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Objective: The hospital anxiety and depression scale (HADS) is a widely used scale of anxiety and depression. However, recent studies have challenged the bi-dimensional scoring of the HADS. The present study was to examine the dimensionality of the Chinese HADS. Methods: We recruited a convenience sample of 214 adult psychiatric outpatients at a medical centre in Taiwan, and they completed the Chinese HADS. We used Mokken scale analysis (MSA), exploratory factor analysis (EFA), exploratory bifactor analysis (EBA) and confirmatory factor analysis (CFA) to examine the dimensionality of the Chinese HADS. Results: The Chinese HADS was a moderate Mokken scale (Hs = 0.44), and had a two-factor structure. EBA showed that one general factor, emotional distress, explained 68% of the common variance of the Chinese HADS. CFA confirmed that the bifactor model had the best fit statistics. The items 5 and 7 of the Chinese HADS contributed to structural ambiguity in the Chinese HADS subscales. Conclusions: The sum scores of the Chinese HADS were a reliable and valid unidimensional measure of emotional distress. The Chinese HADS subscales were incapable of differentiating between anxiety and depression. Clinicians and researchers should choose other scales that are specifically designed for measuring anxiety and depression. [ABSTRACT FROM AUTHOR]

The current study examined the psychometric characteristics of the Chinese translation of the Marital Satisfaction Inventory–Revised (MSI-R) in a community sample of 117 couples from Taiwan. The Chinese MSI-R demonstrated moderate to strong internal consistency. Confirmatory factor analysis revealed similar scale factor structures in the Taiwanese and U.S. standardization samples. Mean profile comparisons between the current Taiwanese sample and the original MSI-R standardization sample revealed statistically significant but small differences on several subscales. Overall, the psychometric characteristics of the Chinese MSI-R lend support to its use with couples from diverse cultural backgrounds whose sole or preferred language is Chinese. It may also be appropriate to use the MSI-R in clinical settings for prevention or intervention efforts directed at Chinese-speaking couples. The implications of these findings for clinical and research purposes are discussed. [ABSTRACT FROM AUTHOR]