Personality traits, gender differences and symptoms of anhedonia: What does the Hospital Anxiety and Depression Scale (HADS) measure in nonclinical settings?

Abstract

In healthy populations men report more depressive symptoms than women when depression is measured by the Hospital Anxiety and Depression Scale (HADS). This study aims to investigate the role of neuroticism and extroversion in symptom reporting by men and women and whether anhedonia can explain these reversed gender differences in depression observed when using HADS. HADS, Positive and Negative Affect Schedule (PANAS) and NEO Five Factor Inventory (NEO FFI) were administered twice to a sample of university students. Number of subjects at T1 was 372 and 160 at T2, measured two months apart. Men had a higher average score on depressive symptoms measured by HADS-D compared to women (p = 0.029). Women scored higher than men on HADS-A (p = 0.012), neuroticism (p < 0.001) and PANAS-negative affect (p < 0.029). No significant gender differences were observed in extroversion and positive affect. Test-retest stabilities on HADS-A and HADS-D were high. Neuroticism predicted HADS-A at Time 2. Gender, extroversion, and neuroticism predicted HADS-D at Time 2. The anhedonic content in HADS may be a plausible explanation of reversed gender differences in the HADS depression scale. HADS-D represents a specific anhedonic subtype of depression where symptom reporting reflects dispositional tendencies related specifically to extroversion.

Keywords: HADS; anhedonia; anxiety; depression; gender differences; validation.