title: Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: validation of the Danish Global Mood Scale.
abstract: OBJECTIVE
  The Global Mood Scale (GMS), assessing negative affect (NA) and positive affect (PA), is sensitive to tapping treatment-related changes in patients with cardiac conditions. We examined the psychometric properties of the Danish GMS and the influence of NA and PA on distress and health-related quality of life (HRQL).
  
  
  METHODS
  A mixed group of patients with cardiac conditions (n=502) completed the GMS, the Hospital Anxiety and Depression Scale, the Type D Scale, and the 36-item Short-Form Health Survey.
  
  
  RESULTS
  The two-factor model of the Danish GMS was confirmed, and the scale was shown to be valid, internally consistent (Cronbach's alpha NA/PA=.93/.85), and stable over 3 weeks (Pearson's r NA/PA=.82/.80). Unadjusted multiple linear regression analyses showed NA (beta=0.67, P<.001), PA (beta=-0.17, P=.001), and the interaction effect NA x PA (beta=-0.17, P=.015) to be associated with anxiety and depressive symptoms (NA:beta=0.99, P<.001; PA:beta=-0.12, P=.004; NA x PA:beta=-0.43, P<.001), as well as with physical HRQL (NA:beta=-0.37, P<.001; PA:beta=0.17, P=.001; NA x PA: beta=-0.27, P<.001) and mental HRQL (NA:beta=-0.72, P<.001; PA:beta=0.27, P=.004; NA x PA:beta=0.23, P<.001). When adjusting for demographic and clinical characteristics, only NA (beta=0.26, P=.003) was associated with anxiety, whereas NA (beta=0.75, P<.001) and NA x PA (beta=-0.34, P=.002) were associated with depressive symptoms. For physical HRQL, PA (beta=0.21, P=.03) and NA x PA (beta=-0.36, P=.005) remained significant, whereas NA (beta=-0.38, P<.001) and PA (beta=0.21, P=.002) remained significant for mental HRQL.
  
  
  CONCLUSIONS
  The Danish GMS is a psychometrically sound measure of affect in patients with cardiac conditions. Future studies should examine changes in both PA and NA and their impact on health outcomes.
authors.affiliation: Department of Psychology, Aarhus University, Aarhus, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Spindler
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kruse
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000339:Affect; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003718:Denmark; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires