Q: What is Global Distress?
A: The PHQ9 and GAD7 are popular screening tools due to their wide spread usage and due to their high face-validity. For example, splitting up the questions to ask in myriad ways about anxiety looks useful. It is also very familiar in the primary care setting, which means many people get more exposure to these tools, as opposed to other screening measures.
What is ACORN measuring?
It turns out, when you factor analyze anxiety and depression, you do not see two separate factors. You see one common factor, which is called Global Distress. For this reason, ACORN doesn’t necessitate usage of a separate screening measure.
In ACORN questionnaires, you’ll notice items very similar to the PHQ9/GAD7. We ask about feeling down, sleep, eating, energy level, concentration and self harm. We have factor analyzed all of our items and we only use them if the correlate highly with the common factor: Global Distress.
So you can think of Global Distress as a many-in-1, something that assures you will catch symptoms for not only anxiety and depression, but risk indicators, social cohesion, functioning impairments. While substance abuse and therapeutic alliance don’t correlate with GDS, we have separate factors for them they you can break out on your case graph (see below).
Global Distress is shown over time by the black dotted line on the case graph.