School of Psychology and Psychiatry, Monash University, Melbourne, Australia.
J Affect Disord. 2013 Oct;151(1):392-6. doi: 10.1016/j.jad.2013.06.011. Epub 2013 Jul 4.
Anxiety and depression following traumatic brain injury (TBI) are associated with poorer outcomes. A brief self-report questionnaire would assist in identifying those at risk, however validity of such measures is complicated by confounding symptoms of the injury. This study investigated the validity of the Depression Anxiety Stress Scales (DASS) and Hospital Anxiety and Depression Scale (HADS), in screening for clinical diagnoses of anxiety and mood disorders following TBI.
One hundred and twenty-three participants with mild to severe TBI were interviewed using the SCID (Axis I) and completed the DASS and HADS.
The DASS, DASS21 and HADS scales demonstrated validity compared with SCID diagnoses of anxiety and mood disorders as measured by Area Under ROC Curve, sensitivity and specificity. Validity of the DASS depression scale benefited from items reflecting symptoms of devaluation of life, self-deprecation, and hopelessness that are not present on the HADS. Validity of the HADS anxiety scale benefited from items reflecting symptoms of tension and worry that are measured separately for the DASS on the stress scale.
Participants were predominantly drawn from a rehabilitation centre which may limit the extent to which results can be generalized. Scores for the DASS21 were derived from the DASS rather than being administered separately.
The DASS, DASS21 and HADS demonstrated validity as screening measures of anxiety and mood disorders in this TBI sample. The findings support use of these self-report questionnaires for individuals with TBI to identify those who should be referred for clinical diagnostic follow-up.
创伤性脑损伤（TBI）后出现的焦虑和抑郁与较差的预后相关。一个简短的自我报告问卷将有助于识别那些有风险的人，然而，这些措施的有效性受到损伤的混杂症状的影响。本研究旨在调查抑郁焦虑压力量表（DASS）和医院焦虑抑郁量表（HADS）在筛查 TBI 后临床诊断的焦虑和情绪障碍的有效性。
123 名轻度至重度 TBI 患者接受了 SCID（轴 I）访谈，并完成了 DASS 和 HADS。
与 SCID 诊断的焦虑和情绪障碍相比，DASS、DASS21 和 HADS 量表的曲线下面积、敏感性和特异性均显示出有效性。DASS 抑郁量表的有效性得益于反映对生活的贬值、自我贬低和绝望等症状的项目，这些症状在 HADS 中不存在。HADS 焦虑量表的有效性得益于反映紧张和担忧症状的项目，这些症状在 DASS 的压力量表中分别进行测量。
参与者主要来自康复中心，这可能限制了结果的推广程度。DASS21 的分数是从 DASS 得出的，而不是单独进行的。
DASS、DASS21 和 HADS 在 TBI 样本中表现出了作为焦虑和情绪障碍筛查工具的有效性。这些发现支持使用这些自我报告问卷来识别 TBI 患者中那些应该转介进行临床诊断随访的患者。
