Validation Study of a Distress Screener

Abstract

Objectives A 3-item screening instrument called the Distress Screener was developed for early identification of distress among employees on sick leave. The Distress Screener consists of three items obtained from the distress subscale of the four-dimensional symptom questionnaire (4DSQ). This study assessed an optimal cut-off point and validated the Distress Screener by relating it to the 4DSQ and to medical diagnoses. Methods 171 sick-listed employees filled in the Distress Screener and the 4DSQ (containing four subscales: distress, depression, anxiety and somatisation) and medical diagnoses were obtained from occupational physicians (OPs). The optimal cut-off point was assessed by computing sensitivity and specificity values. Validity was assessed by relating the Distress Screener score to the scores on 4DSQ subscales. In addition scores were compared to mental health medical diagnoses and the degree of similarity between two repeated measurements was obtained. Results Using the 4DSQ distress score >10 as reference standard, the optimal cut-off point of the Distress Screener was ≥4. Regarding validity, a high correlation (0.82) existed between the Distress Screener and the 4DSQ distress subscale and it was significantly different from the correlations with the other 4DSQ subscales. Also a high correlation existed for the test–retest reliability (0.83). Furthermore, a high score on the Distress Screener seemed to be related to the medical diagnosis ‘Stress-related complaints’. All low scores seemed to be related to the medical diagnosis ‘Other complaints’. Sensitivity (0.85) and specificity (0.78) values, and positive and negative predictive values of the screener were comparable to those of the 4DSQ distress subscale. Conclusions The Distress Screener is a valid instrument for use by the OP during consulting time as a quick scan for early identification of distress in employees on sick leave. The cut-off point ≥4 is useful for early identification of distress in employees on sick leave.

A Participatory Workplace Intervention for Employees With Distress and Lost Time: A Feasibility Evaluation Within a Randomized Controlled Trial

“…The distress screener correlated high (0.82) with the 4DSQ distress scale. Sensitivity and specificity of the distress screener were, respectively, 0.85 and 0.78 [22].…”

Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mental disorders

“…Because during recruitment it was no longer possible to recruit on the basis of a registered mental health complaint, every newly sick-listed worker received an invitation and was asked to indicate whether he/she was sick-listed due to mental health problems. Furthermore, the short questionnaire consisted of a screener for distress (25), questions about the intention to return to work despite ongoing health complaints, and about the date of sick-listing. The RTW intention was measured on a 5-point Likert scale with responses: "certainly not", "probably not", "maybe", "probably", and "certainly".…”

A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes

“…Distress Screener has been validated in several languages among which Dutch (internal consistency: 0.6-0.7; test-retest coefficients: ≥ 0.9; criterion-related validity: sensitivity 0. 8, specificity 0.7, Area Under ROC Curve ≥0.8) [12,13]. A total score ranging from 0 to 6 was obtained by summing up the answers on the three items, a total score of 3 or less indicating the absence of distress and a total score of 4 or more indicating the presence of distress [12,13].…”

“…8, specificity 0.7, Area Under ROC Curve ≥0.8) [12,13]. A total score ranging from 0 to 6 was obtained by summing up the answers on the three items, a total score of 3 or less indicating the absence of distress and a total score of 4 or more indicating the presence of distress [12,13]. The 12-item General Health Questionnaire (GHQ-12) was used to assess psychological symptoms related to anxiety/depression (e.g.…”