Tuohy Alan, McVey Cynthia
Department of Psychology, Glasgow Caledonian University, Glasgow, UK.
Br J Clin Psychol. 2008 Jun;47(Pt 2):153-69. doi: 10.1111/j.2044-8260.2008.tb00463.x. Epub 2007 Aug 29.
There has been considerable research and clinical interest in the comorbidity of anxiety and depression in the post-partum period, and specifically in the possibility that the commonly used Edinburgh Postnatal Depression Scale (EPDS) incorporates an anxiety component. We hypothesized that the recommended version of factor analysis (Fabrigar, Wegener, MacCallum, & Strahan, 1999) would identify such covert dimensions more reliably than the commonly used principal components analysis with varimax rotation and eigenvalues greater than 1.
Principal axis factor extraction with parallel analysis and oblique (direct quartimin) factor rotation was applied to the 10 EPDS items.
The study used a sample of recent mothers recruited and assessed via e-mail and the Internet (N=440). In addition to the EPDS, the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Scales (PANAS) were also administered.
Three factors were found, which were identified as 'non-specific depressive symptoms', 'anhedonia', and 'anxietal symptoms' subscales, respectively. These subscales were regressed on the HADS anxiety and depression and the PANAS positive and negative affectivity scales, with results substantially consistent with current structural models of the taxonomy of the emotional disorders.
The data were obtained from a self-selected non-clinical sample. In addition, it is known that the use of computer-based assessment may tend to inflate self-report scores.
It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.
产后焦虑与抑郁的共病现象已引发了大量研究及临床关注,特别是常用的爱丁堡产后抑郁量表(EPDS)可能包含焦虑成分这一可能性。我们假设,推荐版本的因子分析(Fabrigar、Wegener、MacCallum和Strahan,1999年)比常用的具有方差最大化旋转且特征值大于1的主成分分析,能更可靠地识别出这些潜在维度。
对EPDS的10个项目应用主轴因子提取、平行分析及斜交(直接四次最小化)因子旋转。
本研究使用通过电子邮件和互联网招募并评估的近期产妇样本(N = 440)。除了EPDS外,还施测了医院焦虑抑郁量表(HADS)和正负性情绪量表(PANAS)。
发现了三个因子,分别被确定为“非特异性抑郁症状”、“快感缺失”和“焦虑症状”分量表。这些分量表与HADS焦虑和抑郁量表以及PANAS正负性情绪量表进行回归分析,结果与当前情绪障碍分类的结构模型基本一致。
数据来自自我选择的非临床样本。此外,众所周知,使用基于计算机的评估可能会使自我报告分数偏高。
得出的结论是,现在有足够的证据表明临床医生不应假定EPDS是单维的,而在筛查产后抑郁和/或产后焦虑易感性时应评估所有三个分量表。