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Psychometric properties of the Dysexecutive Questionnaire (DEX) in individuals with a previous cardiac event

Vig, Amáta ; Vestberg, Susanna LU ; Evald, Lars ; Mion, Marco ; Segerström, Magnus ; Ullén, Susann LU ; Årestedt, Kristofer LU ; Nielsen, Niklas LU orcid ; Cronberg, Tobias LU and Lilja, Gisela LU , et al. (2025) In Neuropsychological Rehabilitation
Abstract

This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω... (More)

This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω > 0.90). Slight positive associations were found between the DEX and the performance-based executive function measures, while strong positive associations emerged between the self-assessed DEX and the HADS. Overall, self-assessed and informant-reported scores did not differ significantly (self-assessed DEX median = 11, Q1–Q3 = 5.75–20; informant-reported DEX median = 11, Q1–Q3 = 4–19, p = 0.924). However, participants with severe executive dysfunction (TMT-B z-scores ≤−2) rated their own symptoms as less severe than informants (p =.001), indicating impaired self-awareness in a subgroup of participants. In conclusion, the DEX provides a useful perspective into general executive dysfunction in daily life but should be complemented with performance-based measures. Trial registration:ClinicalTrials.gov identifier: NCT03543371.

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Abstract (Swedish)
This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω... (More)
This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω > 0.90). Slight positive associations were found between the DEX and the performance-based executive function measures, while strong positive associations emerged between the self-assessed DEX and the HADS. Overall, self-assessed and informant-reported scores did not differ significantly (self-assessed DEX median = 11, Q1–Q3 = 5.75–20; informant-reported DEX median = 11, Q1–Q3 = 4–19, p = 0.924). However, participants with severe executive dysfunction (TMT-B z-scores ≤−2) rated their own symptoms as less severe than informants (p = .001), indicating impaired self-awareness in a subgroup of participants. In conclusion, the DEX provides a useful perspective into general executive dysfunction in daily life but should be complemented with performance-based measures.

Trial registration: ClinicalTrials.gov identifier: NCT03543371. (Less)
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
behaviour rating scale, cognitive dysfunction, Executive function, myocardial infarction, out-of-hospital cardiac arrest, executive function, cognitive dysfunction, out-of-hospital cardiac arrest, myocardial infarction, behaviour rating scale
in
Neuropsychological Rehabilitation
publisher
Taylor & Francis
external identifiers
  • scopus:105023464441
  • pmid:41308659
ISSN
0960-2011
DOI
10.1080/09602011.2025.2591784
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
id
e8bca84f-3998-496c-b5a2-415fdbbf5b0e
date added to LUP
2025-12-11 13:25:51
date last changed
2025-12-12 03:07:40
@article{e8bca84f-3998-496c-b5a2-415fdbbf5b0e,
  abstract     = {{<p>This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω &gt; 0.90). Slight positive associations were found between the DEX and the performance-based executive function measures, while strong positive associations emerged between the self-assessed DEX and the HADS. Overall, self-assessed and informant-reported scores did not differ significantly (self-assessed DEX median = 11, Q<sub>1</sub>–Q<sub>3</sub> = 5.75–20; informant-reported DEX median = 11, Q<sub>1</sub>–Q<sub>3</sub> = 4–19, p = 0.924). However, participants with severe executive dysfunction (TMT-B z-scores ≤−2) rated their own symptoms as less severe than informants (p =.001), indicating impaired self-awareness in a subgroup of participants. In conclusion, the DEX provides a useful perspective into general executive dysfunction in daily life but should be complemented with performance-based measures. Trial registration:ClinicalTrials.gov identifier: NCT03543371.</p>}},
  author       = {{Vig, Amáta and Vestberg, Susanna and Evald, Lars and Mion, Marco and Segerström, Magnus and Ullén, Susann and Årestedt, Kristofer and Nielsen, Niklas and Cronberg, Tobias and Lilja, Gisela and Blennow Nordström, Erik}},
  issn         = {{0960-2011}},
  keywords     = {{behaviour rating scale; cognitive dysfunction; Executive function; myocardial infarction; out-of-hospital cardiac arrest; executive function; cognitive dysfunction; out-of-hospital cardiac arrest; myocardial infarction; behaviour rating scale}},
  language     = {{eng}},
  publisher    = {{Taylor & Francis}},
  series       = {{Neuropsychological Rehabilitation}},
  title        = {{Psychometric properties of the Dysexecutive Questionnaire (DEX) in individuals with a previous cardiac event}},
  url          = {{http://dx.doi.org/10.1080/09602011.2025.2591784}},
  doi          = {{10.1080/09602011.2025.2591784}},
  year         = {{2025}},
}