Monash University, Melbourne, Australia.
Psychiatry Res. 2010 Oct 30;179(3):342-9. doi: 10.1016/j.psychres.2009.07.003. Epub 2010 May 18.
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.
创伤性脑损伤（TBI）个体的焦虑和抑郁筛查缺乏经过验证的量表。本研究的目的是检验 HADS 在 TBI 个体中的因子结构。共有 294 名 TBI 患者（72.1%为男性；平均年龄 37.1 岁，标准差 17.5，创伤后遗忘期（PTA）中位数为 17 天）在受伤后 1 年完成了 HADS。进行了一系列验证性因子分析，以检验单因素、双因素和三因素解决方案的拟合情况，同时控制和不控制项目措辞效应（多特质多方法方法）。只有在控制负面项目措辞的情况下，单因素、双因素或三因素模型才适合数据。研究结果支持 HADS 焦虑和抑郁分量表的有效性，并证明在检查问卷的因子结构时评估项目措辞效应的重要性。研究结果还证明了 HADS 作为一种单一的情绪困扰量表的合理性。然而，即使三因素解决方案适合数据，如果评估的目的是分别测量压力症状、焦虑和抑郁，那么应该使用替代量表。
