Validity of Simple Indicators of Emotional I11-Health for Use in Epidemiological Studies

Abstract

The validity of simple symptom inventories as indicators of emotional ill-health was tested by a comparison with clinical appraisals of emotional health status. The indices tested were the Health Opinion Survey Index, an index based on ten »key« questions from the Cornell Medical Index, and the anxiety index used in the Israel Ischemic Heart Disease Project. The test was conducted in a household sample and a sample of patients attending a psychiatric clinic.All the indices were found to be of moderate validity as indicators of the presence or absence of emotional disturbance. All were weakly correlated with the degree of disturbance. The indices did not differ significantly in their validity. Educational level significantly affected the responses to the Health Opinion Survey Index.It was concluded that when superior methods are not feasible, but only then, it is justifiable to use simple indices of this sort for the measurement of emotional health in epidemiological studies. The indices should not be regarded as being of more than moderate validity, and due attention should be paid to the possible confounding influence of factors other than emotional health.