A systematic review and meta-analysis of the Brief Illness Perception Questionnaire

Objective: This paper aims to systematically review the use and performance of the Brief Illness Perception Questionnaire (Brief IPQ).

Design: Electronic databases were searched for papers administering the Brief IPQ published in peer-reviewed journals. Data were extracted from the results for meta-analysis.

Main outcome measures: Use by illness population, country, language and study design. The questionnaire’s concurrent validity, predictive validity, sensitivity to change, discriminant validity and mean scores for different populations were summarised.

Results: The review included 188 papers. The Brief IPQ has been administered to patients from age 8 to over 80, with a wide range of illnesses, in 26 languages from 36 countries. Pooled correlations between illness perceptions and depression, anxiety, blood glucose levels and quality of life were consistent with previous research and theory (range .25–.49 for consequences, identity and emotional representations; ?.12 to ?.27 for personal control). All items were able to predict some outcomes up to one-year follow-up. Each subscale demonstrated sensitivity to change after intervention in randomised controlled trials with the personal control and causal items showing most frequent change.

Conclusions: The Brief IPQ is widely used and has good psychometric properties. More studies should include and analyse the causal item.     

The Convergent Validity of Four Burnout Measures in a Chinese Sample: A Confirmatory Factor‐Analytic Approach

The purpose of this paper is to study the convergent validity of the four most widely used burnout measures in a sample of Chinese nurses (N= 717). First, Structural Equation Modeling was used to investigate the factor structure of scores produced by the Maslach Burnout Inventory‐General Survey (MBI‐GS), the Burnout Measure (BM), the Shirom‐Melamed Burnout Measure (SMBM), and the Oldenburg Burnout Inventory (OLBI). Next, several competing models were tested to investigate the convergent validity of these four burnout instruments. The final results suggest that burnout is best conceived of as a multidimensional construct consisting of exhaustion and withdrawal, which are two related but conceptually distinct aspects. In addition, positively phrased items should be dropped from burnout measures for they constitute a separate factor that is considered to be an artifact.     

The construct validity of burnout

Considerable confusion exists in the burnout literature about the similarities and separateness among the constructs of burnout, depression and job satisfaction. This study examined the construct validity of burnout using Campbell & Fiske's multitrait-multimethod approach. The constructs of burnout, depression and orderliness (chosen as a discriminant construct) were assessed by three types of self-report instruments. Data were analysed for 181 females and 139 male faculty members who spent at least 50 per cent of their time in teaching. Results indicated that measures of burnout largely met Campbell & Fiske's criteria for construct validity: burnout measures possessed adequate to good internal reliability and convergent validity. However, burnout measures also correlated substantially with measures of depression. Results are discussed in terms of possible explanations for the substantial overlap that has been demonstrated among measures of burnout, depression and job satisfaction.     

Differentiating anxiety and depression: the State-Trait Anxiety-Depression Inventory

ABSTRACT

The differentiation of trait anxiety and depression in nonclinical and clinical populations is addressed. Following the tripartite model, it is assumed that anxiety and depression share a large portion of negative affectivity (NA), but differ with respect to bodily hyperarousal (specific to anxiety) and anhedonia (lack of positive affect; specific to depression). In contrast to the tripartite model, NA is subdivided into worry (characteristic for anxiety) and dysthymia (characteristic for depression), which leads to a four-variable model of anxiety and depression encompassing emotionality, worry, dysthymia, and anhedonia. Item-level confirmatory factor analyses and latent class cluster analysis based on a large nation-wide representative German sample (N?=?3150) substantiate the construct validity of the model. Further evidence concerning convergent and discriminant validity with respect to related constructs is obtained in two smaller nonclinical and clinical samples. Factors influencing the association between components of anxiety and depression are discussed.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

A psychometric evaluation of the Icelandic version of the WHO‐5

The psychometric properties of the Icelandic version of the World Health Organization five wellbeing index (WHO‐5) were evaluated using two samples, a randomly selected sample (N = 3,896) from the Icelandic National Registry and a convenience sample of primary care patients (N = 126). The factor structure of the scale was tested with confirmatory factor analysis (CFA). The correlation between the WHO‐5 and other measures of depression and anxiety were calculated to assess the scale's convergent and divergent validity. The discriminant validity of the WHO‐5 was explored with a receiver operating analysis compared to the Mini International Neuropsychiatric Interview. The CFA indicated that the factor structure of the WHO‐5 was one‐dimensional and factorial invariant between groups. The internal reliability of the WHO‐5 was adequate and the convergent, divergent and discriminant validity of the WHO‐5 was supported. It is concluded that the psychometric properties of the Icelandic version of the WHO‐5 are satisfactory.     

A depressive symptom scale for the California Psychological Inventory: construct validation of the CPI-D

To facilitate life span research on depressive symptomatology, a depressive symptom scale for the California Psychological Inventory (CPI) is needed. The authors constructed such a scale (the CPI-D) and compared its psychometric properties with 2 widely used self-report depression scales: the Beck Depression Inventory and the Center for Epidemiological Studies Depression Scale. Construct validity of the CPI-D was examined in 3 studies. Study 1 established content validity, classifying CPI-D items into Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition depressive symptoms. Study 2 used 3 large samples to gather evidence for reliability and validity: correlational analyses demonstrated alpha reliability and convergent and discriminant validity; factor analysis provided evidence for discriminant validity with anxiety; and regression analyses demonstrated comparative validity with existing standard PI scales. Study 3 used clinician ratings of depression and anxiety as criteria for external validity.     

A Multitrait Multimethod Measurement Approach to the Traits (or States) of Anxiety,Depression and Hostility

This study tested the convergent and discriminant validities of various psychological techniques used for the measurement of the affects of anxiety, depression and hostility. The subjects were 29 psychiatric patients and 25 normal controls, all males. Subjects were interviewed and rated for the three affects and given an extensive battery of tests. Anxiety and depression measures from ratings, checklists, and questionnaires demonstrated good convergent validity but poor discriminant validity. The projective methods did not demonstrate much convergent validity. Hostility was separable from anxiety and depression but the tests showed poor convergent validity for hostility. In the normals, fantasy hostility (TAT) and admitted hostility (Multiple Affect Adjective Check List) showed some convergence, but in the patients there was no congruence between these two levels.     

Progress in the development of a multidimensional measure of fear of failure: The performance failure appraisal inventory (pfai)

Abstract

Measuring fear of failure (FF) is a tremendous challenge for researchers and practitioners because (a) existing measures have demonstrated limited support for the validity of their score interpretations, and (b) existing measures are unidimensional while accumulating evidence suggests that FF is multidimensional. The Performance Failure Appraisal Inventory (PFAI) was developed to measures a set of empirically-derived congnitive-motivational-relational appraisals associated with FF. Results indicated that PFAI scores represented fears of (a) experiencing shame and embarrassment, (b) devaluing one's self-estimate, (c) losing social influence, (d) having an uncertain future, and (e) upsetting important others. Correlations with external measures of achievement goal orientations, trait anxiety, and social desirability were consistent with theoretical predictions. PFAI scores correctly classified 76.5% of participants' perceptions of underachievement.     

Anxiety,depression, and the suicidal spectrum: a latent class analysis of overlapping and distinctive features

ABSTRACT

Anxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: (1) a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (2) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and (3) a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report of worthlessness, crying, and sadness; higher levels of anxious arousal and negative affect; and lower levels of positive affect. Depression and anxiety diagnoses were not discriminant between higher and lower suicide risk classes. This transdiagnostic and dimensional approach to understanding the suicidal spectrum contrasts with treating it as a depressive symptom, and illustrates the advantages of a tripartite model for conceptualising suicide risk.     

Effectiveness of the Hamilton Anxiety Rating Scale with Older Generalized Anxiety Disorder Patients

To expand the collection of instruments available for assessment of anxiety in the elderly, this report examined the original and revised Hamilton anxiety scales in a sample of 50 older adults diagnosed with Generalized Anxiety Disorder (GAD) and 93 normal community participants (ages 55–82). Although the revised anxiety scale had better discriminant validity (lower correlation with the revised Hamilton depression scale) than the original anxiety and depression scales, a considerable amount of shared variance still existed (41% shared variance, GAD sample alone; 17% control sample alone; 74% shared variance, both samples combined). Near-perfect group classification was possible using 7 items from the original anxiety scale and 10 items from the revised anxiety scale. Results are discussed in light of their implications for use of the Hamilton anxiety rating scale with older anxiety-disordered patients.     

The Value of Certain Non-Intellectual Factors for Direct and Differential Prediction of Academic Success

Summary

To examine the convergent and discriminant validity of an attitudinal questionnaire measure of traditionalism-modernism in Thai exchange students, questionnaire scores were correlated with self and peer measures of traditionalism-modernism and with a measure of “culture-shock.” For the latter, it was anticipated that high scores on modernism would inversely correlate with culture-shock scores. Results indicated that the questionnaire measures were positively correlated with self and peer measures at significant levels; however, the relationship was not very substantial. Thus, there appears to be only a tenuous degree of convergent validity for questionnaire measures of traditionalism-modernism. The results further indicate a marginal amount of discriminant validity as measured by the relationship between the traditionalism-modernism questionnaire and the culture-shock questionnaire. Caution was suggested in using unvalidated attitudinal questionnaire measures of traditionalism-modernism, and the need for recognizing the multidimensional rather than unidimensional nature of traditionalism-modernism as a personality characteristic was pointed out.     

Preliminary Validation of a Korean Version of the Acquired Capability for Suicide Scale‐Fearlessness About Death

The interpersonal‐psychological theory of suicide proposes that the desire for suicide must be accompanied by the capability to do so in order for an individual to engage in suicidal behavior. The Acquired Capability for Suicide Scale‐Fearlessness about Death (ACSS ‐FAD ) measures fearlessness about death, a core component of the capability for suicide. This study aimed to validate a Korean version of the ACSS ‐FAD in a college student sample. We administered the ACSS ‐FAD and measures of suicide ideation, fear of suicide, death anxiety, pain anxiety, and depression in a sample of Korean college students (N  = 301) and analyzed its reliability, factor structure, invariance across genders, convergent validity, and discriminant validity. The one‐factor model achieved satisfactory model fit. Across genders, partial metric invariance and partial scalar invariance were established. The results also revealed that the ACSS ‐FAD has good internal consistency, convergent validity (positive correlations with fear of suicide, death anxiety, and pain anxiety), and discriminant validity (no relation with depression). The Korean version of the ACSS ‐FAD presents adequate psychometric properties and may be considered to be a promising instrument for measuring fearlessness about death in college students.     

Discriminant Validity of the Inventory to Diagnose Depression

Measures of depression and anxiety correlate highly with one another. It has been hypothesized that this shared variance partly reflects poor discriminant validity, which could be improved by linking item content more closely to diagnostic criteria. We tested this speculation by comparing the Inventory to Diagnose Depression (Zimmerman, Coryell, Corenthai, & Wilson, 1986), developed to correspond with diagnostic criteria for major depression, with the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979) in terms of discriminant validity. These measures correlated more strongly with each other than with anxiety but did not differ in their relations with anxiety.     

The surgical anxiety questionnaire (SAQ): development and validation

Objective: Preoperative anxiety is often assessed using general anxiety measures; existing specific measures might lack content coverage and/or are not psychometrically validated. This study aimed to develop a new self-report measure of surgery-specific anxiety and test its psychometric properties.

Design: The surgical anxiety questionnaire (SAQ) was developed from themes identified in qualitative research and reviewed by an interdisciplinary expert team. It was administered preoperatively to 135 patients (56% female, mean age 51) on the day of surgery alongside additional measures of preoperative anxiety, state anxiety, perceived stress, depression and social desirability. Follow-up assessment was conducted immediately post-surgery and two weeks post-surgery (n?=?114) to examine recovery and predictive validity of the scale.

Results: Factor analysis revealed a three component structure, including: concerns about health (six items), concerns about recovery (four items) and concerns about procedures (four items). Three additional items of relatively high concern were retained in the total score (17 items). The SAQ displayed good reliability, validity (content, construct and predictive) and adequate overall psychometric properties.

Conclusions: Preliminary results suggest that the SAQ is a promising tool for measuring preoperative anxiety and predicting recovery. Recommendations for future research include employing a confirmatory factor analysis and examining test-retest reliability.     

Anger and postcombat mental health: Validation of a brief anger measure with U.S. Soldiers postdeployed from Iraq and Afghanistan

The involvement of anger in the psychological adjustment of current war veterans, particularly in conjunction with combat-related posttraumatic stress disorder (PTSD), warrants greater research focus than it has received. The present study concerns a brief anger measure, Dimensions of Anger Reactions (DAR), intended for use in large sample studies and as a screening tool. The concurrent validity, discriminant validity, and incremental validity of the instrument were examined in conjunction with behavioral health data for 3,528 treatment-seeking soldiers who had been in combat in Iraq and Afghanistan. Criterion indices included multiple self-rated measures of psychological distress (including PTSD, depression, and anxiety), functional difficulties (relationships, daily activities, work problems, and substance use), and violence risk. Concurrent validity was established by strong correlations with single anger items on 4 other scales, and discriminant validity was found against anxiety and depression measures. Pertinent to the construct of anger, the DAR was significantly associated with psychosocial functional difficulties and with several indices of harm to self and to others. Hierarchical regression performed on a self/others harm index found incremental validity for the DAR, controlling for age, education, military component, officer rank, combat exposure, PTSD, and depression. The ability to efficiently assess anger in at-risk military populations can provide an indicator of many undesirable behavioral health outcomes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Measuring Latinos' perceptions of depression: a confirmatory factor analysis of the Illness Perception Questionnaire

This study examined the psychometric properties of the Revised Illness Perception Questionnaire adapted for a clinical sample of low-income Latinos suffering from depression. Participants (N = 339) were recruited from public primary care centers. Their average age was 49.73 years and the majority was foreign born females of either Mexican or Central American descent. Confirmatory factor analysis was used to test the factor structure of this measure. Construct and discriminant validity and internal consistency were evaluated. After the elimination of three items because of low factor loadings (< .40) and the specification of seven error covariances, a revised model composed of 24 items had adequate goodness-of-fit indices and factor loadings, supporting construct validity. Each of the subscales reported satisfactory internal consistency. Intercorrelations between the 5 illness perception factors provided initial support for the discriminant validity of these factors in the context of depression. The establishment of the psychometric properties of this adapted measure will pave the way for future studies examining the role illness perceptions play in the help seeking and management of depression among Latinos.     

Arousability,trait anxiety and the worry and emotionality components of test anxiety

Abstract

Eleventh- and twelfth-grade high-school students (or equivalent subjects in Saudi Arabia, Egypt and Brazil) participated in this study. All subjects were administered the Test Anxiety Inventory and the Anxiety/Arousability Inventory in their native language. A confirmatory factor analysis yielded the following conclusions: (1) the measures of trait anxiety arousability, test anxiety (worry), and test anxiety (emotionality) demonstrated high reliability, factorial validity and discriminant validity in each of the four samples; (2) as hypothesized, significant positive correlations were found between all four measures in each of the four samples; (3) analyses of invariance supported the invariance of factor loadings and factor true variances across three cultural groups: Egypt, Brazil and the USA. (Saudi Arabia was eliminated from the invariance analysis because the sample was all male.) Analyses of invariance did not support the invariance of error/uniquenesses and factor correlations.     

Validity of the Devereux Scales of Mental Disorders with adolescent psychiatric inpatients

Tested the validity of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) in a sample of 108 adolescent psychiatric inpatients. DSMD scales were compared to parent-report, interview-based, self-report and diagnostic measures. DSMD measures of conduct problems and delinquency were significantly associated with the predicted parent-report, interview-based, and diagnostic measures of conduct disorder and substance abuse and not with any measures of anxiety or depression. DSMD measures of anxiety and depression were related to other parent-report ratings of internalizing symptoms but had more limited convergent and discriminant validity. The DSMD was compared to the Child Behavior Checklist (CBCL; Achenbach, 1991) for diagnostic classification accuracy. The two measures were comparable in classifying oppositional or conduct disorder. The CBCL was superior for classification of major depression. The DSMD was superior for classification of substance abuse.     

Anxiety and depression: toward overlapping and distinctive features

ABSTRACT

This Special Issue of Cognition and Emotion addresses one of the cardinal concerns of affective science, which is overlapping and distinctive features of anxiety and depression. A central finding in the study of anxiety and depression is that they are moderately highly correlated with each other. This leads us to the question: What is behind this co-occurrence? Possible explanations relate to poor discriminant validity of measures; both emotional states are associated with negative affect; stressful life events; impaired cognitive processes; they share a common biological/genetic diathesis. However, despite a set of common (nonspecific) features, anxiety and depression are clearly not identical emotional states. Differences between them might be best viewed, for example, through their heterogeneous and multi-layered nature, adaptive functions and relations with regulatory processes, positive affect, and motivation or complex cognitive processes. In this introduction we consider several approaches (e.g. functional approach; tripartite model and content-specificity hypothesis) to which most research in this Special Issue is relevant. In addition, we have asked contributors to this Special Issue to indicate how their own studies on comparisons between anxiety and depression and models on anxiety and depression move this area of research to more mature science with applicability.