Krijnen-de Bruin Esther, Draisma Stasja, Muntingh Anna D T, Evers Aagje, van Straten Annemieke, Sinnema Henny, Spijker Jan, Batelaan Neeltje M, van Meijel Berno
Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands.
Front Psychol. 2021 Nov 15;12:694583. doi: 10.3389/fpsyg.2021.694583. eCollection 2021.
To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision. The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test-retest reliability were also assessed. Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08-1.00), Standardized Root Mean Square Residual = 0.09 (χ = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> α = 0.75) and test-retest reliability (ICC > 0.75). The first statistical evaluation of the ASAD indicated a high level of internal consistency and test-retest reliability, and identified three distinctive factors. This could aid patients and professionals' assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
本研究旨在探讨专门为（慢性）焦虑症和抑郁症患者设计的焦虑与抑郁自我管理评估（ASAD）问卷的潜在因素结构和心理测量特性。此外，本研究还评估了能否在不显著降低问卷精度的情况下减少ASAD的项目数量。171名参与者在两个样本中完成了ASAD问卷：一个样本包括有残留焦虑或抑郁症状的患者，另一个样本由被正式诊断患有慢性焦虑或抑郁症的患者组成。所有参与者此前均接受过治疗。研究同时进行了探索性因素分析（EFA）和验证性因素分析（CFA），并评估了内部一致性和重测信度。EFA和CFA均表明存在三个稳定因素：寻求支持、日常生活策略和承担责任[比较拟合指数=0.80，塔克-刘易斯指数=0.78，近似误差均方根=0.09（95%置信区间0.08 - 1.00），标准化残差均方根=0.09（χ=439.35，自由度=168）]。因此，ASAD从45个项目减少到21个项目，形成了ASAD简表（SF）。所有子量表均具有较高的内部一致性（>α=0.75）和重测信度（组内相关系数>0.75）。对ASAD的首次统计评估表明其具有较高的内部一致性和重测信度，并确定了三个不同的因素。这有助于患者和专业人员评估患者所采用的自我管理类型。鉴于本研究表明21项的ASAD-SF是合适的，应在（慢性或部分缓解的）焦虑症和抑郁症患者样本中进一步探索和验证该版本。与此同时，为了提高普遍性，还需要更多研究在其他环境和国家检验ASAD的英文版本。
