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A confirmatory factor analysis of the Hospital Anxiety and Depression scale: Comparing empirically and theoretically derived structures
Author(s) -
Dunbar Martin,
Ford Graeme,
Hunt Kate,
Der Geoff
Publication year - 2000
Publication title -
british journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.479
H-Index - 92
eISSN - 2044-8260
pISSN - 0144-6657
DOI - 10.1348/014466500163121
Subject(s) - psychology , anxiety , confirmatory factor analysis , negative affectivity , depression (economics) , hospital anxiety and depression scale , clinical psychology , anhedonia , exploratory factor analysis , structural equation modeling , scale (ratio) , psychometrics , psychiatry , statistics , schizophrenia (object oriented programming) , physics , mathematics , quantum mechanics , economics , macroeconomics
Objectives. To compare the fit of various factor solutions for the Hospital Anxiety and Depression scale (HAD; Zigmond & Snaith, 1983). Design. A cross‐sectional postal survey was used to collect the data from community‐based participants in the West of Scotland Twenty‐07 study. Methods. The HAD scale, a 14‐item self‐administered measure of anxiety and depression, was completed by 2547 participants from three age cohorts (aged approximately 18, 39 and 58 years). Using confirmatory factor analyses four models suggested by prior exploratory factor analyses were compared to a model derived from Clark and Watson's (1991) tripartite theory of anxiety and depression. Results. The model derived from the tripartite theory of anxiety and depression (with factors labelled negative affectivity, anhedonic depression and autonomic anxiety) produced the closest fit to the data. This model produced a good fit in all three cohorts although group comparisons suggested that there were variations in the strength of some factor loadings across the three age groups. A model that had a hierarchical arrangement of the three factors in the tripartite model was also produced. This model fit the data equally as well as did the ‘flat’ tripartite model. Conclusions. Three factors appear to underlie the HAD scale. Research is needed that examines whether or not using sub‐scales based on these factors increases the ability of the HAD scale to detect cases of anxiety and depression.