Skip to main content
Log in

Normative values for the distress thermometer (DT) and the emotion thermometers (ET), derived from a German general population sample

  • Brief Communication
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The distress thermometer (DT) and the emotion thermometers (ET) are short screening instruments for use in oncological practice. The aim of this study was to provide normative values and to analyze the correlational structure of the ET.

Methods

A representative sample of the adult German general population (N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale, and the demoralization scale.

Results

The percentages of people above the cutoff (≥ 4) and the mean scores of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62, anxiety: 12.3%, M = 1.36 ± 1.93, depression: 16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16, and need for help: 10.7%, M = 1.18 ± 1.90. Women reported significantly higher levels of burden than men, with effect sizes between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated (r between 0.44 and 0.69) and significantly correlated with the other scales (r between 0.36 and 0.68).

Conclusions

The normative scores can help qualify assessments of groups of patients. The new four dimensions of the ET provide relevant additional information that is not already covered by the DT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Mitchell, A. J. (2010). Short screening tools for cancer-related distress: A review and diagnostic validity meta-analysis. Journal of the National Comprehensive Cancer Network, 8(4), 487–494.

    Article  PubMed  Google Scholar 

  2. Mitchell, A. J. (2007). Pooled results from 38 analyses of the accuracy of distress thermometer and other ultra-short methods of detecting cancer-related mood disorders. Journal of Clinical Oncology, 25(29), 4670–4681.

    Article  PubMed  Google Scholar 

  3. National Comprehensive Cancer Network (NCCN). (2003). Distress management. Clinical practice guidelines. Journal of the National Comprehensive Cancer Network, 1(3), 344–374.

    Article  Google Scholar 

  4. Roth, A. J., Kornblith, A. B., Batel-Copel, L., Peabody, E., Scher, H. I., & Holland, J. C. (1998). Rapid screening for psychologic distress in men with prostate carcinoma. Cancer, 82(10), 1904–1908.

    Article  CAS  Google Scholar 

  5. Recklitis, C. J., Blackmon, J. E., & Chang, G. (2016). Screening young adult cancer survivors for distress with the distress thermometer: Comparisons with a structured clinical diagnostic interview. Cancer, 122(2), 296–303.

    Article  PubMed  Google Scholar 

  6. Ma, X., Zhang, J., Zhong, W., Shu, C., Wang, F., Wen, J., et al. (2014). The diagnostic role of a short screening tool—The distress thermometer: A meta-analysis. Supportive Care in Cancer, 22(7), 1741–1755.

    Article  PubMed  Google Scholar 

  7. Donovan, K. A., Grassi, L., McGinty, H. L., & Jacobsen, P. B. (2014). Validation of the distress thermometer worldwide: State of the science. Psycho-Oncology, 23(3), 241–250.

    Article  PubMed  Google Scholar 

  8. Leclair, T., Carret, A.-S., Samson, Y., & Sultan, S. (2016). Stability and repeatability of the distress thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with parents of childhood cancer survivors. PLoS ONE, 11(7), e0159773.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Mitchell, A. J., Baker-Glenn, E. A., Park, B., Granger, L., & Symonds, P. (2010). Can the distress thermometer be improved by additional mood domains? Part II. What is the optimal combination of emotion thermometers? Psycho-Oncology, 19(2), 134–140.

    Article  PubMed  Google Scholar 

  10. Mitchell, A. J., Baker-Glenn, E. A., Granger, L., & Symonds, P. (2010). Can the distress thermometer be improved by additional mood domains? Part I. Initial validation of the emotion thermometers tool. Psycho-Oncology, 19(2), 125–133.

    Article  PubMed  Google Scholar 

  11. Mitchell, A. J., Morgan, J. P., Petersen, D., Fabbri, S., Fayard, C., Stoletniy, L., et al. (2012). Validation of simple visual-analogue thermometer screen for mood complications of cardiovascular disease: The emotion thermometers. Journal of Affective Disorders, 136(3), 1257–1263.

    Article  PubMed  Google Scholar 

  12. Beck, K. R., Tan, S. M., Lum, S. S., Lim, L. E., & Krishna, L. K. (2016). Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: Screening cancer patients for distress, anxiety and depression. Asia-Pacific Journal of Clinical Oncology, 12(2), 9.

    Article  Google Scholar 

  13. Schubart, J. R., Mitchell, A. J., Dietrich, L., & Gusani, N. J. (2015). Accuracy of the emotion thermometers (ET) screening tool in patients undergoing surgery for upper gastrointestinal malignancies. Journal of Psychosocial Oncology, 33(1), 1–14.

    Article  PubMed  Google Scholar 

  14. van Oers, H. A., Schepers, S. A., Grootenhuis, M. A., & Haverman, L. (2017). Dutch normative data and psychometric properties for the distress thermometer for parents. Quality of Life Research, 26(1), 177–182.

    Article  PubMed  Google Scholar 

  15. Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., et al. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122(1–2), 86–95.

    Article  Google Scholar 

  16. Yellen, S. B., Cella, D. F., Webster, K., Blendowski, C., & Kaplan, E. (1997). Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of Pain and Symptom Management, 13(2), 63–74.

    Article  CAS  PubMed  Google Scholar 

  17. Cella, D., Lai, J.-S., Chang, C.-H., Peterman, A., & Slavin, M. (2002). Fatigue in cancer patients compared with fatigue in the general United States population. Cancer, 94(2), 528–538.

    Article  PubMed  Google Scholar 

  18. Mehnert, A., Vehling, S., Hocker, A., Lehmann, C., & Koch, U. (2011). Demoralization and depression in patients with advanced cancer: Validation of the German version of the demoralization scale. Journal of Pain and Symptom Management, 42(5), 768–776.

    Article  PubMed  Google Scholar 

  19. Kissane, D. W., Wein, S., Love, A., Lee, X. Q., Kee, P. L., & Clarke, D. M. (2004). The demoralization scale: A report of its development and preliminary validation. Journal of Palliative Care, 20(4), 269–276.

    Article  Google Scholar 

  20. Faller, H., Weis, J., Koch, U., Brähler, E., Härter, M., Keller, M., et al. (2017). Utilization of professional psychological care in a large German sample of cancer patients. Psycho-Oncology, 26(4), 537–543.

    Article  PubMed  Google Scholar 

  21. Bidstrup, P. E., Mertz, B. G., Dalton, S. O., Deltour, I., Kroman, N., Kehlet, H., et al. (2012). Accuracy of the Danish version of the ‘distress thermometer’. Psycho-Oncology, 21(4), 436–443.

    Article  PubMed  Google Scholar 

  22. Lazenby, M., Dixon, J., Bai, M., & McCorkle, R. (2014). Comparing the distress thermometer (DT) with the patient health questionnaire (PHQ)-2 for screening for possible cases of depression among patients newly diagnosed with advanced cancer. Palliative & Supportive Care, 12(1), 63–68.

    Article  Google Scholar 

  23. Ryan, D. A., Gallagher, P., Wright, S., & Cassidy, E. M. (2012). Sensitivity and specificity of the distress thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a ‘help’ question for psychological distress and psychiatric morbidity in patients with advanced cancer. Psycho-Oncology, 21(12), 1275–1284.

    Article  Google Scholar 

  24. Rogers, S. N., Mepani, V., Jackson, S., & Lowe, D. (2017). Health-related quality of life, fear of recurrence, and emotional distress in patients treated for thyroid cancer. British Journal of Oral & Maxillofacial Surgery, 55(7), 666–673.

    Article  CAS  Google Scholar 

  25. Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., et al. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care, 46(3), 266–274.

    Article  Google Scholar 

  26. Ziegler, M., Kemper, C. J., & Kruyen, P. (2014). Short scales—five misunderstandings and ways to overcome them. Journal of Individual Differences, 35(4), 185–189.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andreas Hinz.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of the University of Leipzig. All procedures were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hinz, A., Mitchell, A.J., Dégi, C.L. et al. Normative values for the distress thermometer (DT) and the emotion thermometers (ET), derived from a German general population sample. Qual Life Res 28, 277–282 (2019). https://doi.org/10.1007/s11136-018-2014-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-018-2014-1

Keywords

Navigation