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Using Multivariate Statistics

BACKGROUND
Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable.


METHODS
Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales.


RESULTS
The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15.


CONCLUSIONS
The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization.

Iconography : The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review

"Constant Stress Has Become the New Normal": Stress and Anxiety Inequalities Among U.S. College Students in the Time of COVID-19.

Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health's 2012-2016 database-of whom 892 identified outside the gender binary-we conducted analyses of demographic and outcome measures administered in participants' 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals. We found that genderqueer individuals were harassed, sexually abused, and subjected to traumatic events at higher rates than were either cisgender or binary transgender individuals, with approximately 50% of genderqueer individuals reporting one of these experiences. We found that genderqueer individuals experienced more anxiety, depression, psychological distress, and eating concerns than did binary transgender and cisgender individuals and more social anxiety than did cisgender individuals. Genderqueer individuals more frequently reported self-harm and suicidality than did any other group, with approximately 2/3 of participants' having contemplated and nearly 50% making a suicide attempt. We extend current theorizing about minority stress (Hendricks & Testa, 2012; Meyer, 2003) to include genderqueer individuals and delineate several structural aspects of genderqueer experiences that may be responsible for these trends, including others' lack of knowledge about genderqueer experiences and pronouns, poor access to legal and medical resources, and systemic discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory.

The current study reports the development from the Male Role Norms Inventory-Revised (MRNI-R; Levant, Rankin, Williams, Hasan, & Smalley, 2010) of the 21-item MRNI-Short Form (MRNI-SF). Confirmatory factor analysis of MRNI-SF responses from a sample of 1,017 undergraduate participants (549 men, 468 women) indicated that the best fitting \"bifactor\" model incorporated the hypothesized 7-factor structure while explicitly modeling an additional, general traditional masculinity ideology factor. Specifically, each item-level indicator loaded on 2 factors: a general traditional masculinity ideology factor and a specific factor corresponding to 1 of the 7 hypothesized traditional masculinity ideology norms. The bifactor model was assessed for measurement invariance across gender groups, with findings of full configural invariance and partial metric invariance, such that factor loadings were equivalent across the gender groups for the 7 specific factors but not for the general traditional masculinity ideology factor. Theoretical explanations for this latter result include the potential that men's sense of self or identity may be engaged when responding to questions asking to what extent they agree or disagree with normative statements about their behavior, a possibility that could be investigated in future research by examining the associations of the general and specific factors with measures of masculine identity. Additional exploratory invariance analyses demonstrated latent mean differences between men and women on 4 of the 8 factors, and equivocal results for invariance of item intercepts, item uniquenesses, and factor variances-covariances.

Development, confirmatory factor analytic investigation of structure, and measurement invariance across gender

Empirical findings indicate that sexual and gender minorities report notably poorer outcomes on measures of mental health when compared with cisgender/heterosexual individuals. Although several studies have examined these issues, few have taken the time to examine differences between cisgender/heter

Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals.

The purpose of the present study was to evaluate whether phonemic and semantic verbal fluency were more related to aspects of language processing than executive functioning (EF). An exploratory factor analysis was performed on a college-aged sample of 320 healthy participants using principle axis factoring and promax rotation on nine measures of EF. The first three factors, labeled: working memory, fluid reasoning, and shifting/updating, were extracted and used as latent executive variables. Participants were also split into low, medium, and high phonemic and semantic verbal fluency ability groups. Phonemic and semantic fluency correlated similarly across all three extracted EF factors and word knowledge. Using one-way analysis of variance (ANOVAs), there was a main effect for both phonemic and semantic verbal fluency groups and all outcome variables (i.e., the EF factors and word knowledge). Tukey HSD post hoc analyses showed that those in the low verbal fluency ability groups had significantly lower scores across all outcome measures compared to the high verbal fluency ability groups. Across all analyses, semantic fluency had stronger relations with the EF factors, signifying a large executive component involved in the task. Both phonemic and semantic fluency were similarly related to multiple dimensions of EF and word knowledge and should be considered executive language tasks.

Executive, language, or both? An examination of the construct validity of verbal fluency measures

Ecological Momentary Assessment of Urban Adolescents’ Technology Use and Cravings for Unhealthy Snacks and Drinks: Differences by Ethnicity and Sex

Measures of traditional masculinity ideology (TMI) provide important information related to men’s well-being. However, most TMI measures are too long to be included in large public health, psychological, or medical survey batteries. Drawing on previous bifactor analyses of the Male Role Norms Invent

Development and validation of a five-item Male Role Norms Inventory using bifactor modeling.

This study examined how scrupulosity, depression, anxiety, stress, and neuroticism may statistically predict problematic pornography viewing dimensions. Participants (n = 507 women and n = 250 men)...

Nicholas C. Borgogna

Papers

Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals.

Executive, language, or both? An examination of the construct validity of verbal fluency measures

Ecological Momentary Assessment of Urban Adolescents’ Technology Use and Cravings for Unhealthy Snacks and Drinks: Differences by Ethnicity and Sex

Development and validation of a five-item Male Role Norms Inventory using bifactor modeling.

Is scrupulosity behind the relationship between problematic pornography viewing and depression, anxiety, and stress?