Psychometric properties of the 7-item Generalized Anxiety Disorder scale in antepartum women from Ghana and Côte d'Ivoire
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Psychometric properties of the 7-item Generalized Anxiety Disorder scale in antepartum women from Ghana and Côte d'Ivoire. / Barthel, Dana; Barkmann, Claus; Ehrhardt, Stephan; Bindt, Carola; International CDS Study Group.
in: J AFFECT DISORDERS, Jahrgang 169, 01.12.2014, S. 203-11.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Psychometric properties of the 7-item Generalized Anxiety Disorder scale in antepartum women from Ghana and Côte d'Ivoire
AU - Barthel, Dana
AU - Barkmann, Claus
AU - Ehrhardt, Stephan
AU - Bindt, Carola
AU - International CDS Study Group
N1 - Copyright © 2014 Elsevier B.V. All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - BACKGROUND: To explore the psychometric properties of the 7-item Generalized Anxiety Disorder scale (GAD-7) in West African pregnant women.METHODS: In a cross-sectional study, the GAD-7, the PHQ-9 (depression module of the Patient Health Questionnaire) and the WHO-DAS II (12-item World Health Organization Disability Scale) were administered to n=647 Ivorian and n=395 Ghanaian antepartum women with low-risk pregnancies (third trimester; gestational age range: 28-40 weeks) in 2010-2011. Statistical analyses combined classical test theory (CTT) and item response theory (IRT).RESULTS: Cronbach׳s α was close to acceptable (α=.69 in Côte d'Ivoire; α=.67 in Ghana). Construct validity was demonstrated by correlations between the GAD-7 and both the PHQ-9 and the WHO-DAS II. Results regarding factorial validity were ambiguous: confirmatory and exploratory factor analyses indicated that the data fit the unidimensionality assumption; however, the explained variance was low. IRT methods suggested excellent item infit and outfit measures. Yet, residual principal component analyses showed a lack of unidimensionality. Rasch analyses revealed that the response options were not used as intended. Item-person-fit was not optimal since the items did not discriminate well on the range of the latent construct where most of the women drawn from the general population were located.LIMITATIONS: Both samples were somewhat homogenous regarding gestational age and urban residence; test-retest reliability was not investigated.CONCLUSION: The GAD-7 met the requirements of CTT. However, applying the stricter criteria of IRT suggested areas for potential improvements. Cross-cultural adaption and a dichotomized response format might ameliorate the GAD-7 for the use in sub-Saharan countries.
AB - BACKGROUND: To explore the psychometric properties of the 7-item Generalized Anxiety Disorder scale (GAD-7) in West African pregnant women.METHODS: In a cross-sectional study, the GAD-7, the PHQ-9 (depression module of the Patient Health Questionnaire) and the WHO-DAS II (12-item World Health Organization Disability Scale) were administered to n=647 Ivorian and n=395 Ghanaian antepartum women with low-risk pregnancies (third trimester; gestational age range: 28-40 weeks) in 2010-2011. Statistical analyses combined classical test theory (CTT) and item response theory (IRT).RESULTS: Cronbach׳s α was close to acceptable (α=.69 in Côte d'Ivoire; α=.67 in Ghana). Construct validity was demonstrated by correlations between the GAD-7 and both the PHQ-9 and the WHO-DAS II. Results regarding factorial validity were ambiguous: confirmatory and exploratory factor analyses indicated that the data fit the unidimensionality assumption; however, the explained variance was low. IRT methods suggested excellent item infit and outfit measures. Yet, residual principal component analyses showed a lack of unidimensionality. Rasch analyses revealed that the response options were not used as intended. Item-person-fit was not optimal since the items did not discriminate well on the range of the latent construct where most of the women drawn from the general population were located.LIMITATIONS: Both samples were somewhat homogenous regarding gestational age and urban residence; test-retest reliability was not investigated.CONCLUSION: The GAD-7 met the requirements of CTT. However, applying the stricter criteria of IRT suggested areas for potential improvements. Cross-cultural adaption and a dichotomized response format might ameliorate the GAD-7 for the use in sub-Saharan countries.
U2 - 10.1016/j.jad.2014.08.004
DO - 10.1016/j.jad.2014.08.004
M3 - SCORING: Journal article
C2 - 25212996
VL - 169
SP - 203
EP - 211
JO - J AFFECT DISORDERS
JF - J AFFECT DISORDERS
SN - 0165-0327
ER -