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 (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.