Structure and invariance of the Hospital Anxiety Depression Scale (HADS) in adolescents

Abstract

The main objective of this study was to test the factorial structure and gender invariance of the Hospital Anxiety Depression Scale (HADS) in a non-clinical sample of 657 adolescents (Mage = 16.3 years; SD = 1.19). The research design was an instrumental investigation, based on a cross-sectional survey with a sample of adolescents in Brazil. The results presented satisfactory evidence of the validity of the factorial structure and gender invariance for the sample. The composite reliability was also satisfactory, and no problems were detected related to common method bias. The mean of the items explained variance was .31 (31 %), with a Cronbach’s Alpha at .84 for the total scale, .81 and .69 for the anxiety and depression subscales, respectively. In the discussion, we analyzed questions related to the average variance extracted of the scale, which was lower than expected. Thus, we conclude that the current findings provide validity evidence to the application of the HADS with Brazilian adolescents for clinical or research purposes.

Keywords

• confirmatory factor analysis
• measurement invariance
• adolescents
• anxiety
• depression