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Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression

Conway, Paul Maurice; Høgh, Annie; Nabe-Nielsen, Kirsten; Grynderup, Matias Brødsgaard; Mikkelsen, Eva Gemzøe; Persson, Roger LU ; Rugulies, Reiner; Bonde, Jens Peter Ellekilde; Francioli, Laura and Hansen, Åse Marie (2018) In Annals of Occupational Hygiene
Abstract

Objectives: The behavioural experience method has been extensively used in the literature for the measurement of potential bullying behaviours at work. However, this approach presents limitations when used to classify respondents as targets or non-targets of workplace bullying. Therefore, the present study aimed to: (i) identify optimal cut-off points, reflecting a possible subjectively experienced exposure to occasional and frequent workplace bullying, for the 9-item Short Negative Act Questionnaire (S-NAQ), and (ii) examine the criterion validity of these cut-off points in relation to depressive symptoms and diagnosis of depression.

Methods: The study was based on a sample of 4882 participants from the Danish MODENA cohort study... (More)

Objectives: The behavioural experience method has been extensively used in the literature for the measurement of potential bullying behaviours at work. However, this approach presents limitations when used to classify respondents as targets or non-targets of workplace bullying. Therefore, the present study aimed to: (i) identify optimal cut-off points, reflecting a possible subjectively experienced exposure to occasional and frequent workplace bullying, for the 9-item Short Negative Act Questionnaire (S-NAQ), and (ii) examine the criterion validity of these cut-off points in relation to depressive symptoms and diagnosis of depression.

Methods: The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9-45) and a one-item measure applying the self-labelling method with a definition to assess occasional and frequent workplace bullying. We employed receiver operating characteristic (ROC) curve analyses to derive the cut-off points for the S-NAQ. Based on these cut-off points, we created a new S-NAQ variable with three levels of exposure (i.e. 'not exposed', 'first threshold', and 'second threshold') and tested its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844).

Results: The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification accuracy (area under the curve = 0.89 and 0.93) as well as good sensitivity (84.8% and 88.0%) and specificity (77.4% and 94.7%). In the adjusted linear regression analyses, both the first (B = 0.78, 95% confidence interval [CI] = 0.66-0.90) and the second threshold of exposure (B = 1.65, 95% CI = 1.44-1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98-6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93-11.88) were significantly associated with diagnosis of depression.

Conclusions: The two cut-off points for the S-NAQ identified in this study showed a significant association with both depressive symptoms and diagnosis of depression. However, future prospective studies are needed to establish the predictive validity of the proposed cut-off points.

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organization
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publication status
epub
subject
keywords
behavioural experience method, depressive symptoms, diagnosis of depression, ROC curve analysis, self-labelling method with a definition, Short Negative Act Questionnaire, workplace bullying
in
Annals of Occupational Hygiene
pages
14 pages
publisher
Oxford University Press
ISSN
1475-3162
DOI
language
English
LU publication?
yes
id
1ec570b4-6cff-419c-9c4c-a65b63165366
date added to LUP
2018-01-08 16:09:50
date last changed
2018-05-29 09:43:28
@article{1ec570b4-6cff-419c-9c4c-a65b63165366,
  abstract     = {<p>Objectives: The behavioural experience method has been extensively used in the literature for the measurement of potential bullying behaviours at work. However, this approach presents limitations when used to classify respondents as targets or non-targets of workplace bullying. Therefore, the present study aimed to: (i) identify optimal cut-off points, reflecting a possible subjectively experienced exposure to occasional and frequent workplace bullying, for the 9-item Short Negative Act Questionnaire (S-NAQ), and (ii) examine the criterion validity of these cut-off points in relation to depressive symptoms and diagnosis of depression.</p><p>Methods: The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9-45) and a one-item measure applying the self-labelling method with a definition to assess occasional and frequent workplace bullying. We employed receiver operating characteristic (ROC) curve analyses to derive the cut-off points for the S-NAQ. Based on these cut-off points, we created a new S-NAQ variable with three levels of exposure (i.e. 'not exposed', 'first threshold', and 'second threshold') and tested its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844).</p><p>Results: The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification accuracy (area under the curve = 0.89 and 0.93) as well as good sensitivity (84.8% and 88.0%) and specificity (77.4% and 94.7%). In the adjusted linear regression analyses, both the first (B = 0.78, 95% confidence interval [CI] = 0.66-0.90) and the second threshold of exposure (B = 1.65, 95% CI = 1.44-1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98-6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93-11.88) were significantly associated with diagnosis of depression.</p><p>Conclusions: The two cut-off points for the S-NAQ identified in this study showed a significant association with both depressive symptoms and diagnosis of depression. However, future prospective studies are needed to establish the predictive validity of the proposed cut-off points.</p>},
  author       = {Conway, Paul Maurice and Høgh, Annie and Nabe-Nielsen, Kirsten and Grynderup, Matias Brødsgaard and Mikkelsen, Eva Gemzøe and Persson, Roger and Rugulies, Reiner and Bonde, Jens Peter Ellekilde and Francioli, Laura and Hansen, Åse Marie},
  issn         = {1475-3162},
  keyword      = {behavioural experience method,depressive symptoms,diagnosis of depression,ROC curve analysis,self-labelling method with a definition,Short Negative Act Questionnaire,workplace bullying},
  language     = {eng},
  month        = {01},
  pages        = {14},
  publisher    = {Oxford University Press},
  series       = {Annals of Occupational Hygiene},
  title        = {Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression},
  url          = {http://dx.doi.org/},
  year         = {2018},
}