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Quality of Life Research

Erschienen in:

01.12.2013

Factor analyses of the Hospital Anxiety and Depression Scale: a Bayesian structural equation modeling approach

Erschienen in: Quality of Life Research | Ausgabe 10/2013

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Abstract

Purpose

The latent structure of the Hospital Anxiety and Depression Scale (HADS) has caused inconsistent results in the literature. The HADS is frequently analyzed via maximum likelihood confirmatory factor analysis (ML-CFA). However, the overly restrictive assumption of exact zero cross-loadings and residual correlations in ML-CFA can lead to poor model fits and distorted factor structures. This study applied Bayesian structural equation modeling (BSEM) to evaluate the latent structure of the HADS.

Methods

Three a priori models, the two-factor, three-factor, and bifactor models, were investigated in a Chinese community sample (N = 312) and clinical sample (N = 198) using ML-CFA and BSEM. BSEM specified approximate zero cross-loadings and residual correlations through the use of zero-mean, small-variance informative priors. The model comparison was based on the Bayesian information criterion (BIC).

Results

Using ML-CFA, none of the three models provided an adequate fit for either sample. The BSEM two-factor model with approximate zero cross-loadings and residual correlations fitted both samples well with the lowest BIC of the three models and displayed a simple and parsimonious factor-loading pattern.

Conclusions

The study demonstrated that the two-factor structure fitted the HADS well, suggesting its usefulness in assessing the symptoms of anxiety and depression in clinical practice. BSEM is a sophisticated and flexible statistical technique that better reflects substantive theories and locates the source of model misfit. Future use of BSEM is recommended to evaluate the latent structure of other psychological instruments.

Vorheriger Artikel Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients

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Titel: Factor analyses of the Hospital Anxiety and Depression Scale: a Bayesian structural equation modeling approach
Publikationsdatum: 01.12.2013
Erschienen in: Quality of Life Research / Ausgabe 10/2013
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-013-0429-2

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Abstract

Purpose

Methods

Results

Conclusions

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