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Observational Study
. 2017;59(3):987-996.
doi: 10.3233/JAD-170289.

Evaluation of the Reliability, Validity, and Predictive Validity of the Subscales of the Perceived Stress Scale in Older Adults

Julie M Jiang  1 , Elizabeth K Seng  2   3 , Molly E Zimmerman  3 , Martin Sliwinski  4 , Mimi Kim  1 , Richard B Lipton  2   1
Affiliations
Observational Study

Evaluation of the Reliability, Validity, and Predictive Validity of the Subscales of the Perceived Stress Scale in Older Adults

Julie M Jiang et al. J Alzheimers Dis. 2017.

Abstract

Background: The Perceived Stress Scale (PSS) is made up of two subscales but is typically used as a single summary measure. However, research has shown that the two subscales may have differential properties in older adults.

Objective: To evaluate the internal consistency, test-retest reliability, and the concurrent and predictive validity for development of amnestic mild cognitive impairment (aMCI) of the positively-worded (PSS-PW) and negatively-worded (PSS-NW) subscale scores of the PSS in older adults.

Methods: We recruited community residing older adults free of dementia from the Einstein Aging Study. Reliability of the PSS-PW and PSS-NW was assessed using Cronbach's alpha for internal consistency and intraclass correlation for one year test-retest reliability. Concurrent validity was evaluated by examining the relationship between the PSS subscales and depression, anxiety, neuroticism, and positive and negative affect. Predictive validity was assessed using multivariate Cox regression analyses to examine the relationship between baseline PSS-PW and PSS-NW score and subsequent onset of aMCI.

Results: Both PSS-PW and PSS-NW showed adequate internal consistency and retest reliabilities. Both the PSS-PW and PSS-NW were associated with depression, neuroticism, and negative affect. The PSS-NW was uniquely associated with anxiety while the PSS-PW was uniquely associated with positive affect. Only the PSS-PW was associated with a statistically significant increased risk of incident aMCI (HR = 1.27; 95% CI: 1.06-1.51 for every 5-point increase in PSS-PW).

Conclusions: Evaluating the separate effects of the two PSS subscales may reveal more information than simply using a single summation score. Future research should investigate the PSS-PW and PSS-NW as separate subscales.

Keywords: Adult; cognitive dysfunction; cohort study; dementia; psychological stress; reproducibility of results.

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Figures

Figure 1
Figure 1. Cumulative probability of remaining free of aMCI
Cumulative probability of remaining free of aMCI in a.high PSS-PW and low PSS-PW, and b.high PSS-NW and low PSS-NW groups. (High is defined as the upper half of the sample and low is defined as the lower half of the sample)
See this image and copyright information in PMC

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