Terrill Alexandra L, Hartoonian Narineh, Beier Meghan, Salem Rana, Alschuler Kevin
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA (ALT, NH, MB, RS, KA); and Veterans Affairs Puget Sound Health Care System, Multiple Sclerosis Center of Excellence West, Seattle, WA, USA (NH).
Int J MS Care. 2015 Mar-Apr;17(2):49-56. doi: 10.7224/1537-2073.2014-008.
Generalized anxiety disorder (GAD) is common in multiple sclerosis (MS) but understudied. Reliable and valid measures are needed to advance clinical care and expand research in this area. The objectives of this study were to examine the psychometric properties of the 7-item Generalized Anxiety Disorder Scale (GAD-7) in individuals with MS and to analyze correlates of GAD.
Participants (N = 513) completed the anxiety module of the Patient Health Questionnaire (GAD-7). To evaluate psychometric properties of the GAD-7, the sample was randomly split to conduct exploratory and confirmatory factor analyses.
Based on the exploratory factor analysis, a one-factor structure was specified for the confirmatory factor analysis, which showed excellent global fit to the data (χ(2) 12 = 15.17, P = .23, comparative fit index = 0.99, root mean square error of approximation = 0.03, standardized root mean square residual = 0.03). The Cronbach alpha (0.75) indicated acceptable internal consistency for the scale. Furthermore, the GAD-7 was highly correlated with the Hospital Anxiety and Depression Scale-Anxiety (r = 0.70). Age and duration of MS were both negatively associated with GAD. Higher GAD-7 scores were observed in women and individuals with secondary progressive MS. Individuals with higher GAD-7 scores also endorsed more depressive symptoms.
These findings support the reliability and internal validity of the GAD-7 for use in MS. Correlational analyses revealed important relationships with demographics, disease course, and depressive symptoms, which suggest the need for further anxiety research.
广泛性焦虑障碍（GAD）在多发性硬化症（MS）中很常见，但研究不足。需要可靠且有效的测量方法来推进临床护理并扩大该领域的研究。本研究的目的是检验7项广泛性焦虑障碍量表（GAD-7）在MS患者中的心理测量特性，并分析GAD的相关因素。
参与者（N = 513）完成了患者健康问卷的焦虑模块（GAD-7）。为了评估GAD-7的心理测量特性，将样本随机拆分以进行探索性和验证性因素分析。
基于探索性因素分析，为验证性因素分析指定了单因素结构，该结构显示出与数据的良好整体拟合度（χ(2)12 = 15.17，P = 0.23，比较拟合指数 = 0.99，近似均方根误差 = 0.03，标准化均方根残差 = 0.03）。克朗巴哈α系数（0.75）表明该量表的内部一致性可接受。此外，GAD-7与医院焦虑抑郁量表-焦虑分量表高度相关（r = 0.70）。MS的年龄和病程均与GAD呈负相关。在女性和继发进展型MS患者中观察到较高的GAD-7得分。GAD-7得分较高的个体也认可更多的抑郁症状。
这些发现支持GAD-7在MS中使用的可靠性和内部有效性。相关性分析揭示了与人口统计学、疾病进程和抑郁症状的重要关系，这表明需要进一步开展焦虑研究。
