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The Factor Structure of the Hospital Anxiety and Depression Scale (HADS) in a Traumatic Brain Injury (TBI) Population


Skilbeck, C and Holm, K and Slatyer, M and Thomas, M and Bell, T, The Factor Structure of the Hospital Anxiety and Depression Scale (HADS) in a Traumatic Brain Injury (TBI) Population, Brain Impairment, 12, (1) pp. 22-32. ISSN 1443-9646 (2011) [Refereed Article]

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Copyright Statement

Copyright © 2011 Cambridge University Press

DOI: doi:10.1375/brim.12.1.22


P rimary Objectives: To examine the HADS structure in TBI, using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), and investigate the effects of TBI severity, Gender, and Age on factor scores. Methods and Procedures: HADS data from 186 TBI patients in a population study in Tasmania were subjected to EFA. HADS data from a second sample of 185 TBI participants in the same study underwent CFA. One-month follow-up data were used, allowing inclusion of severe TBI patients while still being early post-injury. Factor loadings were used to investigate the effects of demographic and clinical variables at 2 weeks post-injury. Results: While EFA suggested 2-factor (anxiety, depression) and 3-factor (anxiety, psychomotor, depression) structures provided adequate descriptions, CFA strongly supported the 3-factor model. Using this model, significant effects of TBI severity were noted on Psychomotor and Depression scores at 2 weeks post-injury. Males reported significantly fewer symptoms on all 3 factors, as did younger participants. Conclusions: CFA indicates that a 3-factor model provides the best fit for HADS data in TBI. One factor, Psychomotor, has been relatively neglected in the literature, and the current findings suggest its assessment and rehabilitation should receive more attention.

Item Details

Item Type:Refereed Article
Keywords:HADS, mood, TBI, factor analysis, age, gender
Research Division:Psychology
Research Group:Biological psychology
Research Field:Behavioural neuroscience
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Skilbeck, C (Associate Professor Clive Skilbeck)
UTAS Author:Holm, K (Dr Kieran Holm)
UTAS Author:Slatyer, M (Dr Mark Slatyer)
UTAS Author:Bell, T (Professor Tony Bell)
ID Code:76406
Year Published:2011
Web of Science® Times Cited:9
Deposited By:Psychology
Deposited On:2012-03-07
Last Modified:2017-11-06
Downloads:2 View Download Statistics

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