Improving Measurement Properties of the Patient Health Questionnaire-9 With Rating Scale Analysis

Ryan T. Williams; Allen W. Heinemann; Rita K. Bode; Catherine S. Wilson; Jesse R. Fann; Denise G. Tate; PRISMS

doi:10.1037/a0015529

Improving Measurement Properties of the Patient Health Questionnaire-9 With Rating Scale Analysis

Ryan T. Williams^*, Allen W. Heinemann, Rita K. Bode, Catherine S. Wilson, Jesse R. Fann, Denise G. Tate, PRISMS

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

50 Scopus citations

Abstract

Objective: The goal of this study was to explore the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, & J. B. W. Williams, 1999). Method: Factor analysis and Rasch rating scale analysis were used to examine the psychometric properties of the PHQ-9. The sample consisted of 202 adults with spinal cord injury (SCI). Results: The PHQ-9 items appear to form a usefully unidimensional scale. One "double-barreled" item, "Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you've been moving around a lot more than usual," misfit the Rasch model. Category probability curves indicate respondent difficulty in distinguishing between the 2 intermediate rating scale categories: several days and more than half the days. Combining these categories eliminated this problem and resulted in all items fitting the measurement model. Conclusions: The measurement properties of the PHQ-9 can be improved by collapsing rating scale categories and by restructuring several double- and triple-barreled items. Adopting these changes may improve sensitivity in measuring depression after SCI.

Original language	English (US)
Pages (from-to)	198-203
Number of pages	6
Journal	Rehabilitation Psychology
Volume	54
Issue number	2
DOIs	https://doi.org/10.1037/a0015529
State	Published - May 1 2009

Keywords

PHQ-9
Rasch
depression
factor analysis
rating scale analysis
spinal cord injury

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation
Clinical Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1037/a0015529

Cite this

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title = "Improving Measurement Properties of the Patient Health Questionnaire-9 With Rating Scale Analysis",

abstract = "Objective: The goal of this study was to explore the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, & J. B. W. Williams, 1999). Method: Factor analysis and Rasch rating scale analysis were used to examine the psychometric properties of the PHQ-9. The sample consisted of 202 adults with spinal cord injury (SCI). Results: The PHQ-9 items appear to form a usefully unidimensional scale. One {"}double-barreled{"} item, {"}Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you've been moving around a lot more than usual,{"} misfit the Rasch model. Category probability curves indicate respondent difficulty in distinguishing between the 2 intermediate rating scale categories: several days and more than half the days. Combining these categories eliminated this problem and resulted in all items fitting the measurement model. Conclusions: The measurement properties of the PHQ-9 can be improved by collapsing rating scale categories and by restructuring several double- and triple-barreled items. Adopting these changes may improve sensitivity in measuring depression after SCI.",

keywords = "PHQ-9, Rasch, depression, factor analysis, rating scale analysis, spinal cord injury",

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AU - Wilson, Catherine S.

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AU - Tate, Denise G.

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N2 - Objective: The goal of this study was to explore the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, & J. B. W. Williams, 1999). Method: Factor analysis and Rasch rating scale analysis were used to examine the psychometric properties of the PHQ-9. The sample consisted of 202 adults with spinal cord injury (SCI). Results: The PHQ-9 items appear to form a usefully unidimensional scale. One "double-barreled" item, "Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you've been moving around a lot more than usual," misfit the Rasch model. Category probability curves indicate respondent difficulty in distinguishing between the 2 intermediate rating scale categories: several days and more than half the days. Combining these categories eliminated this problem and resulted in all items fitting the measurement model. Conclusions: The measurement properties of the PHQ-9 can be improved by collapsing rating scale categories and by restructuring several double- and triple-barreled items. Adopting these changes may improve sensitivity in measuring depression after SCI.

AB - Objective: The goal of this study was to explore the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, & J. B. W. Williams, 1999). Method: Factor analysis and Rasch rating scale analysis were used to examine the psychometric properties of the PHQ-9. The sample consisted of 202 adults with spinal cord injury (SCI). Results: The PHQ-9 items appear to form a usefully unidimensional scale. One "double-barreled" item, "Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you've been moving around a lot more than usual," misfit the Rasch model. Category probability curves indicate respondent difficulty in distinguishing between the 2 intermediate rating scale categories: several days and more than half the days. Combining these categories eliminated this problem and resulted in all items fitting the measurement model. Conclusions: The measurement properties of the PHQ-9 can be improved by collapsing rating scale categories and by restructuring several double- and triple-barreled items. Adopting these changes may improve sensitivity in measuring depression after SCI.

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KW - factor analysis

KW - rating scale analysis

KW - spinal cord injury

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Improving Measurement Properties of the Patient Health Questionnaire-9 With Rating Scale Analysis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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