Bureau of Sociological Research (BOSR)


Date of this Version

June 2003


Published in Arthritis Care & Research 49:3 (2003), pp. 368–376; doi 10.1002/art.11116 Copyright © 2003 by the American College of Rheumatology; published by John Wiley & Sons Co. Used by permission. http://www3.interscience.wiley.com/journal/76509746/home


Objective—To compare 3 commonly used psychiatric symptom checklists (the Center for Epidemiological Studies Depression Scale [CES-D], the Positive and Negative Affect Schedule, and the Endler Multidimensional Anxiety Scales [EMAS] to determine their sensitivity, specificity, and ability to discriminate between a disorder (Major Depression [MD], Generalized Anxiety Disorder [GAD], and no disorder. To compare the checklists for their ability to discriminate between type of disorder (MD and GAD). To evaluate the discriminant ability of the subscales, particularly positive affect; whether the somatic items in the CES-D artificially inflate affective scores; and the optimal cut off score for the CES-D.

Methods—We compared the 3 scales to diagnostic criterion of MD, GAD, and comorbid disorder using receiver operator characteristic (ROC) and logistic regression analyses. The sample consisted of a national panel of 415 individuals with rheumatoid arthritis (RA).

Results—Each of the scales had high sensitivity and specificity (areas under the curve: CES-D = 0.92, negative affect = 0.88, positive affect and EMAS = 0.82). The CES-D, however, demonstrated better sensitivity and specificity than the positive affect and the EMAS, but not the negative affect scale.

Conclusion—All 3 self-reports have high combined sensitivity and specificity as measures of affective disorders among RA patients.

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