A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients Development of a questionnaire measuring Attitudes towards Psychological Online Interventions-the APOI. The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration Faked depression: comparing malingering via the internet, pen-and-paper, and telephone administration modes. Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing haemodialysis Methodological Issues in Internet-Mediated Research: A Randomized Comparison of Internet Versus Mailed Questionnaires Targeted Prevention of Common Mental Health Disorders in University Students: Randomised Controlled Trial of a Transdiagnostic Trait-Focused Web-Based Intervention Internet Versus Mailed Questionnaires: A Randomized Comparison
Background Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes . However , many clinicians do not use self-report measures systematic ally in their clinical practice . Internet-based question naires could facilitate administration , but the psychometric properties of the online version of an instrument should be explored before implementation . The recommendation from the International Test Commission is to test the psychometric properties of each question naire separately . Objective Our objective was to compare the psychometric properties of paper- and -pencil versions and Internet versions of two question naires measuring depressive symptoms . Methods The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden . Participants completed the  Beck Depression Inventory ( BDI-II )  and the  Montgomery-Åsberg Depression Rating Scale — Self-rated ( MADRS-S )  , both on paper and on the Internet . The order was r and omized to control for order effects . Symptom severity in the sample ranged from mild to severe depressive symptoms . Results Psychometric properties of the two administration formats were mostly equivalent . The internal consistency was similar for the Internet and paper versions , and significant correlations were found between the formats for both MADRS-S ( r = .84 ) and the BDI-II ( r = .89 ) . Differences between paper and Internet total scores were not statistically significant for either question naire nor for the MADRS-S question dealing with suicidality ( item 9 ) when analyzed separately . The score on the BDI-II question about suicidality ( item 9 ) was significantly lower when administered via the Internet compared with the paper score , but the difference was small ( effect size , Cohen ’s [ d ] = 0.14 ) . There were significant main effects for order of administration on both question naires and significant interaction effects between format and order . This should not , however , pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made . Conclusions The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinical ly meaningful way . The full BDI-II also seems to retain its properties when transferred ; however , the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study . The use of online question naires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save re sources BACKGROUND Only a minority of people suffering from depression receive adequate treatment . Psychological Online Interventions ( POIs ) could help bridge existing treatment gaps and augment the effectiveness of current treatments . Apart from effectiveness , user acceptance of POIs must be achieved if such interventions are to be broadly implemented in existing health-care . Valid measurement tools examining attitudes towards POIs are lacking . Therefore , we examined the dimensionality of attitudes towards POIs , developed a novel question naire , the Attitudes towards Psychological Online Interventions Question naire ( APOI ) , and gathered data to examine its reliability . METHODS We recruited a sample of 1004 adults with mild to moderate depressive symptoms from a range of sources . We constructed a set of 35 items based on literature review as well as expert and patient queries . The initial items were subjected to an exploratory factor analysis ( EFA ) in a r and omly selected sub sample . A final set of 16 items was subjected to a confirmatory factor analysis ( CFA ) to cross-vali date the factor structure in a separate sub sample . RESULTS The EFA revealed four dimensions : " Scepticism and Perception of Risks " , " Confidence in Effectiveness " , " Technologization Threat " and " Anonymity Benefits " . The model fit in the CFA was excellent relating to all applied indices ( χ(2)=105.816 , p=.651 ; SRMR=.042 ; RMSEA=.013 ; CFI=.994 ) and the APOI total scale showed acceptable to good internal consistency . CONCLUSIONS Further research with the APOI might facilitate the development and dissemination of POIs and , ultimately , help improve the quality of care for people experiencing depressive symptoms Background When evaluating hearing rehabilitation , it is reasonable to use self-report question naires as outcome measure . Question naires used in audiological research are developed and vali date d for the paper- and -pencil format . As computer and Internet use is increasing , st and ardized question naires used in the audiological context should be evaluated to determine the viability of the online administration format . The aim of this study was to compare administration of question naires online versus paper- and pencil of four st and ardised question naires used in hearing research and clinic . We included the Hearing H and icap Inventory for the Elderly ( HHIE ) , the International Outcome Inventory for Hearing Aids ( IOI-HA ) , Satisfaction with Amplification in Daily Life ( SADL ) , and the Hospital Anxiety and Depression Scale ( HADS ) . Methods A cross-over design was used by r and omly letting the participants complete the question naires either online or on paper . After 3 weeks the participants filled out the same question naires again but in the other format . A total of 65 hearing-aid users were recruited from a hearing clinic to participate on a voluntary basis and of these 53 completed both versions of the question naires . Results A significant main effect of format was found on the HHIE ( p < 0.001 ) , with participants reporting higher scores on the online format than in the paper format . There was no interaction effect . For the other question naires were no significant main or interaction effects of format . Significant correlations between the two ways of presenting the measures was found for all question naires ( p<0.05 ) . The results from reliability tests showed Cronbachs α ’s above .70 for all four question naires and differences in Cronbachs α between administration formats were negligible . Conclusions For three of the four included question naires the participants ’ scores remained consistent across administrations and formats . For the fourth included question naire ( HHIE ) a significant difference of format with a small effect size was found . The relevance of the difference in scores between the formats depends on which context the question naire is used in . On balance , it is recommended that the administration format remain stable across assessment points BACKGROUND The Internet and telephone are valuable re sources for mental health practitioners when access to face-to-face assessment or therapy is difficult . However , despite the high stakes ( such as access to medication or financial compensation ) often involved in psychological testing , little is known about how test administration mode influences test scores when patients are malingering . The aim of this research was to examine for the first time the equivalence of a malingered measure of depression when administered over the Internet , over the telephone , and with pen and paper . SUBJECTS AND METHODS A mixed experimental design was used with participants ( n=91 ) r and omly allocated to Internet , telephone , or pen- and -paper groups .  Participants completed the Edinburgh Depression Scale , first under st and ard instructions and then under instructions to fake as if experiencing severe depression . A manipulation check was included to ensure participants had understood and followed instructions to fake . RESULTS As predicted , participants were able to significantly increase their depression scores when asked to fake depression . Participants reported significantly lower faked depression scores over the telephone than in pen- and -paper format . Faked depression scores in the online group did not differ significantly from those in the telephone and pen- and -paper groups . However , participants in all groups met criteria indicative of a provisional diagnosis of depression . CONCLUSIONS Overall , the results indicate that there may be no meaningful difference between malingering across administration modes . If an individual is malingering depression , administration mode has minimal influence . These findings provide preliminary support for the use of online/telephone technologies in the assessment of depression Introduction Psychological distress is common in end-stage kidney disease ( ESKD ) and is associated with poorer health outcomes . Cognitive behavioural therapy ( CBT ) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions . Access to skilled therapists competent in managing the competing mental and physical health dem and s of ESKD is limited . Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-re source d services . This study examines the feasibility and acceptability of implementing a two-arm parallel r and omised controlled trial of online CBT with ( intervention arm ) and without ( control arm ) therapist support to improve psychological distress in patients undergoing haemodialysis . Methods Patients will be screened for depression and anxiety while attending for their haemodialysis treatments . We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and /or anxiety . Patients will be r and omised individually ( using a 1:1 computerised sequence ratio ) to either online CBT with therapist telephone support ( intervention arm ) , or online CBT with no therapist ( control arm ) . Outcomes include feasibility and acceptability descriptive data on rates of recruitment , r and omisation , retention and treatment adherence . Self-report outcomes include measures of depression ( Patient Health Question naire-9 ) , anxiety ( Generalised Anxiety Disorder-7 ) , quality of life ( Euro-QoL ) , service use ( client service receipt inventory ) and illness cognitions ( brief illness perception question naire ) . A qualitative process evaluation will also be conducted . The statistician will be blinded to treatment allocation . Ethics and dissemination A National Health Service ( NHS ) research ethics committee approved the study . Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis . Any amendments to the protocol will be su bmi tted to the NHS committee and study sponsor . Trial registration number NCT023528702 ; Pre- results Background The majority of Internet-mediated studies use measures developed as paper- and -pencil measures or face-to-face-delivered material . Previous research suggests that the equivalence between online and offline measures must be demonstrated rather than assumed . Objective The objective of this study was to explore the equivalence 4 measures completed in an online or offline setting . Methods A sample of students ( n = 1969 ) was r and omly assigned to complete 4 popular scales ( the SF-12v2 , the Hospital Anxiety and Depression Scale ( HADS ) , the Fatigue Symptom Inventory , and a single-item fatigue measure ) either online or by mail survey ( pencil and paper ) . The response rate was 52.51 % ( n = 1034 ) and comparable between the online and offline groups . Results Significant differences were noted in fatigue levels between the online and offline group ( P = .01 ) as measured by the Fatigue Symptom Inventory , with the online sample demonstrating higher levels of fatigue . Equivalency was noted for the SF-12v2 , the Hospital Anxiety and Depression Scale , and the single-item fatigue measure . Internal consistency was high except for the SF-12v2 . The SF-12v2 may not be an ideal measure to use for remote administration . Conclusions Equivalency of the Hospital Anxiety and Depression Scale ( HADS ) and the Physical Component Score and Mental Component Score of the SF-12v2 for online and offline data were demonstrated . Equivalency was not demonstrated for the Fatigue Symptom Inventory . Explanations for the difference in fatigue score between the online and offline sample s are unclear . Research that seeks to match sample s and control for extraneous online and offline variables is called for , along with exploration of factors that may mediate the completion of question naires or alter the respondents ’ relationship with the same , to enhance progress in this area Background A large proportion of university students show symptoms of common mental disorders , such as depression , anxiety , substance use disorders and eating disorders . Novel interventions are required that target underlying factors of multiple disorders . Aims To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aim ed at reducing symptoms of common mental disorders in university students . Method Students were recruited online ( n = 1047 , age : M = 21.8 , SD = 4.2 ) and categorised into being at high or low risk for mental disorders based on their personality traits . Participants were allocated to a cognitive-behavioural trait-focused ( n = 519 ) or a control intervention ( n = 528 ) using computerised simple r and omisation . Both interventions were fully automated and delivered online ( trial registration : IS RCT N14342225 ) . Participants were blinded and outcomes were self-assessed at baseline , at 6 weeks and at 12 weeks after registration . Primary outcomes were current depression and anxiety , assessed on the Patient Health Question naire ( PHQ9 ) and Generalised Anxiety Disorder Scale ( GAD7 ) . Secondary outcome measures focused on alcohol use , disordered eating , and other outcomes . Results Students at high risk were successfully identified using personality indicators and reported poorer mental health . A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up . Attrition was high across intervention groups , but comparable to other web-based interventions . Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 ( p<.001 , 95%CI [ 5.19 , 1.98 ] ) and anxiety scores by 2.87 ( p = .018 , 95%CI [ 1.31 , 4.43 ] ) in students at high risk . In high-risk students , between group effect sizes were 0.58 ( depression ) and 0.42 ( anxiety ) . In addition , self-esteem was improved . No changes were observed regarding the use of alcohol or disordered eating . Conclusions This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention . Trial Registration ControlledTrials.com IS RCT Background The use of Internet-based question naires for collection of data to evaluate patient education and other interventions has increased in recent years . Many self-report instruments have been vali date d using paper- and -pencil versions , but we can not assume that the psychometric properties of an Internet-based version will be identical . Objectives To look at similarities and differences between the Internet versions and the paper- and -pencil versions of 16 existing self-report instruments useful in evaluation of patient interventions . Methods Participants were recruited via the Internet and volunteered to participate ( N=397 ) , after which they were r and omly assigned to fill out question naires online or via mailed paper- and -pencil versions . The self-report instruments measured were overall health , health distress , practice mental stress management , Health Assessment Question naire ( HAQ ) disability , illness intrusiveness , activity limitations , visual numeric for pain , visual numeric for shortness of breath , visual numeric for fatigue , self-efficacy for managing disease , aerobic exercise , stretching and strengthening exercise , visits to MD , hospitalizations , hospital days , and emergency room visits . Means , ranges , and confidence intervals are given for each instrument within each type of question naire . The results from the two question naires were compared using both parametric and non-parametric tests . Reliability tests were given for multi-item instruments . A separate sample ( N=30 ) filled out identical question naires over the Internet within a few days and correlations were used to assess test-retest reliability . Results Out of 16 instruments , none showed significant differences when the appropriate tests were used . Construct reliability was similar within each type of question naire , and Internet test-retest reliability was high . Internet question naires required less follow-up to achieve a slightly ( non-significant ) higher completion rate compared to mailed question naires . Conclusions Among a convenience sample recruited via the Internet , results from those r and omly assigned to Internet participation were at least as good as , if not better than , among those assigned mailed question naires , with less recruitment effort required . The instruments administered via the Internet appear to be reliable , and to be answered similarly to the way they are answered when they are administered via traditional mailed paper question naires
For common instruments such as the CES-D , MADRS-S and HADS there is mounting evidence for adequate psychometric properties .
Background Online question naires for measuring common mental health disorders such as depression and anxiety disorders are increasingly used .
The psychometrics of several pen- and -paper question naires have been re-examined for online use and new online instruments have been developed and tested for validity as well .
This study aims to review and synthesis e the literature on this subject and provide a framework for future research .