title: Responsiveness and construct validity of the depression, anxiety, and positive outlook scale (DAPOS).
abstract: BACKGROUND
  The Depression, Anxiety, and Positive Outlook Scale (DAPOS) was designed to measure mood in pain populations without contamination from somatic items.
  
  
  OBJECTIVE
  The current study examined responsiveness, internal consistency, and construct validity in pain patients.
  
  
  METHODS
  A questionnaire survey before and after a multidisciplinary rehabilitation intervention was completed by chronic pain patients, the majority of whom had back pain.
  
  
  RESULTS
  The DAPOS showed excellent internal consistency (N=222, Cronbach alpha=0.86 for the Depression subscale, 0.90 for the Anxiety subscale, and 0.74 for the Positive Outlook subscale) and construct validity (N=82) in comparison with a variety of measures (SF-36; Pain Catastrophizing Scale; Zung Depression). Responsiveness was acceptable (ranging between 0.5 and 0.7, for both the mean change in score after treatment to the variability in patients at baseline, and the standardized response mean), although considerably lower than the Zung Depression Inventory. However, reanalysis without somatic items rendered the responsiveness of the Zung inadequate, indicating that change on this measure was due almost entirely to change in somatic symptoms without change in mood.
  
  
  CONCLUSIONS
  Responsiveness of the DAPOS should be reassessed in treatment targeting mood change explicitly. The DAPOS scales show acceptable clinimetric and psychometric properties, and add a measurement of positive outlook to create a more balanced indication of mood in pain patients.
authors.affiliation: Department of Psychology, Royal Holloway, University of London, Egham, UK. t.pincus@rhul.ac.uk
authors.forename: Tamar
authors.initials: T
authors.lastname: Pincus
authors.forename: Adina
authors.initials: A
authors.lastname: Rusu
authors.forename: Rita
authors.initials: R
authors.lastname: Santos
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D004185:Disability Evaluation; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires