The structure of the hospital anxiety and depression scale in four cohorts of community-based, healthy older people: the HALCyon program
The structure of the hospital anxiety and depression scale in four cohorts of community-based, healthy older people: the HALCyon program
Background: The Hospital Anxiety and Depression Scale (HADS) is widely used but evaluation of its psychometric properties has produced equivocal results. Little is known about its structure in non-clinical samples of older people.
Methods: We used data from four cohorts in the HALCyon collaborative research program into healthy aging: the Caerphilly Prospective Study, the Hertfordshire Ageing Study, the Hertfordshire Cohort Study, and the Lothian Birth Cohort 1921. We used exploratory factor analysis and confirmatory factor analysis with multi-group comparisons to establish the structure of the HADS and test for factorial invariance between samples.
Results: Exploratory factor analysis showed a bi-dimensional structure (anxiety and depression) of the scale in men and women in each cohort. We tested a hypothesized three-factor model but high correlations between two of the factors made a two-factor model more psychologically plausible. Multi-group confirmatory factor analysis revealed that the sizes of the respective item loadings on the two factors were effectively identical in men and women from the same cohort. There was more variation between cohorts, particularly those from different parts of the U.K. and in whom the HADS was administered differently. Differences in social-class distribution accounted for part of this variation.
Conclusions: Scoring the HADS as two subscales of anxiety and depression is appropriate in non-clinical populations of older men and women. However, there were differences between cohorts in the way that individual items were linked with the constructs of anxiety and depression, perhaps due to differences in sociocultural factors and/or in the administration of the scale.
psychometric properties, rating scales, factor analysis
559-571
Gale, Catherine R.
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Allerhand, Michael
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Sayer, Avan Aihie
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1
Starr, John M.
92fc6cf8-b0f7-47dc-93d8-8fd246d40585
Ben-Shlomo, Yoav
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Gallacher, John E.
e05d736b-eb13-4f6b-b8ca-6f417d60a6a7
Kuh, Diana
4f3b51aa-21a0-4d68-be14-e1ed75448aaf
Deary, Ian J.
027158ae-fbfb-40ea-98b1-32d2690499ac
10 March 2010
Gale, Catherine R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Allerhand, Michael
9007afe3-8320-4dc7-9889-6230c3fedac5
Sayer, Avan Aihie
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1
Starr, John M.
92fc6cf8-b0f7-47dc-93d8-8fd246d40585
Ben-Shlomo, Yoav
df80bd02-a908-4296-b293-825d42203729
Gallacher, John E.
e05d736b-eb13-4f6b-b8ca-6f417d60a6a7
Kuh, Diana
4f3b51aa-21a0-4d68-be14-e1ed75448aaf
Deary, Ian J.
027158ae-fbfb-40ea-98b1-32d2690499ac
Gale, Catherine R., Allerhand, Michael, Sayer, Avan Aihie, Cooper, Cyrus, Dennison, Elaine M., Starr, John M., Ben-Shlomo, Yoav, Gallacher, John E., Kuh, Diana and Deary, Ian J.
(2010)
The structure of the hospital anxiety and depression scale in four cohorts of community-based, healthy older people: the HALCyon program.
International Psychogeriatrics, 22 (4), .
(doi:10.1017/S1041610210000256).
Abstract
Background: The Hospital Anxiety and Depression Scale (HADS) is widely used but evaluation of its psychometric properties has produced equivocal results. Little is known about its structure in non-clinical samples of older people.
Methods: We used data from four cohorts in the HALCyon collaborative research program into healthy aging: the Caerphilly Prospective Study, the Hertfordshire Ageing Study, the Hertfordshire Cohort Study, and the Lothian Birth Cohort 1921. We used exploratory factor analysis and confirmatory factor analysis with multi-group comparisons to establish the structure of the HADS and test for factorial invariance between samples.
Results: Exploratory factor analysis showed a bi-dimensional structure (anxiety and depression) of the scale in men and women in each cohort. We tested a hypothesized three-factor model but high correlations between two of the factors made a two-factor model more psychologically plausible. Multi-group confirmatory factor analysis revealed that the sizes of the respective item loadings on the two factors were effectively identical in men and women from the same cohort. There was more variation between cohorts, particularly those from different parts of the U.K. and in whom the HADS was administered differently. Differences in social-class distribution accounted for part of this variation.
Conclusions: Scoring the HADS as two subscales of anxiety and depression is appropriate in non-clinical populations of older men and women. However, there were differences between cohorts in the way that individual items were linked with the constructs of anxiety and depression, perhaps due to differences in sociocultural factors and/or in the administration of the scale.
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Published date: 10 March 2010
Keywords:
psychometric properties, rating scales, factor analysis
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Local EPrints ID: 158975
URI: http://eprints.soton.ac.uk/id/eprint/158975
ISSN: 1041-6102
PURE UUID: 897f5971-2b6d-4646-b5c7-da0a138cc921
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Date deposited: 25 Jun 2010 08:40
Last modified: 18 Mar 2024 02:45
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Author:
Michael Allerhand
Author:
Avan Aihie Sayer
Author:
John M. Starr
Author:
Yoav Ben-Shlomo
Author:
John E. Gallacher
Author:
Diana Kuh
Author:
Ian J. Deary
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