Mokken scaling analysis of the Hospital Anxiety and Depression Scale in individuals with cardiovascular disease.
OBJECTIVE: The Hospital Anxiety and Depression Scale (HADS) is a prolifically used scale of anxiety and depression. The original bidimensional anxiety-depression latent structure of the HADS has come under significant scrutiny, with previous studies revealing one-, two-, three- and four-dimensional structures. The current study examines the latent structure of the HADS using a non-parametric item response theory method. METHOD: Using data conglomerated from four independent studies of cardiovascular disease employing the HADS (n=893), Mokken scaling procedure was conducted to assess the latent structure of the HADS. RESULTS: A single scale consisting of 12 of 14 HADS items was revealed, indicating a unidimensional latent HADS structure. DISCUSSION: The HADS was initially intended to measure mutually exclusive levels of anxiety and depression; however, the current study indicates that a single dimension of general psychological distress is captured.
CommentsThis article is also available at, http://www.sciencedirect.com/science/article/pii/S016383431100363X
Published CitationCosco TD, Doyle F, Ward M, McGee H. Mokken scaling analysis of the Hospital Anxiety and Depression Scale in individuals with cardiovascular disease. General Hospital Psychiatry. 2012;34(2):167-72 2011.
- Health Psychology