Four-Dimensional Symptom Questionnaire – 4DSQ

Q: How many questions does the Four-Dimensional Symptom Questionnaire – 4DSQ have?

The Four-Dimensional Symptom Questionnaire – 4DSQ contains 50 items and takes approximately 13 minutes to complete.

Q: How is the Four-Dimensional Symptom Questionnaire – 4DSQ scored?

Scores range from 0 to 32. Interpretation levels: Distress: Low/Normal (0-10), Distress: Moderately elevated (11-20), Distress: Strongly elevated (21-32), Depression: Low/Normal (0-2), Depression: Moderately elevated (3-5), Depression: Strongly elevated (6-12), Anxiety: Low/Normal (0-8), Anxiety: Moderately elevated (9-12), Anxiety: Strongly elevated (13-24), Somatization: Low/Normal (0-10), Somatization: Moderately elevated (11-20), Somatization: Strongly elevated (21-32).

Q: Is the Four-Dimensional Symptom Questionnaire – 4DSQ free?

Yes, this assessment is completely free. You will receive your results immediately after completion, with an optional AI-powered personalized interpretation.

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Scale Development & Technical Details

Scale Overview

The Four-Dimensional Symptom Questionnaire – 4DSQ was developed by Berend Terluin (2004). It is designed to measure Distress, depression, anxiety, and somatization. The scale is intended for use with Adults (primary care and general population).

Scale Structure

This instrument consists of 50 items organized into 4 factors/subscales: Somatization, Distress, Depression, Anxiety.

Factor / Subscale	Items	N
Somatization	1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16	16
Distress	17,19,20,22,25,26,29,32,35,36,37,38,39,41,47,48	16
Depression	28,30,31,33,34,46	6
Anxiety	18,21,23,24,27,40,42,43,44,45,49,50	12

Response Format

Respondents rate each item using a custom response format.

Response anchors: 0 = No, 1 = Sometimes, 2 = Regularly, often, very often, or constantly.

Scoring

Items are scored by subscale, with each subscale sum representing a distinct dimension.

Total scores range from 0 to 32. Interpretation guidelines:

Distress: Low/Normal: 0 – 10
Distress: Moderately elevated: 11 – 20
Distress: Strongly elevated: 21 – 32
Depression: Low/Normal: 0 – 2
Depression: Moderately elevated: 3 – 5
Depression: Strongly elevated: 6 – 12
Anxiety: Low/Normal: 0 – 8
Anxiety: Moderately elevated: 9 – 12
Anxiety: Strongly elevated: 13 – 24
Somatization: Low/Normal: 0 – 10
Somatization: Moderately elevated: 11 – 20
Somatization: Strongly elevated: 21 – 32

Psychometric Properties

Internal Consistency: The scale has demonstrated good to excellent internal consistency with reported Cronbach’s alpha values of Cronbach's alpha > .80.

Administration

The scale is self-administered and typically takes approximately 10 minutes to complete. It can be administered individually or in group settings. No special training is required for administration.