Open Access Research

Some psychometric properties of the Chinese version of the Modified Dental Anxiety Scale with cross validation

Siyang Yuan1, Ruth Freeman1, Satu Lahti23, Ffion Lloyd-Williams4 and Gerry Humphris5*

Author Affiliations

1 Dental Health Research Unit, Mackenzie Building, Ninewells Hospital, University of Dundee, UK

2 Department of Community Dentistry, University of Oulu, Finland

3 Oral and Maxillo-facial Department, Oulu University Hospital, Oulu, Finland

4 Department of Public Health, University of Liverpool, UK

5 Health Psychology, Bute Medical School, University of St-Andrews, UK

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Health and Quality of Life Outcomes 2008, 6:22  doi:10.1186/1477-7525-6-22

Published: 25 March 2008



To assess the factorial structure and construct validity for the Chinese version of the Modified Dental Anxiety Scale (MDAS).

Materials and methods

A cross-sectional survey was conducted in March 2006 from adults in the Beijing area. The questionnaire consisted of sections to assess for participants' demographic profile and dental attendance patterns, the Chinese MDAS and the anxiety items from the Hospital Anxiety and Depression Scale (HADS). The analysis was conducted in two stages using confirmatory factor analysis and structural equation modelling. Cross validation was tested with a North West of England comparison sample.


783 questionnaires were successfully completed from Beijing, 468 from England. The Chinese MDAS consisted of two factors: anticipatory dental anxiety (ADA) and treatment dental anxiety (TDA). Internal consistency coefficients (tau non-equivalent) were 0.74 and 0.86 respectively. Measurement properties were virtually identical for male and female respondents. Relationships of the Chinese MDAS with gender, age and dental attendance supported predictions. Significant structural parameters between the two sub-scales (negative affectivity and autonomic anxiety) of the HADS anxiety items and the two newly identified factors of the MDAS were confirmed and duplicated in the comparison sample.


The Chinese version of the MDAS has good psychometric properties and has the ability to assess, briefly, overall dental anxiety and two correlated but distinct aspects.