The Hospital Anxiety and Depression Scale: A meta confirmatory factor analysis
The Hospital Anxiety and Depression Scale: A meta confirmatory factor analysis
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DOI：
10.1016/j.jpsychores.2012.10.010
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发表时间：
2013-01-01
影响因子：
4.7
通讯作者：
Sacker, Amanda
中科院分区：
文献类型：
--
作者：
Norton, Sam;Cosco, Theodore;Sacker, Amanda
目的：目的：通过对既往研究的再分析和Meta验证性因素分析（CFA），系统评价医院焦虑抑郁量表（HADS）的潜在结构。十个模型被认为是，包括八个以前确定的模型和两个双因子模型。每个模型的拟合在每个样本中单独评估，并通过Meta CFA进行评估。Meta CFA进行使用所有的样本和使用的社区样本，心血管疾病样本和样本管理的英语版本的HADS.Results的研究组成的亚组：一个双因素模型，包括所有项目加载到一个一般的困扰因素和两个正交的焦虑和抑郁组因素提供了最适合的大多数样本。Meta CFA进一步支持了双因素模型。这是使用所有样本以及所有亚组分析的情况。一般困扰因素解释项目之间的协方差的73%，（自主）焦虑和（快感缺乏）抑郁因素解释11%和16%.Conclusion：双因素结构提供了最可接受的实证解释HADS相关结构。由于存在一个强有力的一般因素，HADS不能很好地区分焦虑和抑郁的症状。我们建议它最好用作一般痛苦的衡量标准。(C)2012 Elsevier Inc. All rights reserved.
Objective: To systematically evaluate the latent structure of the Hospital Anxiety and Depression Scale (HADS) through reanalysis of previous studies and meta confirmatory factor analysis (CFA).Method: Data from 28 samples were obtained from published studies concerning the latent structure of the HADS. Ten models were considered, including eight previously identified models and two bifactor models. The fit of each model was assessed separately in each sample and by meta CFA. Meta CFA was conducted using all samples and using subgroups consisting of community samples, cardiovascular disease samples and samples from studies administering the English language version of the HADS.Results: A bifactor model including all items loading onto a general distress factor and two orthogonal anxiety and depression group factors provided the best fit for the majority of samples. Meta CFA provided further support for the bifactor model with two group factors. This was the case using all samples, as well as all subgroup analyses. The general distress factor explained 73% of the covariance between items, with the (autonomic) anxiety and (anhedonic) depression factors explaining 11% and 16%, respectively.Conclusion: A bifactor structure provides the most acceptable empirical explanation for the HADS correlation structure. Due to the presence of a strong general factor, the HADS does not provide good separation between symptoms of anxiety and depression. We recommend it is best used as a measure of general distress. (C) 2012 Elsevier Inc. All rights reserved.