title: Reliability and factor structure of the Hospital Anxiety and Depression Scale in a polytrauma clinic.
abstract: The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure of anxiety and depression symptoms. This study examined the internal consistency and factor structure of the HADS among Veterans in a polytrauma/traumatic brain injury clinic. The sample consisted of 312 Veterans. A confirmatory factor analysis of the depression and anxiety subscales showed, not surprisingly, that the two factors were highly correlated (r = 0.7). Goodness of fit statistics for the two-factor model were acceptable (root mean square error of approximation = 0.06, comparative fit index = 0.94). The HADS demonstrated very good reliability overall (alpha = 0.89) and for the individual subscales (alpha = 0.84). This study supports the use of the HADS as a screen for depression and anxiety in the assessment of mild traumatic brain injury in a Veteran population.
authors.affiliation: Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Laura
authors.initials: L
authors.lastname: Boxley
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Flaherty
authors.affiliation: Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spencer
authors.affiliation: Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Drag
authors.affiliation: Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.|University of Michigan Health System, University of Michigan, Ann Arbor, MI.
authors.forename: Percival H
authors.initials: PH
authors.lastname: Pangilinan
authors.affiliation: Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.|University of Michigan Health System, University of Michigan, Ann Arbor, MI.
authors.forename: Linas A
authors.initials: LA
authors.lastname: Bieliauskas
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis*; D000070642:Brain Injuries, Traumatic / Q000150:complications; D003863:Depression / Q000175:diagnosis*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000150:complications; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires / Q000592:standards*; D014728:Veterans; D055815:Young Adult
keywords: anxiety; concussion; confirmatory factor analysis; depression; factor structure; internal consistency; mild traumatic brain injury; polytrauma; reliability; self-report