The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations

The Hospital Anxiety and Depression Scale (HADS; Zigmond - Snaith, 1983) is widely used; however, its factor structure is unclear, with studies reporting differing unidimensional, two-factor and three-factor models. We aimed to address some key theoretical and methodological issues contributing to inconsistencies in HADS structures across samples. We reviewed existing HADS models and compared their fit using confirmatory factor analysis (CFA). We also investigated methodological effects by comparing factor structures derived from Rasch and Principal Components Analysis (PCA) methods, as well as effects of a negative wording factor. An Australian community-dwelling sample consisting of 189 females and 158 males aged 17–86 (M = 35.73, SD = 17.41) completed the 14-item HADS. The Rasch Analysis, PCA and CFA all supported the original two-factor structure. Although some three-factor models had good fit, they had unacceptable reliability. In the CFA, a hierarchical bifactor model with a general distress factor and uncorrelated depression and anxiety subscales produced the best fit, but the general factor was not unidimensional. The addition of a negative wording factor improved model fit. These findings highlight the effects of differing methodologies in producing inconsistent HADS factor structures across studies. Further replication of model fit across samples and refinement of the HADS items is warranted.     

Moral Identity Predicts Adherence to COVID-19 Mitigation Procedures Depending on Political Ideology: A Comparison Between the USA and New Zealand

Reducing the spread of infectious viruses (e.g., COVID-19) can depend on societal compliance with effective mitigations. Identifying factors that influence adherence can inform public policy. In many cases, public health messaging has become highly moralized, focusing on the need to act for the greater good. In such contexts, a person's moral identity may influence behavior and serve to increase compliance through different mechanisms: if a person sees compliance as the right thing to do (internalization) and/or if a person perceives compliance as something others will notice as the right thing to do (symbolization). We argue that in societies that are more politically polarized, people's political ideology may interact with their moral identity to predict compliance. We hypothesized that where polarization is high (e.g., USA), moral identity should positively predict compliance for liberals to a greater extent than for conservatives. However, this effect would not occur where polarization is low (e.g., New Zealand). Moral identity, political ideology, and support for three different COVID-19 mitigation measures were assessed in both nations (N = 1,980). Results show that while moral identity can influence compliance, the political context of the nation must also be taken into account.     

The Relevance of People Versus Objects in Explaining Females’ Advantage over Males in Appearance Accuracy

Do females remember their surroundings better than males? Does it matter who or what is in those surroundings? In small groups, 108 undergraduates from a Midwestern university in the USA were instructed to pay attention to a videotaped person (target) while seated in an office with an experimenter (non-target). Afterwards, in a surprise recall task, participants’ memory for the appearance of the target, non-target, and office was tested. Females’ greater interpersonal orientation was predicted to give them an advantage over males in memory for only the people. Results showed that females had better memory for the target and non-target but not the office. Discussion centers on the importance of people versus objects in explaining females’ greater appearance accuracy.     

Inferential errors in taxometric analyses of ordered three-class constructs

Taxometric analysis (Waller & Meehl, 1998) has become a popular tool for investigating whether personality and psychopathology constructs are better modeled as dimensional or categorical. Monte Carlo evidence for the validity of taxometric methods, however, has been restricted to data that are derived either from latent dimensional or dichotomous models. There are various circumstances in which the correct model for a psychosocial construct could involve three or more ordered classes. It was demonstrated both mathematically and empirically that under these circumstances, the results of taxometric analyses can lead to incorrect conclusions about the population structure. Recommendations are provided for future studies intended to distinguish between categorical and dimensional structures.     

Predictor combination in binary decision-making situations

Professional psychologists are often confronted with the task of making binary decisions about individuals, such as predictions about future behavior or employee selection. Test users familiar with linear models and Bayes's theorem are likely to assume that the accuracy of decisions is consistently improved by combination of outcomes across valid predictors. However, neither statistical method accurately estimates the increment in accuracy that results from use of additional predictors in the typical applied setting. It was demonstrated that the best single predictor often can perform better than do multiple predictors when the predictors are combined using methods common in applied settings. This conclusion is consistent with previous findings concerning G. Gigerenzer and D. Goldstein's (1996) "take the best" heuristic. Furthermore, the information needed to ensure an increment in fit over the best single predictor is rarely available.     

The Owl of Minerva: Reflections on the Theological Significance of Mary Midgley

This paper offers a theologically-orientated examination of some core themes of the works of the philosopher Mary Midgley (1919–2018), identifying areas of possible theological exploration and development. Particular attention is paid to her critique of the reductionist strategies of writers such as Richard Dawkins, her development of the ‘mapping’ metaphor for engaging complex issues, and her emphasis on the critical role of philosophy. Although the paper offers some brief examples of theological issues which are illuminated by Midgley’s philosophical approach (such as soteriological mapping), the primary purpose of the paper is to highlight the theological hospitality that it offers.     

The making of meaning: comments on Hofstee and Ten Berge

Hofstee and Ten Berge (2004/this issue) outline a method of scale transformation that places scores on a common absolute scale. This contrasts with traditional relative methods of transformation, which involve scaling in relation to a sample mean. Their primary intention seems to be to produce a scale that is intrinsically meaningful. This issue of scale meaning is discussed in some detail, including reference to an alternate approach to absolute scaling offered by Cohen, Cohen, Aiken, and West (1999). Ultimately, neither approach to absolute scaling seems completely satisfactory as a resolution to this problem. It is suggested that the lack of meaning inherent to many psychosocial measures is a natural product of traditional aggregative practices in scale development and may be invulnerable to statistical correction.     

Enhancing accuracy in observational test scoring: the comprehensive system as a case example

Inaccuracies in administration and scoring can potentially compromise the validity of any standardized psychosocial measure. The threat is particularly pertinent to methods involving behavioral observation, a category that includes many intelligence tests, neuropsychological measures, personality assessment instruments, and diagnostic procedures. Despite evidence and conjecture that errors in testing procedure are common for at least some of these measures and that these errors are often severe enough to influence interpretation, the topic has received relatively little attention. In particular, the absence of any safeguard against inaccurate test use in clinical situations can put the respondent at risk and violates ethical standards for the use of tests. In this article, I review some issues surrounding accuracy in testing procedures, including a discussion of what is known about the problem, an evaluation of several approaches to improving testing practices, and a review of recommendations for the statistical evaluation of rater accuracy. In this article, I use the Rorschach Comprehensive System (Exner, 1993) to demonstrate the concepts discussed.     

A comparison of the PAI and MMPI-2 as predictors of faking bad in college students

Both the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and Personality Assessment Inventory (PAI; Morey, 1991) offer a large set of scales devoted to the identification of response styles. This study directly compared the effectiveness of the 2 inventories as indicators of overreporting. The 2 measures were administered to 52 college students instructed to fake bad under conditions describing either a forensic (n = 24) or psychiatric (n = 28) setting as well as to 432 psychiatric patients. Results indicated that the MMPI-2 F - K index and Fp Scale were the best single indicators of a faking bad response style and that the MMPI-2 scales were the better indicators as a set. However, the PAI scales demonstrated a significant level of incremental validity over the MMPI-2 indicators in every analysis conducted. The findings suggest that either inventory offers an effective approach to the detection of overreporting, and administering both inventories can enhance the accuracy of prediction further.