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assessment, cardiac, psychosocial



  1. Young, Quincy-Robyn PhD, RPsych
  2. Ignaszewski, Andrew MD, FRCPC
  3. Fofonoff, Doreen MN, RN, CCN(C)
  4. Kaan, Annemarie MCN, RN, CCN(C), CCTN


Objective: To develop and validate a brief psychosocial screening tool (Screening Tool for Psychological Distress [STOP-D]) for use in the outpatient cardiology setting.


Background: Psychosocial factors contribute significantly to the morbidity and mortality associated with coronary artery disease. Yet, it is often considered overly burdensome to implement full-scale psychological assessments for every patient.


Methods: Over 3 months, 194 cardiac patients were consecutively recruited from 3 cardiac clinics: heart transplant (pre and post), cardiac rehabilitation, and adult congenital heart. Subjects filled out a questionnaire that included: (1) demographics, (2) STOP-D, (3) Beck Depression Inventory-II, (4) Beck Anxiety Inventory, (5) State-Trait Anger Expression Inventory-2, and (6) MOS Social Support Survey.


Results: Analyses reveal all STOP-D items are highly correlated with the corresponding measures and have robust receiver operating characteristic curves. Severity scores on STOP-D-depression and STOP-D-anxiety correlate well with established severity cutoff scores on the Beck Depression Inventory and the Beck Anxiety Inventory, respectively.


Conclusions: Overall, the STOP-D performs very well when compared with other longer and validated measures. The STOP-D is a 5-item self-report measure, which provides severity scores for: depression, anxiety, stress, anger, and poor social support. The STOP-D is self-administered and takes between 1 and 2 minutes to fill out, gives valid severity scores on 5 key areas of psychological distress (depression, anxiety, stress, anger, and poor social support), requires no scoring, and is free to use.