Self-Management in Anxiety and Depression: A Psychometric Evaluation of a Questionnaire

Esther Krijnen-De Bruin,Aagje Evers,Neeltje M Batelaan,Stasja Draisma,Anna D T Muntingh,Berno Van Meijel,Henny Sinnema,Jan Spijker,Annemieke Van Straten

doi:10.3389/fpsyg.2021.694583

Abstract

Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision.Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed.Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 (χ2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> α = 0.75) and test–retest reliability (ICC > 0.75).Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.

Highlights

Anxiety and depressive disorders are among the most prevalent mental health disorders across the globe (World Health Organization, 2016)
Out of the 51 participants from the GET READY sample who were invited to re-take the Assessment of Self-management in Anxiety and Depression (ASAD) after a 2-week period, 43 (84.3%) responded positively, of which the scores of 12 patients indicated that they were in complete remission
Given that this study indicated that the 21-item ASAD-Short Form (SF) is appropriate, this version should be further explored and validated among a sample of patients with anxiety and depressive disorders

Summary

Introduction

Anxiety and depressive disorders are among the most prevalent mental health disorders across the globe (World Health Organization, 2016). Many patients experience a chronic course of symptoms, with chronicity ranging from 24.5% for depressive disorders to 41.9% for anxiety disorders (Penninx et al, 2011). Anxiety and depressive disorders have been found to often coincide Out of those patients that reach remission, approximately 57% experience a relapse within the first four years (Scholten et al, 2016). Both the chronicity of these disorders and the frequency of relapses increase the overall burden of disease (Keller, 2006; Penninx et al, 2011), and are associated with a decreased quality of life (Alonso et al, 2004). Alongside the significant burden that it places on patients and their relatives, anxiety and depression cause a tremendous economic burden worldwide (Walker et al, 2015)

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