Abstract
Worry is a transdiagnostic characteristic across many mental health disorders and given the increased interest and recognized importance of measurement-based care and progress monitoring for mental health treatment, there is a need for psychometrically sound questionnaires that can track weekly progress. The Penn State Worry Questionnaire-Past Week (PSWQ-PW; Stöber & Bittencourt Behaviour Research and Therapy, 36(6), 645–656, 1998) was developed to be sensitive to the assessment of short-term changes in worry severity. This study examined the psychometric properties and treatment sensitivity of the PSWQ-PW in a sample of 370 outpatients with anxiety and related disorders. An exploratory factor analysis indicated that the PSWQ-PW has a one-factor structure measuring the unidimensional construct of worry. The PSWQ-PW demonstrated strong reliability and good convergent validity. However, the PSWQ-PW had poor discriminant validity with a measure of depression and stress, which may be explained by the distinct but related nature of these constructs. Additionally, the PSWQ-PW did not have strong diagnostic potential in identifying individuals with Generalized Anxiety Disorder (GAD) from a heterogeneous clinical sample, likely because of the transdiagnostic nature of worry and the state nature of the measure. Finally, the PSWQ-PW demonstrated strong treatment sensitivity (d = 0.85) when measured weekly across a 12-week cognitive behavioural therapy for GAD protocol. These findings suggest that the PSWQ-PW is a reliable and valid way to track changes in worry severity week-to-week to monitor patient progress throughout treatment. However, it should not be used as a diagnostic or screening measure to distinguish patients with GAD from those with other anxiety and related disorders.
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The datasets and materials utilized and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Notes
This analysis was reconducted to determine if the pattern of the results would differ based on assessment format.
For those diagnosed with the DART (n = 177), we compared scores of the PSWQ-PW in those with a clinical diagnosis of GAD (n = 126) with those who did not (n = 51). The result was not statistically significant (t(175) = -1.01, p = .213, d = − 0.08), indicating that the PSWQ-PW scores were not different between those with GAD and those who did not have GAD. The mean for the GAD group was 64.46 (SD = 12.94) whereas the mean was 63.95 (SD = 12.62) for those without a diagnosis of GAD. For those who received a psychiatric consult to determine diagnosis (n = 193), we compared scores of the PSWQ-PW in those with a clinical diagnosis of GAD (n = 120) with those who did not (n = 73). The result was not statistically significant (t(191) = -1.14, p = .258, d = − 0.08), indicating that the PSWQ-PW scores were not different between those with GAD and those who did not have GAD. The mean for the GAD group was 67.03 (SD = 14.18) whereas the mean was 64.47 (SD = 15.78) for those without a diagnosis of GAD.
This analysis was reconducted to determine if the pattern of the results would differ based on assessment format. When the ROC analysis was conducted with those diagnosed with the DART (n = 177), the area under the curve was 0.544 (SE = 0.047, 95% CI: 0.451, 0.637), indicating that the PSWQ-PW did not have strong diagnostic potential in a heterogeneous clinical sample of individuals with varying anxiety and related disorders. When the ROC analysis was conducted with those who received a psychiatric consult to determine diagnosis (n = 193), the area under the curve was 0.536 (SE = 0.043, 95% CI: 0.452, 0.620), indicating that the PSWQ-PW did not have strong diagnostic potential in a heterogeneous clinical sample of individuals with varying anxiety and related disorders.
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Christina Puccinelli, Duncan Cameron, Mélise Ouellette, Randi McCabe and Karen Rowa contributed to the study conception, design, and material preparation. Data collection and analyses were performed by Duncan Cameron. The first draft of the manuscript was written by Christina Puccinelli, Duncan Cameron, and Mélise Ouellette. Randi McCabe and Karen Rowa commented on previous versions. All authors read and approved the final manuscript.
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Puccinelli, C., Cameron, D.H., Ouellette, M.J. et al. Psychometric Properties of the Penn State Worry Questionnaire-Past Week (PSWQ-PW) in an Anxiety and Related Disorders Sample. J Psychopathol Behav Assess 45, 549–557 (2023). https://doi.org/10.1007/s10862-023-10029-9
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DOI: https://doi.org/10.1007/s10862-023-10029-9