The DOI matches its Crossref record; 73 of the 76 references it cites were found in a registry or an index; none of the 25 sources its claims cite is checked for support yet.
Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials
Open accessAbstract
Objective: We examine the reliability and validity of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)—which combines the nine-item Patient Health Questionnaire depression scale and seven-item Generalized Anxiety Disorder scale—as a composite measure of depression and anxiety. Methods: Baseline data from 896 patients enrolled in two primary-care based trials of chronic pain and one oncology-practice–based trial of depression and pain were analyzed. The internal reliability, standard error of measurement, and convergent, construct, and factor structure validity, as well as sensitivity to change of the PHQ-ADS were examined. Results: The PHQ-ADS demonstrated high internal reliability (Cronbach α values of .8 to .9) in all three trials. PHQ-ADS scores can range from 0 to 48 (with higher scores indicating more severe depression/anxiety), and the estimated standard error of measurement was approximately 3 to 4 points. The PHQ-ADS showed strong convergent (most correlations, 0.7–0.8 range) and construct (most correlations, 0.4–0.6 range) validity when examining its association with other mental health, quality of life, and disability measures. PHQ-ADS cutpoints of 10, 20, and 30 indicated mild, moderate, and severe levels of depression/anxiety, respectively. Bifactor analysis showed sufficient unidimensionality of the PHQ-ADS score. PHQ-ADS change scores at 3 months differentiated ( p < .0001) between individuals classified as worse, stable, or improved by a reference measure, providing preliminary evidence for sensitivity to change. Conclusions: The PHQ-ADS may be a reliable and valid composite measure of depression and anxiety which, if validated in other populations, could be useful as a single measure for jointly assessing two of the most common psychological conditions in clinical practice and research. Trial Registration : Clinicaltrials.gov Identifier: NCT00926588 (SCOPE); NCT00386243 (ESCAPE); NCT00313573 (INCPAD).
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS demonstrated high internal reliability (Cronbach's alpha of 0.8 to 0.9) in all 3 trials.”
- Also stated in: § Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials · plain
“All 3 scale scores demonstrated good internal reliability, with Cronbach's alphas in the 0.8 to 0.9 range.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Load-bearingStrength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS showed strong convergent (most correlations 0.7-0.8 range) and construct (most correlations 0.4-0.6 range) validity when examining its association with other mental health, quality of life and disability measures.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS showed strong convergent (most correlations 0.7-0.8 range) and construct (most correlations 0.4-0.6 range) validity when examining its association with other mental health, quality of life and disability measures.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the estimated SEM was approximately 3 to 4 points”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Bi-factor analysis showed sufficient unidimensionality of the PHQ-ADS score.”
- Also stated in: § Structural Validity of the PHQ-ADS · hedged
“further suggesting sufficient unidimensionality and supporting the structural validity of a single PHQ-ADS composite score”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Structural Validity of the PHQ-ADS · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the INCPAD trial, there were 73 patients classified as worse, 115 as unchanged, and 147 as improved.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Sensitivity to Change of the PHQ-ADS
Strength:plain· not yet calibratedn = 73Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A similar incremental “dose-response” effect is seen on all quality of life and disability domains.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Convergent and Construct Validity of the PHQ-ADS Ordinal Categories
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In the paper
“Finally, the scree plots (Figure S1, Supplemental Digital Content 1) of the eigenvalues indicated that there was one dominant factor, because the eigenvalues dropped greatly from the first to the second factor, after which eigenvalues leveled off with much smaller drops between the second and remaining factors.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
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In the paper
“all item-total correlations were good (0.42 to 0.69)”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, the results in the INCPAD trial of oncology patients were, though generally comparable to the two primary care trials, weaker on a few of the psychometric analyses.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the chi-square test was significant in all 3 trials (suggesting some deviation from good fit), this fit index yields high power in larger samples to detect minor deviations.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“According to the MHI-5 change scores at 3 months, there were 56 patients in the SCOPE trial who were classified as worse, 113 as unchanged, and 75 as improved.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Sensitivity to Change of the PHQ-ADS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is a large incremental increase in depression (PHQ-9), anxiety (GAD-7), and psychological composite (PROMIS-ADS, MHI-5, and MCS) scores as one goes from minimal to mild to moderate to severe levels of depression/anxiety as classified by the four PHQ-ADS ordinal categories.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Convergent and Construct Validity of the PHQ-ADS Ordinal Categories
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All 3 scale scores demonstrated good internal reliability, with Cronbach's alphas in the 0.8 to 0.9 range.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Load-bearingStrength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Construct validity was supported by moderate correlations of each of the 3 scales with quality of life and disability measures.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Convergent and Construct Validity of the PHQ-ADS, PHQ-9 and GAD-7
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“First, depression and anxiety frequently co-occur.3-5;10-16”
- Also stated in: § Discussion · plain
“The high comorbidity of depression and anxiety is one reason a composite measure may be useful.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Introduction
What the sources say
- Not checked yetcites [3] source
- Not checked yetcites [4] source
- Not checked yetcites [5] source
- Not checked yetcites [10] source
- Not checked yetcites [11] source
- Not checked yetcites [12] source
- Not checked yetcites [13]
- Not checked yetcites [14] source
- Not checked yetcites [15] source
- Not checked yetcites [16] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The statistically-determined SEM suggests that a 3 to 4 point change on the PHQ-ADS may represent a clinically important difference.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This supports joint use of the PHQ-9 and GAD-7 to increase the detection of comorbid anxiety”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Third, theoretical and empiric evidence supports an overarching psychological construct that encompasses distinct but related dimensions of depression and anxiety.18;19”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Although originally developed as a measure to detect generalized anxiety disorder32, the operating characteristics of the GAD-7 are nearly as good for the other common anxiety disorders in clinical practice – panic disorder, social anxiety disorder, and posttraumatic stress disorder.23”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Methods > Measures
What the sources say
- Not checked yetcites [23] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Sixth, our assessment of construct validity relied on relatively brief PROMIS and SF mental health measures; future studies should compare the PHQ-ADS to more detailed depressive and anxiety scales, both in terms of construct validity as well as responsiveness to treatment.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consequently, selecting a composite score as the primary outcome for interventional studies targeting both depression and anxiety would allow for a smaller sample size than using depression and anxiety as separate co-primary outcomes.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclearA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Also, the comparison of PHQ-ADS change scores among worse, stable, and improved groups as defined by the MHI-5 suggest the PHQ-ADS is sensitive to change over time.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The MHI-5 change classification of worse, unchanged, or improved is a valid reference standard for clinically meaningful change in depression and anxiety symptoms.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, if only the PHQ-9 had been used in these trials, 307 (34.3%) of patients with chronic pain who had anxiety only or, more commonly, combined anxiety and depression, would not have been detected.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- It may state two separate claims as one. 28
- Probably not a substantial claim. 5
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PHQ-ADS change scores at 3 months differentiated (P < .0001) between individuals classified as worse, stable, or improved by a reference measure, providing preliminary evidence for sensitivity to change.”
- Also stated in: § Sensitivity to Change of the PHQ-ADS · plain
“the PHQ-ADS change scores significantly differentiated between the worse, unchanged, and improved groups in both trials”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The MHI-5 change classification of worse, unchanged, or improved is a valid reference standard for clinically meaningful change in depression and anxiety symptoms.
- Also stated in: § Sensitivity to Change of the PHQ-ADS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, the WRMR threshold of ≤ 1.0 was achieved for the bi-factor model in all 3 trials, the 2-factor model in only 1 trial, and the 1-factor model in none of the trials.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 3, the PHQ-ADS had the strongest correlations with the PHQ-9 and GAD-7 (its two component scales), and the PHQ-9 and GAD-7 had moderately strong correlations with one another.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Convergent and Construct Validity of the PHQ-ADS, PHQ-9 and GAD-7
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The INCPAD trial enrolled patients with depression as well as pain and therefore, not surprisingly, had the highest mean depression scores, whereas the SCOPE trial had the lowest depression and anxiety scores.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“First, all 3 trials focused on patients with pain, rather than individuals with depression (except INCPAD) or anxiety.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“The PHQ-ADS change scores among categories were significantly different (P < .0001) by analysis of variance, and pairwise comparisons between the worse, unchanged, and improved categories also differed (p < .001) in both trials.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Sensitivity to Change of the PHQ-ADS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Also, there was a substantial number of patients who met clinical cutpoints for depression and combined depression/anxiety in the 3 trials, but only a small proportion with anxiety only.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“The mean PHQ-ADS score increased 3.63 points in the worse group, declined 3.12 points in the stable group, and declined 7.96 points in the improved group, resulting in SRMs of -0.45, --0.51, and --0.98, respectively.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Sensitivity to Change of the PHQ-ADS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“Using a 1-SEM change to estimate a minimal clinically important difference (MCID), the MCID estimated from these 3 trials would be approximately 2 to 3 points for the PHQ-9 and GAD-7 and 3 to 4 points for the PHQ-ADS.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The number of patients in the 3 trials that achieved this cutpoint on both the PHQ-9 and GAD-7 was 286 (31.9%); on the PHQ-9 only, 266 (29.7%); on the GAD-7 only, 21 (2.3%); and on neither measure, 323 (36.1%).”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“Second, patient samples in two of the trials were exclusively Veterans and predominantly men; thus, data on the PHQ-ADS in non-Veteran samples including more women is warranted.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“most of the factor loadings were substantially higher than the acceptable threshold of 0.40, and were only slightly higher for the 2-factor compared to the 1-factor model”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The 3 scales also showed moderately strong convergent validity with the 3 composite psychological measures (PROMIS-ADS, MHI-5, and MCS) with the PHQ-ADS having slightly higher correlations than the PHQ-9 and GAD-7.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Convergent and Construct Validity of the PHQ-ADS, PHQ-9 and GAD-7
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was generally a small improvement in fit when comparing the 2-factor to 1-factor model, and a greater improvement when comparing the bi-factor to either the 1-factor or 2-factor models.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 2, the mean PHQ-9 and GAD-7 scores in the 3 trials represent moderate levels of depression and mild levels of anxiety, respectively.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean PHQ-ADS score decreased in all 3 groups (--5.10 points in the worse group, --9.72 points in the unchanged group, and --16.40 in the improved group, resulting in SRMs of --0.57, --1.28, and -1.89, respectively.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Sensitivity to Change of the PHQ-ADS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The CFI threshold of ≥ .95 was achieved for all 3 models in the SCOPE and ESCAPE trials but only for the bifactor model in the INCPAD trial.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Using a more conservative estimate of a 2-SEM change, the MCID would be approximately 4 to 6 points for the PHQ-9 and GAD-7 and 6 to 8 points for the PHQ-ADS.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Psychometric Characteristics of PHQ-9, GAD-7 and PHQ-ADS in the 3 Trials
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The RMSEA threshold of ≤ .06 was achieved for the bifactor model in two of the trials but in none of the trials for the 1-factor and 2-factor models.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS may be a reliable and valid composite measure of depression and anxiety”
- Also stated in: § Conclusions · hedged
“The PHQ-ADS may be a reliable and valid composite measure of depression and anxiety which, if validated in other populations, could be useful as a single measure for jointly assessing two of the most common psychological conditions in clinical practice and research.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Conclusions
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Conclusions · hedged
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PHQ-ADS cutpoints of 10, 20, and 30 indicated mild, moderate, and severe levels of depression/anxiety, respectively.”
- Also stated in: § Discussion · hedged
“Second, cutpoints of 10, 20, and 30 on the PHQ-ADS indicate mild, moderate, and severe levels of depression/anxiety symptoms, respectively.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Abstract > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Discussion · hedged
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Taken together, the fit indices and the factor loadings point to the validity of the traditional scoring of the PHQ-9 and GAD-7 as depression and anxiety scale scores as well as the sufficient unidimensionality of scoring the PHQ-ADS as a composite score.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Results > Structural Validity of the PHQ-ADS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS score may be useful in studies for which a single depression/anxiety score is desirable as either an outcome variable or as a covariate to adjust for in multivariable analyses.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, both measures have proven sensitive to change when monitoring treatment response.20;33-36”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Methods > Measures
What the sources say
Strength:boosted· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“The PHQ-9 and GAD-7 have strong internal and test-retest reliability as well as construct and factor-structure validity.20”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Methods > Measures
What the sources say
- Not checked yetcites [20] source
Load-bearingStrength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Certainly, a PHQ-ADS screening cutpoint would be higher than that of the PHQ-9 or GAD-7 (which are ≥ 10) since its score range is greater; for example, 10 represents a cutpoint for moderate depressive symptoms on the PHQ-9 and moderate anxiety symptoms on the GAD-7, whereas 20 represented a cutpoint for moderate depressive/anxiety symptoms on the PHQ-ADS in our sample.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifth, we did not use a structured criterion standard diagnostic interview in these 3 trials to determine which patients met criteria for depressive or anxiety disorders, and thus were unable to compare the sensitivity and specificity of the PHQ-ADS with the PHQ-9 and GAD-7.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, the moderately strong intercorrelation between depression and anxiety makes a composite score attractive as a covariate in multivariate modeling and other types of adjusted analyses.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The Patient Health Questionnaire 9-item depression scale (PHQ-9) and 7-item Generalized Anxiety Disorder scale (GAD-7) are among the best validated and most commonly used depression and anxiety measures, respectively.20-25”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Introduction
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The PHQ-ADS may also be useful in monitoring the concomitant treatment of depression and anxiety, especially since some treatments work across both conditions.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Rests on an assumption: Some interventions, such as cognitive-behavioral therapy and certain classes of antidepressants, are effective for both depression and anxiety.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, we did not test responsiveness to treatment of the PHQ-ADS since none of the 3 trials were specifically treating anxiety and only one was targeting depression.”
§ The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial Validation in Three Clinical Trials > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper relies on this without support.
The MHI-5 change classification of worse, unchanged, or improved is a valid reference standard for clinically meaningful change in depression and anxiety symptoms.
“three MHI-5 change groups (worse, same, improved) were computed for each patient by determining whether the MHI-5 declined or improved by more than 1.0 standard error of measurement (SEM) from baseline to follow-up at 3 months”
“the comparison of PHQ-ADS change scores among worse, stable, and improved groups as defined by the MHI-5 suggest the PHQ-ADS is sensitive to change over time”
The paper relies on this without support.
Some interventions, such as cognitive-behavioral therapy and certain classes of antidepressants, are effective for both depression and anxiety.
“some interventions (e.g., cognitive-behavioral therapy; certain classes of antidepressants) are effective for both depression and anxiety”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Participants who interacted with BalanceUP experienced a clinically important improvement, reporting, on average, a 3.9 (SD 5.59) point reduction [85] of perceived depression and anxiety symptoms after the intervention.”
From Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial (2024) · cites this paper as [85]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“PHQ-ADS is the combined sum score of the questionnaires Generalized Anxiety Disorder Screener (GAD-7) and Patient Health Questionnaire (PHQ-9) as a composite measure of depression and anxiety, with good internal consistency [α = 0.88–0.92; (51)].”
From Clinical and Cost-Effectiveness of PSYCHOnlineTHERAPY: Study Protocol of a Multicenter Blended Outpatient Psychotherapy Cluster Randomized Controlled Trial for Patients With Depressive and Anxiety Disorders (2021) · cites this paper as [51]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The scale has demonstrated good internal consistency (α>.80) [42].”
In the citing paper
“PHQ-ADS is the combined sum score of the questionnaires GAD-7 and PHQ-9 as a composite measure of depression and anxiety, with good internal consistency (α = .88 to .92) [50].”
From Effectiveness and cost-effectiveness of guided Internet- and mobile-based CBT for adolescents and young adults with chronic somatic conditions and comorbid depression and anxiety symptoms (youthCOACHCD): study protocol for a multicentre randomized controlled trial (2020) · cites this paper as [50]
In the citing paper
“In addition, although a 3-category approach (i.e., Worse, Same, or Better SF-36 Vitality scores) has commonly been used to determine MIDs and converges with distribution-based methods [68, 69], it may result in overestimation of MIDs.”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [69]
Citations
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
Self-citationA Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Self-citationKessler, R. C. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010008002 · Cited by 12,370
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
The validity of the Hospital Anxiety and Depression Scale
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00296-3 · Cited by 9,779
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988
MCHORNEY, C. A., JOHNE, W., & ANASTASIAE, R. (1993) · Medical Care · doi:10.1097/00005650-199303000-00006 · Cited by 6,681
Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., et al. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.011 · Cited by 5,128
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-5-200703060-00004 · Cited by 4,741
Self-citationTripartite model of anxiety and depression: psychometric evidence and taxonomic implications
Clark, L. A., & Watson, D. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.3.316 · Cited by 4,601
Flagged first, then by citations
3 of the 76 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Toussaint, A., Hüsing, P., Gumz, A., Wingenfeld, K., Härter, M., Schramm, E., & Löwe, B. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.032 · Cited by 641
Nikčević, A. V., Marino, C., Kolubinski, D. C., Leach, D., & Spada, M. M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.053 · Cited by 344
“Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS; Kroenke et al., 2016).”
Willner, P., Rose, J., Kroese, B. S., Murphy, G. H., Langdon, P. E., Clifford, C., Hutchings, H. A., Watkins, A. J., Hiles, S., & Cooper, V. (2020) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12811 · Cited by 260
“These 7- and 9-item screening instruments are widely used, inter alia within the NHS, and sometimes combined as a 16-item Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS: Kroenke et al., 2016).”
Romero, E., López‐Romero, L., Domínguez-Álvarez, B., Villar, P., & Fraguela, J. A. G. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17196975 · Cited by 244
“Parents’ emotional problems were assessed with the four-item version of the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) [45], an ultra-brief screening tool to assess anxiety (e.g., “Feeling nervous, anxious, or on edge”; α = 0.73; MIC = 0.58) and depressive symptoms (e.g., “Feeling down, depressed,…”
InfluentialMcGuine, T. A., Biese, K. M., Petrovska, L., Hetzel, S., Reardon, C. L., Kliethermes, S., Bell, D. R., Brooks, A., & Watson, A. M. (2020) · Journal of Athletic Training · doi:10.4085/1062-6050-0478.20 · Cited by 234
“In addition to the total score, GAD-7 categorical scores of 0 to 4, 5 to 9, 10 to 14, and 15 to 21 correspond to no, mild, moderate, and severe anxiety symptoms, respectively.(29,30) The PHQ-9 is a 9-item screening questionnaire for depression symptoms with scores ranging from 0 to 27; a higher score indicates a great…”
Background
Metadata
- Authors
- Kroenke, K., Wu, J., Yu, Z., Bair, M. J., Kean, J., Stump, T., & Monahan, P. O.
- Affiliations
- Regenstrief Institute (US)
- Corresponding author
- Kroenke, Kurt
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2016-07
- Volume
- 78
- Issue
- 6
- Pages
- 716-727
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- PMC
- PMC4927366
- OpenAlex
- W2397812290
- Semantic Scholar
- a700e31d97d255b2287483ce1a3755190c55cdd1
- Cited by
- 504
- References
- 76
- Citations by year
- 2026: 70 · 2025: 80 · 2024: 76 · 2023: 50 · 2022: 69 · 2021: 77 · 2020: 43 · 2019: 18 · 2018: 9 · 2017: 9
- FWCI
- 17.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- PMC
- Funders
- U.S. Department of Veterans Affairs (IIR 07-119, IK2 RX000879)
- National Institutes of Health (UL1TR001108)
- National Cancer Institute (R01CA115369)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR064081)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- depression, anxiety, psychometric validation, reliability statistics, sensitivity to change, chronic pain, cancer pain, primary care, bifactor analysis, unidimensionality, quality of life, disability
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychometrics, Veterans, Reproducibility of Results, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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