Global Distress Factor

It has become apparent over the last two decades that virtually all patient self-report outcome measures commonly used in psychotherapy research are, to a large extent, measuring a common factor, usually referred to as global distress. While many outcome questionnaires have subscales that reflect different domains of symptoms, problems, etc., factor analyses have revealed that these subscales tend to correlate strongly with one another. As might be expected, popular outcome measures tend to be highly correlated with one another.

For example, Christopher et al (1988) found that the SLC-90 subscales all load on a common factor, and likewise correlate with similar scales from other measures.

Doefler et al (2002) found that the OQ-45 and the BASIS-32 are highly correlated with one another. Miller et al (2003) likewise found that the Outcome Rating Scale correlates with the OQ-45.

Enns et al (1998) performed factor analyses on the Beck Depression Inventory and the Beck Anxiety Inventory. To quote from the abstract...

"However, the parameter estimate was very high (0.784) and a unidimensional, single-factor model of negative affectivity approached the criteria for good fit. It was concluded that the Beck Anxiety and Depression Inventories assess distinct anxiety and depression phenomena to a limited extent when used in a clinically depressed sample."

The existence of a global distress factor and the fact that multiple outcome questionnaires, including widely used measures of depression, are all found to be correlated with one another other, provide strong evidence of the construct validity patient self-report outcome measures designed to measure assess global subjective distress.

The global distress factor also correlates strongly with measures of "presenteeism" and lost productivity. See Absenteeism & Presenteeism

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Primary topics:

• Measure What? Why?
• Global Distress Factor
• Absenteeism & Presenteeism
• Items or Questionnaires?
• Outcomes Measurement 2.0
• Reliability and Validity
• Measurement Error
• Measuring Change
• Regression to the Mean
• Clinical Cutoff Score
• Reliable Change Index
• Effect Size
• Meta-analysis
• Case Mix Adjustment
• Severity Adjusted Effect Size
• Outcomes Benchmarking
• Trajectory of Change
• Random Walk Hypothesis
• Rational Resource Allocation
• Therapist Effects
• Value Index

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