Validation of the K6 and its depression and anxiety subscales for detecting nonspecific psychological distress and need
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Validation of the K6 and its depression and anxiety subscales for detecting nonspecific psychological distress and need for treatment John W. Lace 1 & Zachary C. Merz 2 & Alex F. Grant 1 & Natalie A. Emmert 3 & Katherine L. Zane 4 & Paul J. Handal 1
# Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract The present study sought to validate cutoff scores for the K6 denoting clinically significant nonspecific psychological distress and need for treatment. One thousand sixty (1060) adults (M age = 36.27) participated online via Amazon’s Mechanical Turk, and completed the K6, IPIP-NEO-120, and demographic information. Results revealed that a two-factor solution (Depression and Anxiety) for the K6 fit data statistically significantly better than a single-factor model. Results also revealed good concurrent validity for the K6 and its two identified subscales: K6-Dep and K6-Anx. Cutoff scores denoting clinically significant distress and need for treatment for the K6 (10), K6-Dep (4) and K6-Anx (4) were identified and each yielded total classification accuracy of approximately 71%. The findings of the present study suggested that the K6 and its two subscales may have clinical utility in discerning between those who are experiencing enough psychological distress to currently need psychological treatment and those who have never received treatment. Future research should validate the K6’ subscales against diagnostic measures of depressive and anxious disorders, and compare them to other epidemiological measures of psychological distress and need for treatment with appropriate methodological considerations. Keywords Psychological distress . Validation study . Cut-off scores . K6 . Factor analysis Nonspecific psychological distress is a Btransdiagnostic feature of mental suffering^ (Thelin et al. 2017, p. 411) characterized by Baffective distress [that is] not specific to any particular psychiatric disorder^ (Dohrenwend et al. 1980, p. 1229). Epidemiological work has noted prevalence of diagnosable mental disorders to be from 15% to 20% (Jacobi et al. 2004; Kessler et al. 1994; Kessler and Frank 1997; Regier et al. 1988), while more recent research has suggested that point prevalence of Bhigh psychological distress^ (Caron et al. 2012, p. 5) may be as high as 38%. Unfortunately, despite the prevalence of psychological distress, relatively low levels of treatmentseeking behavior have been reported, as between 20% and
* John W. Lace [email protected] 1
Saint Louis University, 3700 Lindell Blvd, Suite 1200, St. Louis, MO 63108, USA
2
Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
3
University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
4
Rush University Medical Center, Chicago, IL, USA
30% of individuals experiencing clinically significant psychological distress present for treatment (Kessler et al. 2005). Psychological distress and impairment contribute to disease burden and chronic disability internationally (Vigo et al. 2016; Whiteford et al. 2013), and the creation and utili
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