{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:51:57Z","timestamp":1791381117421,"version":"4.3.3"},"reference-count":60,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Clinic Psychol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Some research funders mandate the use of the Patient Health Questionnaire\u20109 (PHQ\u20109) and Generalized Anxiety Disorder\u20107 (GAD\u20107) as independent measures of depression and anxiety. This study examined their independence in a UK representative sample by testing the structural validity, external validity, longitudinal measurement invariance and growth trajectories of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ\u2010ADS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from Waves 1 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20092025), 2 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091406) and 3 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091166) of the COVID\u201019 Psychological Research Consortium Study were analysed. Confirmatory factor analysis and exploratory structural equation modelling were used to compare PHQ\u2010ADS models. Structural equation modelling examined associations with Cybernetic Big Five Theory traits, intolerance of uncertainty and mental health treatment status. Longitudinal measurement invariance was tested across waves, and curve\u2010of\u2010factors models examined change over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A bifactor model with a correlated residual produced interpretable factors. Auxiliary bifactor statistics supported a composite PHQ\u2010ADS score, whereas PHQ\u20109 and GAD\u20107 summed scores showed little reliable unique variance after accounting for the general factor. Stability and Neuroticism were associated with the general factor (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), Conscientiousness with the PHQ\u20109 group\u2010factor (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and Agreeableness with the GAD\u20107 group\u2010factor (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.003). Intolerance of uncertainty was associated with the general and GAD\u20107 group\u2010factors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Mental health treatment status was primarily associated with the general factor. Residual invariance was supported after inclusion of a trait\u2010factor, and growth trajectories differed across factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the PHQ\u20109 and GAD\u20107 showed some tentative uniqueness within latent models, their summed scores would largely reflect general distress. These findings suggest caution when interpreting PHQ\u20109 and GAD\u20107 total scores as distinct indicators, warranting reconsideration of measurement standardization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjc.70103","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:58:36Z","timestamp":1791377916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Finding salvage in standardization? Structural and longitudinal evaluation of the patient health questionnaire anxiety and depression scale in a\n                    <scp>UK<\/scp>\n                    representative sample"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1781-5376","authenticated-orcid":false,"given":"Joshua James","family":"Crawford","sequence":"first","affiliation":[{"name":"School of Psychology Ulster University  Coleraine UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8574-8947","authenticated-orcid":false,"given":"Gary","family":"Adamson","sequence":"additional","affiliation":[{"name":"School of Psychology Ulster University  Coleraine UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM\u20105\u2010TR)","author":"American Psychiatric Association","year":"2022"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705510903008204"},{"issue":"1","key":"e_1_2_12_4_1","first-page":"5","article-title":"Weighted least squares estimation with missing data","volume":"2010","author":"Asparouhov T.","year":"2010","journal-title":"Mplus Technical Appendix"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/clipsy.9.1.76"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2020.01.013"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0027407"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.21965"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2019.06.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887\u20106185(95)00012\u2010d"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0005\u20107967(01)00092\u20104"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2008.12.004"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/21677026221147872"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705510701301834"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10490\u2010023\u201009880\u2010x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2017.09.007"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0021\u2010843x.100.3.316"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","DOI":"10.4324\/9781315827506","volume-title":"A first course in factor analysis","author":"Comrey A. L.","year":"2013"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2014.07.004"},{"key":"e_1_2_12_20_1","unstructured":"Dueber D. M.(2017).Bifactor Indices Calculator.https:\/\/doi.org\/10.13023\/edp.tool.01"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/01640275221132196"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0026977"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.05.001"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2010.489006"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2024.03.004"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8930"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13428\u2010018\u20101124\u20106"},{"key":"e_1_2_12_29_1","volume-title":"Principles and practice of structural equation modeling","author":"Kline R. B.","year":"2023"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0020327"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000258"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000000322"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.56.10.921"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2010.01.005"},{"key":"e_1_2_12_36_1","volume-title":"Longitudinal structural equation modeling","author":"Little T. D.","year":"2013"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000075"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201034504\u20101"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1880"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1861"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467\u20106494.1992.tb00970.x"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr3903_4"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/10731911231182687"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/09564624231180782"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13333"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2006.02.001"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0029315"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000045"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i02"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2014.882658"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291721001665"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021\u20109010.91.6.1292"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2006.09.017"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/23311908.2022.2095035"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1754470x15000148"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.795672"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2011.12.017"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1177\/21677026221144256"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000459"},{"key":"e_1_2_12_61_1","doi-asserted-by":"crossref","unstructured":"Wickrama K. A. S. Lee T. K. O'Neal C. W. &Lorenz F. O.(2021).Higher\u2010order growth curves and mixture modeling with Mplus.","DOI":"10.4324\/9781003158769"}],"container-title":["British Journal of Clinical Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjc.70103","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bjc.70103","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjc.70103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:58:40Z","timestamp":1791377920000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/10.1111\/bjc.70103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":60,"alternative-id":["10.1111\/bjc.70103"],"URL":"https:\/\/doi.org\/10.1111\/bjc.70103","archive":["Portico"],"relation":{},"ISSN":["0144-6657","2044-8260"],"issn-type":[{"value":"0144-6657","type":"print"},{"value":"2044-8260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"bjc.70103"}}