Psychometric Evaluation of the Patient Health Questionnaire–4 in Hispanic Americans

Sarah D. Mills, Rina S. Fox, Tonya M. Pan, Vanessa L. Malcarne, Scott C. Roesch, Georgia Robins Sadler

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


The present study evaluated the psychometric properties of the Patient Health Questionnaire–4 (PHQ-4), a screener of psychological distress, in English- and Spanish-speaking Hispanic Americans. Hispanic American adults (N = 436) completed the PHQ-4, which yields two subscales (Anxiety and Depression) that can be summed to create a total score. Multiple-group confirmatory factor analysis was used to evaluate structural validity. The two-factor structure was the best fit to the data for both English- and Spanish-speaking Hispanic Americans, and items loaded equivalently across groups, demonstrating measurement invariance. Internal consistency reliability was good as measured by coefficient alpha. Construct validity was evidenced by significant expected relationships with perceived stress. These findings provide support for the reliability and validity of the PHQ-4 as a brief measure of psychological distress for English- or Spanish-speaking Hispanic Americans.

Original languageEnglish (US)
Pages (from-to)560-571
Number of pages12
JournalHispanic Journal of Behavioral Sciences
Issue number4
StatePublished - Nov 1 2015
Externally publishedYes


  • Hispanic Americans
  • Patient Health Questionnaire–4
  • anxiety
  • depression
  • psychometrics

ASJC Scopus subject areas

  • Social Psychology
  • Cultural Studies
  • Anthropology
  • Linguistics and Language


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