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Journal of Psychopathology and Behavioral Assessment

Gepubliceerd in:

01-03-2012

The Penn State Worry Questionnaire—Past Day: Development and Validation of a Measure Assessing Daily Levels of Worry

Auteurs: Els Joos, Debora Vansteenwegen, Els Brunfaut, Tim Bastiaens, Koen Demyttenaere, Guido Pieters, Dirk Hermans

Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment | Uitgave 1/2012

Abstract

Based on the widely used Penn State Worry Questionnaire for trait worry, a scale was developed to measure the level of worry experienced during the past 24 h. This instrument, the Penn State Worry Questionnaire—Past Day (PSWQ-PD), was administered to a student sample and two clinical samples. The PSWQ-PD demonstrated high internal consistency, good convergent validity and adequate test-retest reliability. A confirmatory factor analysis revealed that a unifactorial solution provided the best fit. Moreover, it was shown that the PSWQ-PD is a more state-like worry measure than the original PSWQ. The PSWQ-PD is a promising, brief tool for daily worry assessment, which is apt for frequent administration.

vorige artikel The Structure of Internalizing Disorders in Middle Childhood and Evidence for Personality Correlates

volgende artikel The Perceived Stress Scale: Evaluating Configural, Metric and Scalar Invariance across Mental Health Status and Gender

Confirmatory factor analyses on PSWQ-PD scores in both clinical samples separately yielded similar results.

This index was calculated using the internal consistency reliability (α) of the selected sample at both assessment moments. Using the internal consistency reliability of the whole group (student sample or sample 3) for the first assessment moment yielded the same result in the student sample and similar results (μ_a = .48) in sample 3.

To compare two dependent correlations, the common N after listwise deletion was used, in this case N = 310.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV). Washington: American Psychiatric Association Mental Health Service. doi:10.1176/appi.books.9780890423349.

Arrindell, W. A. (1993). The fear of fear concept: stability, retest artefact and predictive power. Behaviour Research and Therapy, 31, 139–148. doi:10.1016/0005-7967(93)90065-3.PubMedCrossRef

Arrindell, W. A., & Ettema, J. H. M. (2003). SCL-90. Symptom checklist. Handleiding bij een multidimensionele psychopathologie-indicator. [SCL-90. Symptom Checklist. Manual for a multidimensional indicator of psychopathology]. Lisse, NL: Swets Test Publishers.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory (BDI-II) manual. San Antonio, TX: The Psychological Corporation.

Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246. doi:10.1037/0033-2909.107.2.238.PubMedCrossRef

Bentler, P. M. (1995). EQS structural equations program manual. Encino, CA: Multivariate Software.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy. Advance online publication.. doi:10.1016/j.beth.2011.03.007.

Borkovec, T. D., & Costello, E. (1993). Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61, 611–619. doi:10.1037/0022-006X.61.4.611.PubMedCrossRef

Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70, 288–298. doi:10.1037//0022-006X.70.2.288.PubMedCrossRef

Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York, NY: Guilford.

Bozdogan, H. (1987). Model selection and Akaike’s information criterion (AIC): the general theory and its analytical extensions. Psychometrika, 52, 345–370. doi:10.1007/BF02294361.CrossRef

Brosschot, J. F., Van Dijk, E., & Thayer, J. F. (2007). Daily worry is related to low heart rate variability during waking and the subsequent nocturnal sleep period. International Journal of Psychophysiology, 63, 39–47. doi:10.1016/j.ijpsycho.2006.07.016.PubMedCrossRef

Brown, T. A. (2003). Confirmatory factor analysis of the Penn State Worry Questionnaire: multiple factors or method effects? Behaviour Research and Therapy, 41, 1411–1426. doi:10.1016/S0005-7967(03)00059-7.PubMedCrossRef

Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 33–37. doi:10.1016/0005-7967(92)90093-V.PubMedCrossRef

Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. Bollen & S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.

Buhr, K., & Dugas, M. J. (2009). The role of fear of anxiety and intolerance of uncertainty in worry: an experimental manipulation. Behaviour Research and Therapy, 47, 215–223. doi:10.1016/j.brat.2008.12.004.PubMedCrossRef

Burns, G. L., Keortge, S. G., Formea, G. M., & Sternberger, L. G. (1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34, 163–173. doi:10.1016/0005-7967(95)00035-6.PubMedCrossRef

Calmes, C. A., & Roberts, J. E. (2007). Repetitive thought and emotional distress: rumination and worry as prospective predictors of depressive and anxious symptomatology. Cognitive Therapy and Research, 30, 343–356. doi:10.1007/s10608-006-9026-9.CrossRef

Chelminksi, I., & Zimmerman, M. (2003). Pathological worry in depressed and anxious patients. Anxiety Disorders, 17, 533–546. doi:10.1016/S0887-6185(02)00246-3.CrossRef

Davey, G. C. L. (1993). A comparison of three worry questionnaires. Behaviour Research and Therapy, 31, 51–56. doi:10.1016/0005-7967(93)90042-S.PubMedCrossRef

Davey, G. C. L. (2006). The Catastrophising Interview procedure. In G. C. L. Davey & A. Wells (Eds.), Worry and its psychological disorders: Theory, assessment and treatment (pp. 157–176). Chichester, UK: Wiley. doi:10.1002/9780470713143.ch10.CrossRef

de Bruin, G. O., Muris, P., & Rassin, E. (2007). Are there specific meta-cognitions associated with vulnerability to symptoms of worry and obsessional thoughts? Personality and Individual Differences, 42, 689–699. doi:10.1016/j.paid.2006.08.015.CrossRef

Defranc, A., Geypen, L., Raes, F., & Hermans, D. (2004). Cognitive behavioral avoidance scale (Authorized Dutch translation). Unpublished questionnaire. Psychology Department, K.U.Leuven.

Derogatis, L. R. (1977). SCL-90: Administration, scoring and procedures manual-I for the (Revised) version. Baltimore, MD: Johns Hopkins University School of medicine, Clinical Psychometrics Research Unit.

Dupuy, J. B., Beaudoin, S., Rhéaume, J., Ladouceur, R., & Dugas, M. J. (2001). Worry: daily self-report in clinical and non-clinical populations. Behaviour Research and Therapy, 39, 1249–1255. doi:10.1016/S0005-7967(01)00011-0.CrossRef

Floyd, M., Garfield, A., & LaSota, M. T. (2005). Anxiety sensitivity and worry. Personality and Individual Differences, 38, 1223–1229. doi:10.1016/j.paid.2004.08.005.CrossRef

Fresco, D. M., Heimberg, R. G., Mennin, D. S., & Turk, C. L. (2002). Confirmatory factor analysis of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 40, 313–323. doi:10.1016/S0005-7967(00)00113-3.PubMedCrossRef

Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., & McCurry, S. M. (2004). Measuring experiential avoidance: a preliminary test of a working model. The Psychological Record, 54, 553–578.

Hazlett-Stevens, H., Ullman, J. B., & Craske, M. G. (2004). Factor structure of the Penn State Worry Questionnaire: examination of a method factor. Assessment, 11, 361–370. doi:10.1177/1073191104269872.PubMedCrossRef

Hermans, D., Ruys, K., & Van den Bergh, O. (2005). Penn State Worry Questionnaire—Past Week (authorized Dutch version). Unpublished questionnaire. Psychology Department, K.U.Leuven.

Hong, R. Y. (2007). Worry and rumination: differential associations with anxious and depressive symptoms and coping behavior. Behaviour Research and Therapy, 45, 277–290. doi:10.1016/j.brat.2006.03.006.PubMedCrossRef

Howarth, E. (1978). The μ index for differentiation of state and trait scales. Psychological Reports, 43, 474. doi:10.2466/PR0.43.6.474.CrossRef

Jacobs, N., Kleen, M., De Groot, F., & A-Tjak, J. (2008). Het meten van experiëntiële vermijding: De Nederlandstalige versie van de Acceptance and Action Questionnaire-II (AAQ-II) [Measuring experiential avoidance: the Dutch version of the Acceptance and Action Questionnaire-II (AAQ-II)]. Gedragstherapie, 41, 349–361.

Jöreskog, K. G., & Sörbom, D. (2004). LISREL 8.71. [Computer Software]. Chicago, IL: Scientific Software International.

Kuehner, C., & Weber, I. (1999). Responses to depression in unipolar depressed patients: an investigation of Nolen-Hoeksema's response styles theory. Psychological Medicine, 29, 132–1333. doi:10.1017/S0033291799001282.CrossRef

Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000). Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933–941. doi:10.1016/S0005-7967(99)00133-3.PubMedCrossRef

Luyckx, K., Schwartz, S. J., Berzonsky, M. D., Soenens, B., Vansteenkiste, M., Smits, I., & Goossens, L. (2008). Capturing ruminative exploration: extending the four-dimensional model of identity formation in late adolescence. Journal of Research in Personality, 42, 58–82. doi:10.1016/j.jrp.2007.04.004.CrossRef

McLaughlin, K. A., Borkovec, T. D., & Sibrava, N. J. (2007). The effects of worry and rumination on affect states and cognitive activity. Behavior Therapy, 38, 23–38. doi:10.1016/j.beth.2006.03.003.PubMedCrossRef

Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495. doi:10.1016/0005-7967(90)90135-6.PubMedCrossRef

Muris, P., Merckelbach, H., & Horselenberg, R. (1996). Individual differences in thought suppression. The white bear suppression inventory: factor structure, reliability, validity and correlates. Behaviour Research and Therapy, 34, 501–513. doi:10.1016/0005-7967(96)00005-8.PubMedCrossRef

Muris, P., Roelofs, J., Meesters, C., & Boomsma, P. (2004). Rumination and worry in nonclinical adolescents. Cognitive Therapy and Research, 28, 539–554. doi:10.1023/B:COTR.0000045563.66060.3e.CrossRef

Newman, M. G., Castonguay, L. G., Borkovec, T. D., Fisher, A. J., Boswell, J. F., Szkodny, L. E., & Nordberg, S. S. (2011). A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies. Journal of Consulting and Clinical Psychology, 79, 171–181. doi:10.1037/a0022489.PubMedCrossRef

Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121. doi:10.1037/0022-3514.61.1.115.PubMedCrossRef

Olatunji, B. O., Moretz, M. W., & Zlomke, K. R. (2010). Linking cognitive avoidance and GAD symptoms: the mediating role of fear of emotion. Behaviour Research and Therapy, 48, 435–441. doi:10.1016/j.brat.2009.11.014.PubMedCrossRef

Olatunji, B. O., Wolitzky-Taylor, K. B., Sawchuk, C. N., & Ciesielski, B. G. (2011). Worry and the anxiety disorders: a meta-analytic synthesis of specificity to GAD. Applied and Preventive Psychology. doi:10.1016/j.appsy.2011.03.001. Advance online publication.

Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: the construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42, 293–313. doi:10.1016/S0005-7967(03)00140-2.PubMedCrossRef

Raes, F., Hermans, D., & Eelen, P. (2003). De Nederlandstalige versie van de Ruminative Response Scale (RRS-NL) en de Rumination on Sadness Scale (RSS-NL) [The Dutch version of the Ruminative Response Scale (RRS-NL) and the Rumination on Sadness Scale (RSS-NL)]. Gedragstherapie, 36, 97–104.

Robichaud, M., Dugas, M. J., & Conway, M. (2003). Gender differences in worry and associated cognitive-behavioral variables. Anxiety Disorders, 17, 501–516. doi:10.1016/S0887-6185(02)00237-2.CrossRef

Roelofs, J., Huibers, M., Peeters, F., Arntz, A., & van Os, J. (2008). Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals. Behaviour Research and Therapy, 46, 1283–1289. doi:10.1016/j.brat.2008.10.002.PubMedCrossRef

Sanavio, E. (1988). Obsessions and compulsions: the Padua inventory. Behaviour Research and Therapy, 26, 167–177. doi:10.1016/0005-7967(88)90116-7.

Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8, 23–74. Retrieved from http://user.uni-frankfurt.de/~kscherm/schermelleh/mpr_Schermelleh.pdf

Schoofs, H., Hermans, D., & Raes, F. (2010). Brooding and reflection as subtypes of rumination: evidence from confirmatory factor analysis in nonclinical samples using the Dutch ruminative response scale. Journal of Psychopathology and Behavioral Assessment, 32, 609–617. doi:10.1007/s10862-010-9182-9.CrossRef

Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and rumination: repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research, 24, 671–688. doi:10.1023/A:1005587311498.CrossRef

Spielberger, C. D., Gorsuch, R. L., Lushene, P. R., Vagg, P. R., & Jacobs, A. G. (1983). Manual for the state-trait anxiety inventory (Form Y). Palo Alto, CA: Consulting Psychologists.

Starcevic, V., & Berle, D. (2006). Cognitive specificity of anxiety disorders: a review of selected key constructs. Depression and Anxiety, 23, 51–61. doi:10.1002/da.20145.PubMedCrossRef

Startup, H. M., & Erickson, T. M. (2006). The Penn State Worry Questionnaire (PSWQ). In G. C. L. Davey & A. Wells (Eds.), Worry and its psychological disorders: Theory, assessment and treatment (pp. 101–119). Chichester, UK: Wiley. doi:10.1002/9780470713143.

Stöber, J., & Bittencourt, J. (1998). Weekly assessment of worry: an adaptation of the Penn State Worry Questionnaire for monitoring changes during treatment. Behaviour Research and Therapy, 36, 645–656. doi:10.1016/S0005-7967(98)00031-X.PubMedCrossRef

Szabó, M., & Lovibond, P. F. (2006). Worry episodes and perceived problem solving: a diary-based approach. Anxiety, Stress & Coping, 19, 175–187. doi:10.1080/10615800600643562.CrossRef

Tallis, F., Eysenck, M., & Mathews, A. (1992). A questionnaire for the measurement of nonpathological worry. Personality and Individual Differences, 13, 161–168. doi:10.1016/0191-8869(92)90038-Q.CrossRef

Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. Journal of Personality & Social Psychology, 76, 284–304. doi:10.1037/0022-3514.76.2.284.CrossRef

Tucker, L. E., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analyses. Psychometrika, 38, 1–10. doi:10.1007/BF02291170.CrossRef

Turner, S. M., Beidel, D. C., & Stanley, M. A. (1992). Are obsessional thoughts and worry different cognitive phenomena? Clinical Psychology Review, 12, 257–270. doi:10.1016/0272-7358(92)90117-Q.CrossRef

Van der Does, A. J. W. (2002). Handleiding bij de Nederlandse versie van Beck Depression Inventory—second edition (BDI-II-NL) [Manual for the Dutch version of the Beck Depression Inventory—second edition (BDI-II-NL)]. Lisse, NL: Swets Test.

van der Heiden, C., Muris, P., Bos, A. E. R., & van der Molen, H. T. (2010). Factor structure of the Dutch version of the Penn State Worry Questionnaire. Journal of Behavior Therapy & Experimental Psychiatry, 41, 304–309. doi:10.1016/j.jbtep.2010.02.009.CrossRef

Van der Ploeg, H. M. (2000). Handleiding bij de Zelf-Beoordelings Vragenlijst [Manual for the Self-Report Questionnaire]. Amsterdam, NL: Harcourt Assessment B.V.

Van der Ploeg, H. M., Defares, P. B., & Spielberger, C. D. (1980). Handleiding bij de Zelf- Beoordelings Vragenlijst ZBV. Een Nederlandstalige bewerking van de Spielberger State—Trait Anxiety Inventory STAI DY [Manual for the Self-Report Questionnaire ZBV. A Dutch adaptation of the Spielberger State-trait Anxiety Inventory STAI DY]. Lisse, NL: Swets & Zeitlinger.

Van Oppen, P. (1992). Obsessions and compulsions: dimensional structure, reliability, convergent and divergent validity of the Padua Inventory. Behaviour Research and Therapy, 30, 631–637. doi:10.1016/0005-7967(92)90008-5.PubMedCrossRef

Van Oppen, P., Hoekstra, R. J., & Emmelkamp, P. M. G. (1995). The structure of obsessive-compulsive symptoms. Behaviour Research and Therapy, 33, 15–23. doi:10.1016/0005-7967(94)E0010-G.PubMedCrossRef

van Rijsoort, S., Emmelkamp, P., & Vervaeke, G. (1999). The Penn State Worry Questionnaire and the Worry Domains Questionnaire: structure, reliability and validity. Clinical Psychology and Psychotherapy, 6, 297–307. doi:10.1002/(SICI)1099-0879(199910)6:4<297::AID-CPP206>3.0.CO;2-E.CrossRef

van Rijsoort, S., Emmelkamp, P., & Vervaeke, G. (2001). Assessment of worry and OCD: how are they related? Personality and Individual Differences, 31, 247–258. doi:10.1016/S0191-8869(00)00133-1.CrossRef

van Rijsoort, S., Vervaeke, G., & Emmelkamp, P. (1997). De Penn State Worrry Questionnaire en de Worry Domains Questionnaire: Eerste resultaten bij een normale Nederlandse populatie. [The Penn State Worry Questionnaire and the Worry Domains Questionnaire: First results in a normal Dutch population]. Gedragstherapie, 30, 121–128.

Vandromme, H., Raes, F., Defranc, A., & Hermans, D. (2007). De Cognitive-Behavioral Avoidance Scale (CBAS-NL): Een vragenlijst voor vermijdingsgedrag bij depressie [The Cognitive-Behavioral Avoidance Scale (CBAS-NL): a questionnaire for avoidance behaviour in depression]. Gedragstherapie, 40, 285–301.

Watkins, E. (2004). Appraisals and strategies associated with rumination and worry. Personality and Individual Differences, 37, 679–694. doi:10.1016/j.paid.2003.10.002.CrossRef

Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163–206. doi:10.1037/0033-2909.134.2.163.PubMedCrossRef

Watkins, E., Moulds, M., & Mackintosh, B. (2005). Comparisons between rumination and worry in a non-clinical population. Behaviour Research and Therapy, 43, 1577–1585. doi:10.1016/j.brat.2004.11.008.PubMedCrossRef

Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62, 615–641. doi:10.1111/j.1467-6494.1994.tb00311.x.CrossRef

Wells, A., & Papageorgiou, C. (1998). Relationships between worry, obsessive-compulsive symptoms and meta-cognitive beliefs. Behaviour Research and Therapy, 36, 899–913. doi:10.1016/S0005-7967(98)00070-9.PubMedCrossRef

Woelk, H., & Schlafke, S. (2010). A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for Generalized Anxiety Disorder. Phytomedicine, 17, 94–99. doi:10.1016/j.phymed.2009.10.006.PubMedCrossRef

Wolitzky-Taylor, K. B., & Telch, M. J. (2010). Efficacy of self-administered treatments for pathological academic worry: a randomized controlled trial. Behaviour Research and Therapy, 48, 840–850. doi:10.1016/j.brat.2010.03.019.PubMedCrossRef

Titel: The Penn State Worry Questionnaire—Past Day: Development and Validation of a Measure Assessing Daily Levels of Worry
Auteurs: Els Joos
Debora Vansteenwegen
Els Brunfaut
Tim Bastiaens
Koen Demyttenaere
Guido Pieters
Dirk Hermans
Publicatiedatum: 01-03-2012
Uitgeverij: Springer US
Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment / Uitgave 1/2012
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505
DOI: https://doi.org/10.1007/s10862-011-9265-2

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The Penn State Worry Questionnaire—Past Day: Development and Validation of a Measure Assessing Daily Levels of Worry

Abstract

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Factor Invariance of Psychometric Schizotypy in Spanish and American Samples

The Structure of Internalizing Disorders in Middle Childhood and Evidence for Personality Correlates

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Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample

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