The Persistent Physical Symptom Checklist (PPSC) is a self-report screening instrument that measures persistent problems with seven types of physical symptoms, i.e., sleep problems, pain, chronic tiredness fatigue or muscle problems, gastrointestinal problems, heart and chest symptoms, dizziness and/-or related problems and gynaecological problems. Respondents were asked whether they have had problems with a particular symptom for more than six months (one month for sleep problems), whether their symptoms have a known cause, and if so, what is the cause for their problems. The reported causes were considered and coded according to whether they included a possible medical explanation for their symptoms. They were then asked to rate on a 9-point scale the extent to which their problems interfere with their lives. The criteria for a particular PPS are considered met if the problem has been present for more than six months, did not have a clear defined medical cause and was definitely interfering with the respondent’s life (≥4 points). An evaluation of the checklist in an internal sample of 55 participants showed adequate convergent validity.
The Short Health Anxiety Inventory (SHAI) [42 (link),43 (link)] measures health-related anxiety. A cut-off score of 18 has been shown to reliably identify people meeting the DSM-IV hypochondriasis criteria. The scale has good psychometric properties [43 (link),44 ], and in this sample, Cronbach’s alpha was 0.88.
The Patient Health Questionnaire-9 (PHQ-9) [45 (link),46 ] measures depression severity over a two week period [47 (link)]. It has cut-off points of 5, 10, 15 and 20 (interpreted as mild, moderate, moderately severe and severe depression). The scale has good psychometric properties [45 (link),46 ], and in this sample, Cronbach’s alpha was 0.71.
The Generalised Anxiety Disorder-7 (GAD-7) [48 (link),49 ] measures general anxiety. It has cut-off points at 5, 10 and 15 (interpreted as mild, moderate, and severe anxiety). The scale has good psychometric properties [48 (link),49 ], and in our sample, Cronbach’s alpha was 0.92.
The Perseverative Thinking Questionnaire (PTQ) [50 (link)] measures self-reported rumination. The scale has 15 items, a total score that ranges from 0 to 75 and three subscale scores. Only the total score was used in this study. The original PTQ has good psychometric properties [50 (link)] and Cronbach’s alpha was 0.97 in our sample.
The Short Health Anxiety Inventory (SHAI) [42 (link),43 (link)] measures health-related anxiety. A cut-off score of 18 has been shown to reliably identify people meeting the DSM-IV hypochondriasis criteria. The scale has good psychometric properties [43 (link),44 ], and in this sample, Cronbach’s alpha was 0.88.
The Patient Health Questionnaire-9 (PHQ-9) [45 (link),46 ] measures depression severity over a two week period [47 (link)]. It has cut-off points of 5, 10, 15 and 20 (interpreted as mild, moderate, moderately severe and severe depression). The scale has good psychometric properties [45 (link),46 ], and in this sample, Cronbach’s alpha was 0.71.
The Generalised Anxiety Disorder-7 (GAD-7) [48 (link),49 ] measures general anxiety. It has cut-off points at 5, 10 and 15 (interpreted as mild, moderate, and severe anxiety). The scale has good psychometric properties [48 (link),49 ], and in our sample, Cronbach’s alpha was 0.92.
The Perseverative Thinking Questionnaire (PTQ) [50 (link)] measures self-reported rumination. The scale has 15 items, a total score that ranges from 0 to 75 and three subscale scores. Only the total score was used in this study. The original PTQ has good psychometric properties [50 (link)] and Cronbach’s alpha was 0.97 in our sample.
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