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

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 (<i>N</i> = 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 (<i>ω</i> > 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, <i>Q</i>₁-<i>Q</i>₃ = 5.75-20; informant-reported DEX median = 11, <i>Q</i>₁-<i>Q</i>₃ = 4-19, <i>p</i> = 0.924). However, participants with severe executive dysfunction (TMT-B <i>z</i>-scores ≤-2) rated their own symptoms as less severe than informants (<i>p</i> = .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.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT03543371.