Psychometric validation of the 15-item patient health questionnaire – Anxiety and depression scale (PHQ-ADS) to assess psychological distress in breast cancer survivors

Ereza Ibrahimi, Sophie Fawson, Lyndsay. D Hughes, Joseph Chilcot*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objective: Psychological distress persists amongst breast cancer survivors, so reliable assessment of symptoms is essential. The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) is a composite measure of depression and anxiety and has been used to measure distress. This study aimed to evaluate the psychometric properties of the PHQ-ADS within breast cancer survivors. Method: Breast cancer survivors (N = 280) were recruited online and followed up at 12-months. Depression (PHQ-8) and anxiety (GAD-7) items formed the composite PHQ-ADS score. Additional measures included: distress thermometer (convergent validity), fear of cancer recurrence and COVID distress (discriminant validity), and self-compassion (predictive validity). Confirmatory factor analysis (CFA) using weighted least squares mean and variance adjusted estimation was undertaken. Results: One, two, and bifactor models underlying the PHQ-ADS were evaluated. The bifactor model had the most appropriate model fit overall. Omega hierarchical for the general distress factor was 0.914, accounting for 82% of explained variance. This suggests the PHQ-ADS is sufficiently unidimensional to warrant use of a total composite score. The PHQ-ADS demonstrated strong convergent and moderate discriminant validity. Self-compassion was an independent predictor of distress at 12-months. Conclusions: The PHQ-ADS is a valid measure for psychological distress in breast cancer survivors prescribed hormone therapy.

Original languageEnglish
Pages (from-to)68-74
Number of pages7
JournalGENERAL HOSPITAL PSYCHIATRY
Volume88
DOIs
Publication statusPublished - 27 Mar 2024

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