Validity of Brief Scales for Assessing Transdiagnostic Cognitive Emotion Regulation Strategies in Primary Care Patients With Emotional Disorders
Abstract
Abstract. Cognitive emotion regulation strategies have been proposed as an explanation for transdiagnostic vulnerability to emotional disorders, which are highly prevalent in the primary care setting. The use of brief psychological instruments to detect cognitive-emotional factors – such as worry, rumination, interpretative and attentional distortions, and metacognitions – could provide valuable clinical data to better guide treatment in primary care. The aim of the present study was to evaluate the psychometric properties of four brief scales derived from the full versions of four assessment instruments (PSWQ, RRS, IACTA, and MCQ-30). The brief scales were completed by 1,250 primary care patients with an emotional disorder diagnosed by a general practitioner. The following characteristics of the scales were assessed: (a) internal structure (assessed by confirmatory factor analysis), (b) internal consistency, (c) convergent validity, (d) metric invariance across gender and age, and (e) predictive validity. The results showed a unifactorial structure for all of the tested scales, with an acceptable internal consistency and convergent validity, and invariance across gender and age. The brief scales presented predictive validity using the PHQ-4, a 4-item scale used to detect depression and generalized anxiety disorders, suggesting that these brief scales are optimal for use in the primary care setting.
References
2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
(2007). Structural equation modelling: Adjudging model fit. Personality and Individual Differences, 42, 815–824. https://doi.org/10.1016/j.paid.2006.09.018
(2015). Confirmatory factor analysis for applied research (2nd ed.). New York, NY: Guilford Publications.
(2013). Structural equation modeling with AMOS: Basic Concepts, Applications, and Programming (Multivariate Applications Series) (3rd ed.) London, UK: Routledge. https://doi.org/10.4324/9781410600219
(2001). Inventory of cognitive activity in anxiety disorders. (Manuscript under review)
(2018). A computerized version of the Patient Health Questionnaire-4 as an ultra-brief screening tool to detect emotional disorders in primary care. Journal of Affective Disorders, 234, 247–255. https://doi.org/10.1016/j.jad.2018.01.030
(2016). Transdiagnostic cognitive behavioral therapy versus treatment as usual in adult patients with emotional disorders in the primary care setting (PsicAP Study): Protocol for a randomized controlled trial. JMIR Research Protocols, 5, e246. https://doi.org/10.2196/resprot.6351
(2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9, 233–255. https://doi.org/10.1207/S15328007SEM0902_5
(2014). Anxiety disorders in primary care. Medical Clinics of North America, 98, 1007–1023. https://doi.org/10.1016/j.mcna.2014.06.003
(2000). A cognitive approach to trait anxiety. European Journal of Personality, 14, 463–476. https://doi.org/10.1002/1099-0984(200009/10)14:5<463::AID-PER393>3.0.CO;2-3
(2018). Evidence for transdiagnostic repetitive negative thinking and its association with rumination, worry, and depression and anxiety symptoms: A commonality analysis. Collabra: Psychology, 4, 13. https://doi.org/10.1525/collabra.128
(2008). Adaptación al castellano de un instrumento para evaluar el estilo rumiativo
([Spanish adaptation of an instrument to evaluate the ruminative style] . Revista de Psicopatología y Psicología Clínica, 13, 111–121. https://doi.org/10.5944/rppc.vol.13.num.2.2008.40542014). Evidence-based psychological interventions and the common factors approach: The beginnings of a rapprochement? Psychotherapy, 51, 510–513. https://doi.org/10.1037/a0037045
(2003). Assessing worry in older adults: Confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model. Psychological Assessment, 15, 173–183. https://doi.org/10.1037/1040-3590.15.2.173
(2015). Transdiagnostic mechanisms in depression and anxiety: The role of rumination and attentional control. Journal of Affective Disorders, 188, 22–27. https://doi.org/10.1016/j.jad.2015.08.008
(2014). Psychometric properties of abbreviated and ultra-brief versions of the Penn State Worry Questionnaire. Psychological Assessment, 26, 1146–1154. https://doi.org/10.1037/a0037251
(2009). An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics, 50, 613–621. https://doi.org/10.1176/appi.psy.50.6.613
(2013). The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct. Journal of Affective Disorders, 151, 313–320. https://doi.org/10.1016/j.jad.2013.06.014
(2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49, 186–193. https://doi.org/10.1016/j.brat.2010.12.006
(1990). Development and validation of the penn state worry questionnaire. Behaviour Research and Therapy, 28, 487–495. https://doi.org/10.1016/0005-7967(90)90135-6
(2017). Diagnostic and referral hierarchical model of common mental disorders in primary care centers. The PsicAP clinical trial approach. Ansiedad y Estrés, 23, 124–129. https://doi.org/10.1016/j.anyes.2017.10.002
(2015). Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical Psychology Review, 40, 91–110. https://doi.org/10.1016/j.cpr.2015.06.002
(1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology, 61, 115–121. https://doi.org/10.1037/0022-3514.61.1.115
(2013). Spanish version of the Meta-Cognitions Questionnaire 30 (MCQ-30). Spanish Journal of Psychology, 16, E95. https://doi.org/10.1017/sjp.2013.95
(2009). Validación española del cuestionario de preocupación PSWQ: estructura factorial y propiedades psicométricas
([Spanish validation of the PSWQ questionnaire: factor structure and psychometric properties] . Revista de Psicopatología y Psicología Clínica, 14, 107–122. https://doi.org/10.5944/rppc.vol.14.num.2.2009.40702016). Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness. Psychiatry Research, 238, 153–158. https://doi.org/10.1016/j.psychres.2016.02.034
(2017). Dysfunctional metacognition across psychopathologies: A meta-analytic review. European Psychiatry, 45, 139–153. https://doi.org/10.1016/j.eurpsy.2017.05.029
(2014). Development and assessment of brief versions of the Penn State Worry Questionnaire and the Ruminative Response Scale. British Journal of Clinical Psychology, 53, 402–421. https://doi.org/10.1111/bjc.12052
(2008). Metacognitive therapy: Cognition applied to regulating cognition. Behavioural and Cognitive Psychotherapy, 36, 651–658. https://doi.org/10.1017/S1352465808004803
(2004). A short form of the Metacognitions Questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42, 385–396. https://doi.org/10.1016/S0005-7967(03)00147-5
(2017). Depression and other common mental disorders: Global health estimates. Geneva, Switzerland: World Health Organization.
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