TY - JOUR

T1 - A rasch-based validity study of the HSCL-25

AU - Vindbjerg, Erik

AU - Mortensen, Erik Lykke

AU - Makransky, Guido

AU - Nielsen, Tine

AU - Carlsson, Jessica Mariana

PY - 2021

Y1 - 2021

N2 - BackgroundThe Hopkins Symptom Checklist-25 (HSCL-25) is a commonly used questionnaire to assess anxiety and depression in trauma-affected refugees. Despite numerous studies evaluating criterion validity and reliability, few studies have assessed the construct validity of the scale.MethodsIn the current study, a Rasch analysis was carried out based on responses from 635 Arabic and Persian speaking refugees. Results supported the use of an eight- or nine-item anxiety subscale score.ResultsThe anxiety subscale fit the Rasch model with limited modifications, including the exclusion of purely somatic items. Results for the depression subscale revealed a range of issues. While a shortened scale which accounted for gender differences allowed for a fit with the Persian speaking sample, no fit could be obtained for the Arabic speaking sample. We discuss whether more flexible psychometric models may be necessary to derive valid estimates of depression in some cultures.LimitationsBoth constructs studied, anxiety and depression, were comorbid to PTSD in the included sample. Most respondents were chronically affected and often troubled by extensive post-settlement stress. Results may not generalize to other populations, e.g. non-refugees or more recently arrived refugees.ConclusionsPurely somatic items have no clear place in the HSCL-25 anxiety subscale, while the anxiety items show good potential to fit a Rasch model. The HSCL-25 depression subscale may not be suitable for summating a single total score, reflecting the need for either a simpler scale or a more complex approach to assessing responses.

AB - BackgroundThe Hopkins Symptom Checklist-25 (HSCL-25) is a commonly used questionnaire to assess anxiety and depression in trauma-affected refugees. Despite numerous studies evaluating criterion validity and reliability, few studies have assessed the construct validity of the scale.MethodsIn the current study, a Rasch analysis was carried out based on responses from 635 Arabic and Persian speaking refugees. Results supported the use of an eight- or nine-item anxiety subscale score.ResultsThe anxiety subscale fit the Rasch model with limited modifications, including the exclusion of purely somatic items. Results for the depression subscale revealed a range of issues. While a shortened scale which accounted for gender differences allowed for a fit with the Persian speaking sample, no fit could be obtained for the Arabic speaking sample. We discuss whether more flexible psychometric models may be necessary to derive valid estimates of depression in some cultures.LimitationsBoth constructs studied, anxiety and depression, were comorbid to PTSD in the included sample. Most respondents were chronically affected and often troubled by extensive post-settlement stress. Results may not generalize to other populations, e.g. non-refugees or more recently arrived refugees.ConclusionsPurely somatic items have no clear place in the HSCL-25 anxiety subscale, while the anxiety items show good potential to fit a Rasch model. The HSCL-25 depression subscale may not be suitable for summating a single total score, reflecting the need for either a simpler scale or a more complex approach to assessing responses.

KW - Faculty of Social Sciences

KW - Rasch analysis

KW - item response theory

KW - refugees

KW - transcultural

KW - anxiety

KW - depression

U2 - 10.1016/j.jadr.2021.100096

DO - 10.1016/j.jadr.2021.100096

M3 - Journal article

VL - 4

JO - Journal of Affective Disorders Reports

JF - Journal of Affective Disorders Reports

SN - 2666-9153

M1 - 100096

ER -