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Quality of Life Research
Published in: Quality of Life Research 6/2010

Open Access 01-08-2010

Psychometric evaluation of the Hospital Anxiety and Depression Scale in a large community sample of adolescents in Hong Kong

Authors: Ya-Fen Chan, Doris Y. P. Leung, Daniel Y. T. Fong, Chi-Ming Leung, Antoinette M. Lee

Published in: Quality of Life Research | Issue 6/2010

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Abstract

Purpose

The Hospital Anxiety and Depression Scale (HADS) is widely used in adult populations; however, its usefulness with adolescents has been explored less. This study sought to evaluate the reliability, validity, and factor structure of the Chinese version of HADS in a community sample of adolescents residing in Hong Kong.

Methods

A prospective cohort of 5,857 students recruited from 17 secondary schools completed the HADS. Internal consistency and concurrent validity were examined. Confirmatory factor analysis was applied to test the relative fits of six factor structures of the HADS. The best fitting model was further cross-validated by male, female, split-half samples, and age subgroups.

Results

The HADS possessed adequate internal consistency, especially for the anxiety subscale. Significant concurrent intercorrelations with self-reported suicidal thoughts and the Youth Self Report Anxious/Depressed subscale were discovered and found to be stronger for females. The cross-validation supported a two-factor model, where anxiety item 7, “I can sit at ease and feel relaxed”, was placed in the depression subscale.

Conclusions

The HADS showed satisfactory psychometric properties as a screening instrument in assessing anxious and depressive states as two correlated but distinct factors in adolescents. Study implications and recommendations for future research were discussed.
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Metadata
Title
Psychometric evaluation of the Hospital Anxiety and Depression Scale in a large community sample of adolescents in Hong Kong
Authors
Ya-Fen Chan
Doris Y. P. Leung
Daniel Y. T. Fong
Chi-Ming Leung
Antoinette M. Lee
Publication date
01-08-2010
Publisher
Springer Netherlands
Published in
Quality of Life Research / Issue 6/2010
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-010-9645-1

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