Validation of the HADS and PSS‐10 and a cross‐sectional study of psychological status in patients with recurrent aphthous stomatitis

Abstract

Objectives To validate the Hospital Anxiety and Depression Scale (HADS) and the 10‐item Perceived Stress Scale (PSS‐10) for use in clinical studies of recurrent aphthous stomatitis (RAS) and to provide cross‐sectional assessment of anxiety, depressive, and distress symptoms and perceived stress in patients with RAS. Methods The validity and reliability of the HADS and PSS‐10 were evaluated in 120 individuals with RAS through confirmatory factor analysis and calculation of Cronbach's alpha and omega coefficients. The prevalence of comorbid anxiety, depression, distress, and moderate‐to‐high perceived stress, and their association with demographics and clinical factors were assessed through cutoff scores of the HADS and PSS‐10 and bivariate analyses, respectively. Results A bi‐factor model, with all items loading onto general factor with two group factors, provides the best fit to the HADS and PSS‐10 data of this RAS cohort. While omega values suggested adequate reliability of total score of both scales, relatively low ranges of coefficient omega hierarchical limit utility of their subscale scores. The prevalence of anxiety, depression, distress, and moderate‐to‐high perceived stress was 42.5%, 18.33%, 28.33%, and 71.67%, respectively. Ethnicity, alcohol consumption, disease comorbidities, clinical type of RAS, ulcer size, pain, and RAS disease activity were found to be associated with negative psychological symptoms. Conclusion The HADS and PSS‐10 are valid and reliable as general scales of psychological distress and stress in patients with RAS. Significant mental burden among RAS patients makes the use of these validated instruments a sensible and prudent practice for psychological assessment of this patient group.

Mental Health and Resilient Coping in Caregivers of Autistic Individuals during the COVID-19 Pandemic: Findings from the Families Facing COVID Study

“…Total scores were calculated by adding up the scores for each item, and ranged from 0 to 40, with higher scores indicating higher perceived stress. Consistent with previous research (AlAteeq et al, 2021;Alharbi & Alshehry, 2019;Toto & Limone, 2021;Wiriyakijja et al, 2020), a total score between 0 and 13 was considered to be low stress, 14 to 26, considered to be moderate stress, and scores 27 and above indicated high perceived stress. The psychometric properties of the three versions of the PSS (PSS-14, PSS-10, and PSS-4) have been examined in various populations (e.g.…”

Influencing Factors Associated With Mental Health Outcomes Among Dental Medical Staff in Emergency Exposed to Coronavirus Disease 2019: A Multicenter Cross-Sectional Study in China

“…The total scores of these neuropsychological tests were as follows: GAD-7, minimal (0–4), mild (5–9), moderate (10–14), and severe (15–21); PHQ-9, no depression (0–4), mild depression (5–9), moderate depression (10–14), moderately severe depression (15–19), and severe depression (20–27); PSS, low stress (0–13), moderate stress (14–26), and severe stress (27 or above); and ASDS, the cutoff value of dissociation cluster was 9, the cutoff value of reexperience, avoidance, and arousal cluster was 28, and the cutoff value of ASD was 56. Therefore, the cutoff scores in this study for detecting symptoms of anxiety, depression, perceived stress, and ASD were 10 ( 25 ), 10 ( 26 ), 14 ( 27 ), and 56 ( 28 ), respectively.…”

Public mental health under the long-term influence of COVID-19 in China: Geographical and temporal distribution

“…The higher the total score, the higher the psychological stress. A score≥14 indicates the perceived stress is at a moderate to high level ( Wiriyakijja et al, 2020 ).…”