Factorial validity, measurement invariance and concurrent validity of Hospital Anxiety and Depression Scale in a sample of Polish undergraduate students

Abstract

With increasing levels of psychopathology observed in students in recent years, there is a clear need for short and valid tools for evaluating their psychological health. Hospital Anxiety and Depression Scale (HADS) is one of the most commonly used instruments measuring these constructs. The aim of this study was to examine the psychometric properties of the Polish version of HADS in a sample of undergraduate students. Material and methods: A total of 1,032 students took part in the study. The students' were from various universities, years of study, and study courses. Confirmatory factor analysis was used to test the model fit of the original 2-factor structure. A series of hierarchically nested models were tested to assess measurement invariance between genders. Pearson correlation coefficients of HADS scores with criterion variables were calculated. The prevalence of depression was estimated on the basis of an empirical cut-off score. Results: Confirmatory factor analysis showed a good model fit of the Polish version of HADS, and strict measurement invariance between genders. Both anxiety and depression were related to higher levels of stress and lower sleep quality, social support and general quality of life. The prevalence of depression was estimated to be 7.6% or 21.2%, depending on the cut-off score used. Conclusions:The study corroborates good psychometric properties of the original 2-factor structure of the Polish version of HADS in a student sample, including measurement invariance between genders. It is thus concluded that HADS is a valid tool for the short measurement of anxiety and depression among students.

A solution for factorial validity testing of three-item scales: An example of tau-equivalent strict measurement invariance of three-item loneliness scale

“…Seven items measure anxiety, and seven measure depression. The Polish version of the scale showed good validity and reliability in previous research (Czerwiński et al, 2020 ). In the present sample, the Cronbach’s alpha reliability coefficient was .74 for depression, and .85 for anxiety.…”

“…Our study focused on the undergraduate students because they comprise almost half of the population age 19–24 in Poland (Główny Urząd Statystyczny, 2019 ) and previous studies showed that student populations are highly vulnerable to loneliness (American College Health Association, 2016 ). Polish studies showed high prevalence of depression and considerable hopelessness among university students (Czerwiński, Mackiewicz, Mytlewska, & Atroszko, 2020 ; Koryczan, Piotrowski, Roj, Czerwiński, & Atroszko, 2020 ).…”

Compulsive Study Behaviors Are Associated with Eating Disorders and Have Independent Negative Effects on Well-Being: A Structural Equation Model Study among Young Musicians

“…Respondents provided answers on a four-point scale, with response categories from 0 to 3, the labels of which vary depending on the items. The scale showed good validity and reliability in previous research, including in screening studies with student samples [50,51]. The Cronbach's alpha reliability coefficients in the current sample were 0.74 for anxiety and 0.67 for depression.…”

Conspiratorial Beliefs About COVID-19 Pandemic - Can They Pose a Mental Health Risk? The Relationship Between Conspiracy Thinking and the Symptoms of Anxiety and Depression Among Adult Poles

“…The possible number of points for each question is in the range of 0–3, while the maximum number of points possible to obtain in each subscale is 21. α-Cronbach's coefficient for the subscale of depression symptoms is 0.82, and for anxiety 0.83 ( 36 ). In Polish studies, the Cronbach's α coefficient was 0.74 for depression and 0.85 for anxiety ( 37 ). In our study, the α-Cronbach's coefficient was 0.76; 95% CI 0.73–0.77 for depression and 0.84; 95% CI 0.82–0.86 for anxiety.…”