Assessment & Research

Brief Report: Psychometric Properties of the Patient Health Questionaire-9 (PHQ-9) in Autistic Adults.

Arnold et al. (2020) · Journal of autism and developmental disorders 2020
★ The Verdict

The PHQ-9 is a valid depression screener for autistic adults—use the total score confidently in clinic and research.

✓ Read this if BCBAs who screen or consult with autistic adults in outpatient or research settings.
✗ Skip if Clinicians who only serve autistic children under ten.

01Research in Context

01

What this study did

The team checked if the PHQ-9 depression form works for autistic adults.

They ran math tests on answers from adults in the SPARK research cohort.

The goal was to see if the nine items still hang together and give a clean total score.

02

What they found

The PHQ-9 kept its two-factor shape and the total score stayed solid.

In plain words, the same quick form you use with typical clients also fits autistic adults.

03

How this fits with other research

Greene et al. (2019) warned that many autistic adults feel mental-health labels are slapped on them by mistake. That sounds like a clash, but it isn’t: K asked about lived experience, while C et al. asked if the numbers behave.

Wetterneck et al. (2006) built an autism-comorbidity interview for kids years ago. Their work set the stage for later checks like this adult PHQ-9 study.

Sappok et al. (2015) showed the SCQ works for autistic adults with ID. C et al. now add that the PHQ-9 is also safe to use in the same grown-up group, just for a different target—mood, not autism traits.

04

Why it matters

You can keep the PHQ-9 in your intake packet when autistic adults come in. No need to hunt for a special form. If the score is high, follow up with a fuller mood check and remember the client may view the label differently than you do.

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Add the PHQ-9 to your adult intake forms and score it the same way you do for neurotypical clients.

02At a glance

Intervention
not applicable
Design
other
Sample size
581
Population
autism spectrum disorder
Finding
positive

03Original abstract

Despite the high prevalence of depression and other mental illnesses in autistic adults, screening instruments such as the Patient Health Questionnaire (PHQ-9) have not been specifically validated in an autistic sample. Using data from two Autism CRC longitudinal studies (n = 581), confirmatory factor analysis supported the two-factor model (somatic and cognitive/affective) in the autistic sample and one-factor model in the community comparison sample. Confirmatory bifactor analysis also supported use of the PHQ-9 total score in autism. Good convergent validity was found with two measures of psychological well-being for PHQ-9 total and subdomain scores. The PHQ-9 is a useful tool for autism research allowing comparison across autistic and non-autistic participants.

Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-019-03947-9