The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

BACKGROUND: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity. METHODS: Data from 10 different primary care studies have been used. Criterion validity was assessed by comparing the 4DSQ scores with clinical diagnoses, the GPs' diagnosis of any psychosocial problem for Distress, standardised psychiatric diagnoses for Depression and Anxiety, and GPs' suspicion of somatization for Somatization. ROC analyses and logistic regression analyses were used to examine the associations. Construct validity was evaluated by investigating the inter-correlations between the scales, the factorial structure, the associations with other symptom questionnaires, and the associations with stress, personality and social functioning. The factorial structure of the 4DSQ was assessed through confirmatory factor analysis (CFA). The associations with other questionnaires were assessed with Pearson correlations and regression analyses. RESULTS: Regarding criterion validity, the Distress scale was associated with any psychosocial diagnosis (area under the ROC curve [AUC] 0.79), the Depression scale was associated with major depression (AUC = 0.83), the Anxiety scale was associated with anxiety disorder (AUC = 0.66), and the Somatization scale was associated with the GPs' suspicion of somatization (AUC = 0.65). Regarding the construct validity, the 4DSQ scales appeared to have considerable inter-correlations (r = 0.35-0.71). However, 30–40% of the variance of each scale was unique for that scale. CFA confirmed the 4-factor structure with a comparative fit index (CFI) of 0.92. The 4DSQ scales correlated with most other questionnaires measuring corresponding constructs. However, the 4DSQ Distress scale appeared to correlate with some other depression scales more than the 4DSQ Depression scale. Measures of stress (i.e. life events, psychosocial problems, and work stress) were mainly associated with Distress, while Distress, in turn, was mainly associated with psychosocial dysfunctioning, including sick leave. CONCLUSION: The 4DSQ seems to be a valid self-report questionnaire to measure distress, depression, anxiety and somatization in primary care patients. The 4DSQ Distress scale appears to measure the most general, most common, expression of psychological problems

The Amsterdam Growth and Health Longitudinal Study (AGAHLS) 1976-1997

Longitudinal research into health and growth of adolescents. The study up till now contains data from measurements in 1976-1979, 1985, 1991, 1993, 1996 and 1997. The longitudinal group consisted at the start of 307 pupils (age cohorts 1962, 1963 and 1964) from one school for secondary education in Amsterdam, of which 233 completed the first four years of the study. At the first four years a control group of 292 pupils from a comparable school near Amsterdam were studied. In 1985 200 pupils from the longitudinal group were remeasured, their number dropping slowly afterwards. In 1996 control-group subjects were invited for measurement again and this will continue in future. Measurements fell broadly into five categories: 1. Physical measurements of body build, body growth and body composition 2. Physiological measurements of functional and performance characteristics 3. Psychological measurements of personality traits 4. Lifestyle measurements, concerning dietary habits, habitual physical activity, psychosocial behaviour and stress 5. Health measurements, concerning both physical and mental aspects. ad 1. Physical measurements: height / weight / bone diameter / skinfold thickness / circumference / fat mass / skeletal age / curvature of thoracolumbar spine / bone mineral content. ad 2. Physiological measurements: motor performance fitness test / strength / speed / flexibility / aerobic endurance / maximal aerobic power and maximal isokinetic muscle power / treadmill running / cardiovascular measurement / ventilation, respiration, oxygen uptake and carbon dioxide production / maximal isokinetic torque / blood pressure / lung function / analysis of blood (cholesterol) , urine (catecholamines, drug use) and saliva (immoglobulin A). ad 3. Psychological measurements: Dutch Personality Inventory (inadequacy / social inadequacy / rigidity / self-sufficience / dominance) / Achievement motivation test (achievement motivation / debilitating anxiety / facilitating anxiety / social desirability) / sociometric status. ad 4. Lifestyle: Habitual food intake / parents dietary questionnaire / smoking / alcohol intake / habitual physical activity / sports injuries / psychosocial behaviour and stress / coronary-prone behaviour pattern / coping style / life events / daily hassles. ad 5. Health measurements: mental health: mild health complaints, sleep-wake problems, vital exhaustion, inadequacy / physical health: back pain, health questionnaire. The study contains at present some 185 files with varying numbers of cases and variables. Detailed information at the file level is available on request. Background variables: basic characteristics/ household characteristics/ characteristics of parental family/household/ occupation/employment/ income/capital assets/ education/ organizational membership

The impact of nursing hours per patient day (NHPPD) staffing method on patient outcomes: a retrospective analysis of patient and staffing data1)

In dit artikel wordt het door Twigg et al. (2011) uitgevoerde onderzoek kritisch bekeken. In dit onderzoek is gekeken naar de relatie tussen de verpleegkundige bezetting en verbetering van verpleegkundig sensitieve uitkomsten. De onderzoekers constateren een positieve causale relatie maar onderbouwen dat niet door de gepresenteerde resultaten. Daarnaast wordt er geen aandacht geschonken aan andere contextuele factoren (zoals multidisciplinaire samenwerking) die van invloed zijn op de uitkomsten. Geconcludeerd kan worden dat de relatie tussen de verpleegkundige bezetting minder duidelijk is dan de onderzoekers concluderen

Investigation on the practice of euthanasia and assisted suicide by family doctors 1990

Investigation on the practice of euthanasia and assisted suicide by family doctors Description of r.'s practice / r.s attitude to one's right of self-determination, euthanasia and medical assistance with suicide / detailed description of r.'s latest case of euthanasia-assisted suicide / background of patient involved, disease(s), severeness of suffering, talks with patient / consultation of colleagues about patient / consultation of patients' relatives and other persons involved / consultation of the local coroner, health inspector, office medical data on the actual euthanasia treatment (drugs used etc.), reporting of euthanasia to the authorities. Background variables: basic characteristics/ residence/ place of work/ education/ religio

Longitudinal Aging Study Amsterdam, Public Use File data collection 1992 to 2006

The Longitudinal Aging Study Amsterdam (LASA) is initiated by the Ministry of Health, Welfare and Sports in 1991 to investigate predictors and consequences of ageing. LASA has been conducted since then by the VU University and VU University Medical Center. LASA focuses on physical, emotional, cognitive and social functioning in late life, the connections between these aspects, and the changes that occur in the course of time. The deposit covers the data collection from 1992 to 2006. The construction of a Public Use File (PUF) with LASA data has been made possible by a grant from the Data Archiving and Networked Services (DANS). With this grant, the data from multiple measurement waves have been made homogeneous between waves and documentation has been created, which enable the independent use of LASA data by researchers

Establishing norms for the Four-Dimensional Symptom Questionnaire (4DSQ) in the Dutch population

The primary aim of the proposed study is to collect 4DSQ data in a large representative Dutch sample of the broadest composition to provide gender, age and social economic strata specific norms for the general Dutch population, including immigrants. The questionnaire is administered to the LISS-immigrant panel (LISS-I). Earlier this year the questionnaire is administered to the LISS panel

Teacher Report Forms (TRF) and Conners' Teacher Rating Scale ( short version - Revised ) in twins and siblings registered with the Netherlands Twin Registry (NTR)

The data were collected between 1999 and 2013 as part of the Netherlands Twin Register (NTR)'s annual teacher survey. The data collection for the teacher surveys is ongoing and each year, the parents of children that are approximately 7, 9 (before 2009 10 years old) and 12 years old are contacted to ask for their permission to approach the teacher(s) of their children. The survey for the primary school teachers includes limited information on the teacher, class and school, items on adaptive functioning of the child at school, the Teacher report Form (TRF) (Achenbach, 2009; Verhulst & van der Ende, 2004) and the short version of the Conners’ Teacher Ratings Scale - Revised (CTRS-R) (Conners et al., 1998; Conners, 2001). The survey data are stored in harmonized databases organized by age at the time of data collection. Since the CTRS-R data was collected separately from the rest of the teacher survey until 2006, it is stored in a separate database. In EASY, the databases from for the different age versions of TRF and CTRS-R can be linked through anonymous identification numbers. Please consult the data manual (DocumentationDataCollectionTRF_NTR.pdf) for more information about the data collection and the relationships between the datasets from the NTR teacher surve

Establishing norms for the Four-Dimensional Symptom Questionnaire (4DSQ) in the Dutch population

The primary aim of the proposed study is to collect 4DSQ data in a large representative Dutch sample of the broadest composition to provide gender, age and social economic strata specific norms for the general Dutch population, including immigrants. The project consists of three waves, administered in July, October and November 2013

Meaning of autonomy-connectedness in a multi-cultural (treatment) context

This study aims at investigating the meaning of autonomy-connectedness for different ethnic groups, and the relationship between autonomy-connectedness and mental health problems