The Psychometric Properties of PHQ-4 Depression and Anxiety Screening Scale Among College Students
Abstract
Depression and anxiety are some of the most common causes of morbidity, social dysfunction, and reduced academic performance in college students. The combination of improved surveillance and access to care would result in better outreach. Brief screening tools can help reach larger populations of college students efficiently. However, reliability and validity of brief screeners for anxiety and depression have not been assessed in college students. Thus, the purpose of this study was to assess in a sample of college students the psychometric properties of PHQ-4, a brief screening tool for depression and anxiety. Undergraduate students were recruited from general education classes at a Midwestern university. Students were given a questionnaire that asked them whether they had been diagnosed by a doctor or health professional with anxiety or depression. Next, they were asked to respond to the items on the PHQ-4 scale. A total of 934 students responded to the survey (response rate=72%). Majority of the participants were females (63%) and Whites (80%). The internal reliability of PHQ-4 was found to be high (α=0.81). Those who were diagnosed with depression or anxiety had statistically significantly higher scores on PHQ-4 (p<0.01). Corrected item total correlations for PHQ-4 were between r=0.66 and r=0.80. PHQ-4 operating characteristics were estimated and area under the curve (AUC) values were 0.835 and 0.787, respectively for anxiety and depression. The PHQ-4 is a reliable and valid tool that can serve as a mass screener for depression and anxiety in young adults. Widespread implementation of this screening tool should be explored across college campuses.
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The PHQ-4 was shown to be reliable and valid.
“The PHQ-4 was shown to be reliable and valid [40, 44, 45].”
From Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress (2024) · cites this paper as [44]
Caregiver mood was assessed with the Personal Health Questionnaire (PHQ-4), a highly reliable depression and anxiety screening tool (Cronbach's alpha of 0.81).
“Finally, caregiver mood was assessed with the Personal Health Questionnaire (PHQ-4) [56], a highly reliable depression and anxiety screening tool (Cronbach’s alpha of 0.81) [57].”
From Mindfulness and Care Experience in Family Caregivers of Persons Living with Dementia (2023) · cites this paper as [57]
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“The PHQ-4 was shown to be reliable and valid [40, 44, 45].”
MethodMindfulness and Care Experience in Family Caregivers of Persons Living with Dementia
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- Authors
- Khubchandani, J., Brey, R., Kotecki, J., Kleinfelder, J., & Anderson, J.
- Affiliations
- Ball State University (US)
- Corresponding author
- Khubchandani, Jagdish
- Venue
- Archives of Psychiatric Nursing
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 30
- Issue
- 4
- Pages
- 457-462
- ISSN
- 0883-9417 (ISSN-L)
- OpenAlex
- W2277022811
- Cited by
- 168
- References
- 35
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 23 · 2023: 24 · 2022: 25 · 2021: 20 · 2020: 21 · 2019: 12 · 2018: 8 · 2017: 3 · 2016: 2
- FWCI
- 11.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Psychiatric Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- PHQ-4, depression screening, anxiety screening, university students, psychometric properties, reliability statistics, validity, brief screening instrument, mental health surveillance, young adults
- MeSH terms
- Anxiety, Depression, Female, Humans, Male, Mass Screening, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Universities, Young Adult
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