Distress or no distress, that's the question: A cutoff point for distress in a working population

Willem van Rhenen¹^,2 , Frank JH van Dijk¹ , Wilmar B Schaufeli³ and Roland WB Blonk³^,4

¹Academic Medical Center, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands

²Department of Occupational Health Services, ArboNed Utrecht, Utrecht, The Netherlands

³Utrecht University, Department of Psychology and Research Institute Psychology & Health, Utrecht, The Netherlands

⁴TNO Work and Employment, Hoofddorp, The Netherlands

author email corresponding author email

Journal of Occupational Medicine and Toxicology 2008, 3:3doi:10.1186/1745-6673-3-3


Published:	18 January 2008

Abstract

Background

The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders.

Methods

Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted.

Results and conclusion

A distress cutoff point of ≥11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations.