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Title: The factor structure of the Hospital Anxiety and Depression Scale in individuals with traumatic brain injury.
Epworth Authors: Schonberger, Michael
Ponsford, Jennie
Keywords: Traumatic Brain Injury
Hospital Anxiety and Depression Scale
Post Traumatic Amnesia
Anxiety Disorder
Depressive Disorder
Factor Analysis
Brain Injuries
Epworth HealthCare
Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
Issue Date: Oct-2010
Publisher: Elsevier
Citation: Psychiatry Res. 2010 Oct 30;179(3):342-9
Abstract: There is a lack of validated scales for screening for anxiety and depression in individuals with traumatic brain injury (TBI). The purpose of this study was to examine the factor structure of the Hospital Anxiety and Depression Scale (HADS) in individuals with TBI. A total of 294 individuals with TBI (72.1% male; mean age 37.1 years, S.D. 17.5, median post-traumatic amnesia (PTA) duration 17 days) completed the HADS 1 year post-injury. A series of confirmatory factor analyses was conducted to examine the fit of a one-, two- and three-factor solution, with and without controlling for item wording effects (Multi-Trait Multi-Method approach). The one-, two- or three-factor model fit the data only when controlling for negative item wording. The results are in support of the validity of the original anxiety and depression subscales of the HADS and demonstrate the importance of evaluating item wording effects when examining the factor structure of a questionnaire. The results would also justify the use of the HADS as a single scale of emotional distress. However, even though the three-factor solution fit the data, alternative scales should be used if the purpose of the assessment is to measure stress symptoms separately from anxiety and depression.
DOI: 10.1016/j.psychres.2009.07.003
PubMed URL:
ISSN: 0165-1781
Journal Title: Psychiatry Research
Type: Journal Article
Affiliated Organisations: School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Australia
Type of Clinical Study or Trial: Validation Study
Appears in Collections:Mental Health

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