factorial structure and discriminant validity of outcomes six-months after TBI. We also examined the prevalence, co-occurrence, and changes of scores on the PHQ-9 and GAD-7 at 3-, 6-, and 12-month post-TBI assessments. Participants: At six-months post-TBI assessment, 2137 (738 (34.5%) women) participants completed the PHQ-9 and GAD-7 questionnaires. For the longitudinal analysis, we had 1922 participants (672 (35.0%) women). Results: The results of exploratory factor analysis suggested a general latent construct underlying both PHQ-9 and GAD-7 measures. Confirmatory factor analyses showed a slight improvement in the fit indices for the bifactorial model. The Omega hierarchical test clearly differentiated two subfactors of PHQ-9 and GAD-7 items over and above the underlying general factor; however, most of the variance (85.0%) was explained by the general factor and the explained variance of the subfactors was small. The PHQ-9 and GAD-7 performed similarly in detecting post-traumatic stress disorder (PTSD). As defined by conventional cut-offs, depression and anxiety have different prevalence rates in the sample. The scales also differed in their relationships with the short form of health survey (SF-36v2) subscales. The longitudinal analysis showed high stability of depression and anxiety symptoms: 49–67% of the post-TBI patients with comorbid depression and anxiety reported the persistence of the symptoms over time. Discussion: The factorial structure analysis favors a general latent construct underlying both depression and anxiety scales among patients after TBI. We discuss the implications our findings and future research directions. |
format | Online Article Text |
id | pubmed-7141536 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71415362020-04-15 Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury Teymoori, Ali Gorbunova, Anastasia Haghish, Fardzadeh E. Real, Ruben Zeldovich, Marina Wu, Yi-Jhen Polinder, Suzanne Asendorf, Thomas Menon, David v. Steinbüchel, Nicole J Clin Med Article Background: The dimensionality of depression and anxiety instruments have recently been a source of controversy. Objectives and Design: In a European-wide sample of patients after Traumatic Brain Injury (TBI), we aim to examine the factorial structure, validity, and association of the Patient Health Questionnaire for depression (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) instruments. This study is based on longitudinal observational data. We conducted analyses of factorial structure and discriminant validity of outcomes six-months after TBI. We also examined the prevalence, co-occurrence, and changes of scores on the PHQ-9 and GAD-7 at 3-, 6-, and 12-month post-TBI assessments. Participants: At six-months post-TBI assessment, 2137 (738 (34.5%) women) participants completed the PHQ-9 and GAD-7 questionnaires. For the longitudinal analysis, we had 1922 participants (672 (35.0%) women). Results: The results of exploratory factor analysis suggested a general latent construct underlying both PHQ-9 and GAD-7 measures. Confirmatory factor analyses showed a slight improvement in the fit indices for the bifactorial model. The Omega hierarchical test clearly differentiated two subfactors of PHQ-9 and GAD-7 items over and above the underlying general factor; however, most of the variance (85.0%) was explained by the general factor and the explained variance of the subfactors was small. The PHQ-9 and GAD-7 performed similarly in detecting post-traumatic stress disorder (PTSD). As defined by conventional cut-offs, depression and anxiety have different prevalence rates in the sample. The scales also differed in their relationships with the short form of health survey (SF-36v2) subscales. The longitudinal analysis showed high stability of depression and anxiety symptoms: 49–67% of the post-TBI patients with comorbid depression and anxiety reported the persistence of the symptoms over time. Discussion: The factorial structure analysis favors a general latent construct underlying both depression and anxiety scales among patients after TBI. We discuss the implications our findings and future research directions. MDPI 2020-03-23 /pmc/articles/PMC7141536/ /pubmed/32210017 http://dx.doi.org/10.3390/jcm9030873 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Teymoori, Ali Gorbunova, Anastasia Haghish, Fardzadeh E. Real, Ruben Zeldovich, Marina Wu, Yi-Jhen Polinder, Suzanne Asendorf, Thomas Menon, David v. Steinbüchel, Nicole Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title | Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title_full | Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title_fullStr | Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title_full_unstemmed | Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title_short | Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury |
title_sort | factorial structure and validity of depression (phq-9) and anxiety (gad-7) scales after traumatic brain injury |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141536/ https://www.ncbi.nlm.nih.gov/pubmed/32210017 http://dx.doi.org/10.3390/jcm9030873 |
work_keys_str_mv | AT teymooriali factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT gorbunovaanastasia factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT haghishfardzadehe factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT realruben factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT zeldovichmarina factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT wuyijhen factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT polindersuzanne factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT asendorfthomas factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT menondavid factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury AT vsteinbuchelnicole factorialstructureandvalidityofdepressionphq9andanxietygad7scalesaftertraumaticbraininjury |