DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

4) Hospital Anxiety and Depression Scale (HADS)
Zigmond and Snaith (1983)
The HADS is a brief measure of anxiety and depression consisting of 14 items (7 for
each).
Scoring:
Each item is rated on a four point (0–3) response category so the possible scores ranged
from 0 to 21 for anxiety and 0 to 21 for depression. An analysis of scores on the two
subscales enabled provision of information that a score of 0 to 7 for either subscale could
be regarded as being in the normal range, a score of 11 or higher indicating probable
presence ('caseness') of the mood disorder and a score of 8 to 10 being just suggestive of
the presence of the respective state.
The HADS was originally developed for people aged between 16 and 65. Only two
studies focused explicitly on using the HADS in a population sample of adolescents, i.e.
Jorngarden, Wettergen and Von Essen (2006) and White, Leach, Sims, Atkinson, and
Cottrell (1999). The latter aimed at validating the HADS for use with a British adolescent
population (aged 12–16). The study concluded that the HADS is reliable, and has
adequate sensitivity and specificity, and is therefore useful for screening adolescents.
Reliability and Validity:
Cronbach’s coefficient was found to be 0.80 and Depression 0.76, in a sample of 69,648
adult participants, therefore concluding that the basic psychometric properties of the
HADS scale as a self rating instrument should be considered as ‘quite good’ in terms of
factor structure, intercorrelation, homogeneity, and internal consistency (Mykleton,
Stordal and Dahl, 2001). White et al (1999) found that the HADS had adequate testretest
reliability and factor structure, and discriminated between adolescents diagnosed
with depressive or anxiety disorders and those without these diagnoses. They concluded
that the psychometric properties of the HADS and its shortness make it useful for
screening and in clinical settings with adolescents.
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