The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

Terluin, Berend; Marwijk, Harm van; Adèr, H.J.; Vet, Henrica C.W. de; Penninx, Brenda W. J. H.; Hermens, Marleen L M; Boeijen, Christine A van; Balkom, A.J.L.M. van; Klink, Jac J. L. van der; Stalman, W.A.B.

doi:10.1186/1471-244x-6-34

Cited by 395 publications

(460 citation statements)

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“…Just the fact that depression is less prevalent than distress precludes the possibility that distress be entirely caused by depression. Rather, previous research suggests that distress causes depression (Terluin et al 2006). Imagine one of our participants who, at the time of the survey, had a 'clinical' level of distress and a 'subclinical' level of somatization (according to the 4DSQ).…”

Section: Discussionmentioning

confidence: 99%

“…worry, feeling tense) are to be found in the 4DSQ distress scale, along with other stress-related symptoms. In line with the general nature of distress and the disorder nature of depression and anxiety, a special hierarchical relationship exists between distress on the one hand and depression and anxiety on the other hand (Terluin et al 2006). High depression and anxiety scores are virtually always accompanied by high distress scores.…”

Section: Psychological Symptomsmentioning

confidence: 94%

“…The independent (determinant) variables of interest consisted of the scales of the Four-Dimensional Symptom Questionnaire (4DSQ) that measures distress, depression, anxiety, and somatization (Terluin et al 2006). These dimensions, which emerged from the factor analysis of the psychological symptomatology of primary care patients, are necessary and sufficient to describe the whole range of common psychological complaints (Terluin 1996).…”

Section: Psychological Symptomsmentioning

confidence: 99%

“…Reliability coefficients (Cronbach's alpha) of the 4DSQ scales in this study were as follows: distress 0.90, depression 0.82, anxiety 0.79, and somatization 0.80. The validity of the 4DSQ has been established in a number of ways (Terluin et al 2004(Terluin et al , 2006(Terluin et al , 2009.…”

Section: Psychological Symptomsmentioning

confidence: 99%

“…Note that these 'subclinical' symptom levels (i.e. distress 5-10, depression 1-2, anxiety 1-3, and somatization 4-10), which are usually considered as relatively 'normal' and not indicative of clinically important mental problems (Terluin et al 2004(Terluin et al , 2006, appeared to be associated with an increased SA risk. Sickness absence frequency…”

Section: Lines Left Y-axis)mentioning

confidence: 99%

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Psychological symptoms and subsequent sickness absence

Terluin

Rhenen²,

Anema

et al. 2011

Int Arch Occup Environ Health

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Purpose Mental health problems are associated with sickness absence (SA). The present study aimed at establishing which symptoms-distress, depression, anxiety, or somatization-at which symptom levels were associated with SA frequency and duration. Moreover, a number of possible confounders or effect modifiers were taken into account. Methods A survey was completed by 3,678 employees of a large Dutch telecom company. Symptoms were measured using the Four-Dimensional Symptom Questionnaire (4DSQ). SA data were registered by the company's occupational health service during the 12 months' period following the survey. Poisson regression was used to analyze the number of SA spells (SA frequency). Negative binomial regression was used to analyze the total number of SA days (SA duration). Results In the bivariate analyses distress, depression, anxiety, and somatization impacted on SA frequency and duration. In the multivariate analyses, anxiety and depression turned out not to be directly associated with SA, suggesting that the effect of anxiety and depression was due to the association between anxiety/depression and distress/somatization. Regarding the SA frequency, the rate ratio for 'subclinical' distress was 1.13 (95% CI 1.03-1.25), for 'clinical' distress 1.26 (1.08-1.47), for 'subclinical' somatization 1.34 (1.23-1.46), and for 'clinical' somatization 1.69 (1.46-1.95). Regarding the SA duration, the count ratio for 'subclinical' distress was 1.15 (95% CI 0.91-1.44), for 'clinical' distress 1.50 (1.04-2.16), for 'subclinical' somatization 1.34 (1.10-1.64), and for 'clinical' somatization 1.45 (1.04-2.03). Conclusions Somatization and distress are key to understand why depression and anxiety are related to SA.

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Section: Discussionmentioning

confidence: 99%

Section: Psychological Symptomsmentioning

confidence: 94%

Section: Psychological Symptomsmentioning

confidence: 99%

Section: Psychological Symptomsmentioning

confidence: 99%

Section: Lines Left Y-axis)mentioning

confidence: 99%

See 3 more Smart Citations

Psychological symptoms and subsequent sickness absence

Terluin

Rhenen²,

Anema

et al. 2011

Int Arch Occup Environ Health

Self Cite

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The association of subjective fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning problems: A cross-sectional study conducted among young construction project management professionals

Song

Boezeman

Nieuwenhuijsen

et al. 2020

Journal of Occupational Health

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Objectives To investigate the association of subjective fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning, among young construction project management professionals (CPMPs). Methods The research had a cross‐sectional design. Dutch young CPMPs (142 participants, age range: 20 to 30 years of age) completed a questionnaire containing general questions recording their demographic characteristics, and instruments recording the following concepts: perceived person‐organization fit, perceived person‐job fit (including demands‐abilities fit and needs‐supplies fit), distress, emotional exhaustion, work engagement, and work functioning. Correlation analysis and multiple regression analysis were used to examine the association of fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning. Results The correlation analysis indicated that person‐organization fit, needs‐supplies fit, distress, emotional exhaustion, and work engagement correlated significantly with work functioning problems of young CPMPs. The multiple regression analyses corroborated that needs‐supplies fit, distress, and emotional exhaustion related significantly to the work functioning problems of young CPMPs, with the standardized regression coefficients ( β ) of −0.28, 0.52, and 0.38 ( P < .01), respectively. Other than would be expected, the multiple regression analyses also made clear that work engagement does not significantly relate to work functioning problems beyond distress and emotional exhaustion. Conclusions Incongruence between personal needs and job supplies, psychological distress, and emotional exhaustion are central correlates of the work functioning problems of young CPMPs. Occupational health professionals can use these insights to help young CPMPs at work.

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