Cross-cultural validation of the German version of the Four-Dimensional Symptom Questionnaire (4DSQ) in multimorbid elderly people

Purpose Psychosomatic symptoms and mental health problems are highly prevalent in multimorbid elderly people challenging general practitioners to differentiate between normal stress and psychopathological conditions. The 4DSQ is a Dutch questionnaire developed to detect anxiety, depression, somatiza...

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Bibliographic Details
Published in:Quality of life research 2018-10, Vol.27 (10), p.2691-2697
Main Authors: Exner, Anna, Kleinstäuber, Maria, Maier, Wolfgang, Fuchs, Angela, Petersen, Juliana J., Schäfer, Ingmar, Gensichen, Jochen, Riedel-Heller, Steffi G., Weyerer, Siegfried, Bickel, Horst, König, Hans-Helmut, Wiese, Birgitt, Schön, Gerhard, Scherer, Martin, van den Bussche, Hendrik, Terluin, Berend
Format: Article
Language:English
Subjects:
Aged
Anxiety
Brief Communication
Comorbidity
Cross-Cultural Comparison
Female
Humans
INSTRUMENT DEVELOPMENT
Language
Male
Medicine
Medicine & Public Health
Mental health
Multimorbidity - trends
Older people
Primary care
Public Health
Quality of Life - psychology
Quality of Life Research
Questionnaires
Reproducibility of Results
Sociology
Surveys and Questionnaires
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Summary:Purpose Psychosomatic symptoms and mental health problems are highly prevalent in multimorbid elderly people challenging general practitioners to differentiate between normal stress and psychopathological conditions. The 4DSQ is a Dutch questionnaire developed to detect anxiety, depression, somatization, and distress in primary care. This study aims to analyze measurement equivalence between a German version and the original Dutch instrument. Methods A Dutch and a German sample of multimorbid elderly people, matched by gender and age, were analyzed. Equivalence of scale structures was assessed by confirmatory factor analysis (CFA). To evaluate measurement equivalence across languages, differential item functioning (DIF) was analyzed using Mantel-Haenszel method and hybrid ordinal logistic regression analysis. Differential test functioning (DTF) was assessed using Rasch analysis. Results A total of 185 German and 185 Dutch participants completed the questionnaire. The CFA confirmed one-factor models for all scales of both 4DSQ versions. Nine items in three scales were flagged with DIF. The anxiety scale showed to be free of DIF. DTF analysis revealed negligible scale impact of DIF. Conclusions The German 4DSQ demonstrated measurement equivalence to the original Dutch instrument. Hence, it can be considered a valid questionnaire for the screening for mental health problems in primary care.
ISSN:0962-9343
1573-2649
DOI:10.1007/s11136-018-1924-2