Prenatal predictors of maternal and newborn EEG

Ninety-two mothers were recruited at a prenatal ultrasound clinic at which time they were given the CES-D for depression and the State-Trait Anxiety Inventory, and their urines were assayed for cortisol, norepinephrine, epinephrine, dopamine, and serotonin. At the neonatal period the mothers and neonates were assessed on frontal EEG asymmetry. Correlation analyses revealed the following: (1) the mothers’ frontal asymmetry was negatively related to prenatal depression (CES-D) symptoms, negatively related to prenatal norepinephrine levels and positively related to prenatal serotonin levels; (2) the frontal asymmetry of the newborn was positively correlated with the mothers’ frontal asymmetry and negatively correlated with the mothers’ prenatal depression (CES-D) symptoms and negatively correlated with the mothers’ prenatal state anxiety scores. The neonates’ EEG frontal asymmetry was also, like the mother's, negatively related to prenatal maternal norepinephrine and positively related to prenatal maternal serotonin.     

Development and validation of a Rasch-derived CES-D short form

The current study presents a Rasch-derived short form of the Center for Epidemiologic Studies-Depression scale (CES-D) for use as a depression screening tool in the general population. In contrast to short forms developed with reliance on classical measurement techniques, those developed using techniques based on item response theory produce a measure that offers true interval scaling, provide enhanced information about responders with extreme scores, and expand understanding of the underlying latent structure. Cross-validation of the Rasch-derived CES-D short form supported its utility and structural validity across samples. Tests of structural validity using latent variable modeling methodology indicated that a hierarchical, single-factor model of depression had the best fit for the original full form and the Rasch-derived short form of the CES-D. This finding challenges depression researchers and theorists to reconsider the interfactor relationships in the study and assessment of depression.     

Depression as a proxy of negative affect? A critical examination of the use of the CES-D in type 2 diabetes

ObjectivesRecent research suggests depression as measured by self-endorsed symptoms lists is associated with poor health outcomes in chronic illness. Yet, it is probable that these lists of symptoms reflect other concepts such as general distress or negative affect when used as dimensions.MethodsTo test for this hypothesis, we explored associations of the Centre of Epidemiological Studies-Depression, Radloff ([CES-D], 1977) with disease severity in diabetes and how trait negative affect from the Profile of Mood States ([POMS]; Usala & Hertzog, 1989; adaptation by Cohen et al., 1995) impact these associations in a sample of 502 people with type 2 diabetes.ResultsWe found that the CES-D included two dimensions of negative and positive experience. Each CES-D component was independently linked to disease severity. However, controlling for trait negative affect suppressed the correlation between the CES-D negative experience component and disease severity. Item-level analyses revealed that the negative experience component of the CES-D bore an emotional tone of sadness but not anger.ConclusionsWhen using the CES-D, distinguishing positive and negative components is necessary. Self-reported depression symptoms from the CES-D have no incremental validity over negative affect.     

A taxometric study of the Center for Epidemiological Studies Depression Scale

The authors assessed the latent structure of depressive symptoms as measured by the Center for Epidemiological Studies Depression Scale (CES-D; L. S. Radloff, 1977). By using taxometric procedures, the authors conducted analyses of CES-D data obtained from a large college student population. These procedures incorporated strategies for interpreting analyses of skewed indicators and small putative taxa. The authors hypothesized that CES-D total scores would be represented as a dimension, with a taxonic distribution of a factor incorporating somatic symptoms. Results indicated that all CES-D factors, including the factor composed of somatic complaints, were dimensional. Administration of the Diagnostic Interview Schedule-IV (L. N. Robins, L. Marcus, & W. Reich, 1996) to one quarter of the participants indicated that the CES-D was effective in identifying cases of current or recent clinical depression. Evidence of the dimensionality of CES-D indicators in a student population is consistent with a continuity view of depressive symptoms.     

WOMEN WHO USE DOMESTIC VIOLENCE SHELTERS Changes in Depression Over Time

This study examined the levels of depression reported by women who had used a domestic violence shelter. Depressive symptoms were assessed three times: immediately after shelter exit, 10 weeks thereafter, and 6 months later. Whereas 83% of the women reported at least mild depression on the Center for Epidemiological Studies Depression (CES-D) scale upon shelter exit, only 58% were depressed 10 weeks later. This did not change at the 6–month follow-up. An ecological, longitudinal model was evaluated to predict battered women's depression 8/12 months postshelter exit. Results of hierarchical regression analyses suggested that, after controlling for previous levels of depression, the women's feelings of powerlessness, experience of abuse, and decreased social support contributed to their depression symptoms. The women's scores on these three variables (feelings of powerlessness, abuse, and social support) at 10 weeks postshelter exit and at 6-month follow-up predicted depression at 6 months. Thus, there were both predictive and concurrent effects for these constructs. Implications for clinical and community interventions are discussed.     

A confirmatory model for depression among Japanese American and part-Japanese American adolescents

A confirmatory model integrating Japanese ethnicity, cultural identity, and depression was developed (N = 140). The model incorporated the Center for Epidemiologic Studies-Depression Scale (CES-D), Major Life Events Scale, and Japanese Cultural Scale. Japanese American adolescents scored higher on the Japanese Cultural Scale and reported fewer depressive symptoms on the CES-D total and on 2 of the 3 CES-D factors than part-Japanese American adolescents. Predictors for depression were being Japanese American vs. part-Japanese American, female gender, and culturally intensified events. A significant interaction of behavior by self-identification was noted. The model had good overall fit and suggested that the formation of cultural identity may contribute to depressive symptoms experienced by adolescents, particularly adolescents of mixed heritage.     

Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents

The current study examined the associations among dimensions of perfectionism, coping, social support, and depression in 58 adolescents with a history of maltreatment. Participants completed the Child-Adolescent Perfectionism, multidimensional measures of coping and social support, and the CES-D Depression Scale. Correlational analyses showed that depression was associated with socially prescribed perfectionism, internalized emotion-oriented coping, avoidant-oriented distancing, and low family support and peer support. Analyses of coping responses and perfectionism established links between self-oriented perfectionism and internalized emotion-oriented coping responses and self-reliant problem-solving. Socially prescribed perfectionism was associated with avoidance-oriented coping (i.e., distancing). While self-oriented perfectionism and social support were unrelated, socially prescribed perfectionism was associated with reduced levels of family support. Collectively, the findings highlight the roles of poor coping and social support as contributors to the emotional distress experienced by maltreated adolescents. Moreover, it is suggested that the distress experienced by perfectionistic youth with a history of maltreatment reflects, in part, the role of maladaptive coping styles and coping resource deficits. Our findings support further consideration of personality dimensions such as perfectionism as contributors to poor functioning among maltreated youth.     

青少年抑郁综合认知模型及其性别差异

Beck抑郁认知理论认为功能失调性态度和自动思维对抑郁的形成和发展有着重要的影响, 但是不同水平的认知因素在青少年抑郁中起什么样的作用还有待于进一步的研究。根据Oei和Kwon (2007)综合认知模型(ICM), 我们假设在青少年负性生活事件和抑郁症状间功能失调性态度是调节变量, 而自动思维是中介变量。研究采用开学初和临近期末间隔近四个月两个时间点的纵向数据搜集方式, 对613名初中生施以青少年生活事件量表(ASLEC)、功能失调性态度问卷(DAS)、自动思维问卷(ATQ)以及流调中心用抑郁量表(CES-D), 然后通过路径分析对模型进行了拟合度和性别差异检验, 结果表明：(1)各变量显著相关(p<0.01), 且各变量间隔四个月两个时间点的分数差异显著(p<0.01); (2)修正后的青少年抑郁综合认知模型较好地拟了数据, 且功能失调性态度与负性生活事件的交互作用对自动思维的影响上女生的路径系数显著大于男生。结论：功能失调性态度在负性生活事件和青少年抑郁症状间起调节作用, 而自动思维从中起到了认知中介的作用, 且该模型性别差异显著。     

Race/ethnicity and the factor structure of the Center for Epidemiologic Studies Depression Scale: a meta-analysis

The purpose of this meta-analysis was to examine racial/ethnic differences in the factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D). The total number of participants (N) in the assessed studies (k) varied according to whether the original study had used either Exploratory Factor Analysis (EFA; N = 19,206, k = 13) or Confirmatory Factor Analysis (CFA; N = 65,554, k = 16). The factor structures of the CES-D were compared across five racial/ethnic groups: African Americans, American Indians, Asians, Whites, and Hispanics. Meta-analysis results suggest that the structure of the CES-D observed in EFAs varied substantially between racial/ethnic groups, whereas the CFA-assessed structure of the CES-D was mostly consistent between racial/ethnic groups. The meta-analysis of EFA studies did not consistently replicate the original four-factor structure reported by Radloff (1977), but the meta-analysis of CFA studies replicated the original four-factor structure in four of the five racial/ethnic groups. Overall, the present meta-analysis found strong evidence that the original four-factor structure may not be the best fit for all racial/ethnic groups. Thus, in clinical settings where the CES-D is used as a tool to screen for depression, clinicians and researchers should recognize the risk that symptoms of depression may be presented differently by members of different racial/ethnic groups.     

流调中心抑郁量表在老年人群中的因素结构

本研究使用4903名老年人组成的全国样本,系统地检验了流调中心抑郁量表的因素结构。结果表明,Radloff的四因素结构、Guarnaccia等和Yen等的三因素结构对当前样本数据的拟合较好,但信度分析和相关分析显示积极情绪因素降低了总量表信度,并且与其他因素之间不支持共同的高阶因素（抑郁）,基于此,在使用量表合成总分的背景下,4个积极情绪项目不适合包含在CES-D量表中。随后,本研究检验了剔除积极情绪项目后量表各因素结构的拟合情况,发现积极情绪因素对量表因素结构的拟合水平贡献不大。结合拟合指数和Radloff对量表的界定,16项目的三因素结构最适合于我国老年人群,并且,这一因素结构在老年人群中具有跨性别的恒等性。     

Cross-cultural confirmatory factor analysis of the CES-D in Spanish and Mexican dementia caregivers

The Center for Epidemiologic Studies-Depression Scale (CES-D) is the most frequently used scale for measuring depressive symptomatology in caregiving research. The aim of this study is to test its construct structure and measurement equivalence between caregivers from two Spanish-speaking countries. Face-to-face interviews were carried out with 595 female dementia caregivers from Madrid, Spain, and from Coahuila, Mexico. The structure of the CES-D was analyzed using exploratory and confirmatory factor analysis (EFA and CFA, respectively). Measurement invariance across samples was analyzed comparing a baseline model with a more restrictive model. Significant differences between means were found for 7 items. The results of the EFA clearly supported a four-factor solution. The CFA for the whole sample with the four factors revealed high and statistically significant loading coefficients for all items (except item number 4). When equality constraints were imposed to test for the invariance between countries, the change in chi-square was significant, indicating that complete invariance could not be assumed. Significant between-countries differences were found for three of the four latent factor mean scores. Although the results provide general support for the original four-factor structure, caution should be exercised on reporting comparisons of depression scores between Spanish-speaking countries.     

抑郁症计算机化治疗的效果及其影响因素：基于RCT的元分析与元回归分析

运用元分析和元回归分析的方法考察抑郁症计算机化治疗的效果及其影响因素。来源于50篇文献,42项RCT研究的67个样本满足了元分析标准（N=7920）。结果发现：（1）整体效果量为0.53,三个月追踪效果量为0.14;6个月追踪效果量为0.16;（2）在年龄段、抑郁严重程度、支持方式和测量量表四个亚组分析中,其效果量存在显著差异。干预方式、干预取向和分析方法对效果量的影响不显著;（3）出版年份显著影响治疗效果量,脱落率和干预单元数对整体效果量的影响不显著。结果表明：抑郁症的计算机化治疗具有中等的效果量;年龄段、抑郁严重程度、支持方式、测量量表和出版年份对其整体效果量有调节作用。将来抑郁症计算机化治疗的研究应重视上述调节变量对治疗效果的影响。     

The Effect of Perfectionism and Unconditional Self-acceptance on Depression

The study examined the relationships between perfectionism, unconditional self-acceptance and depression. The non-clinical sample comprised 134 participants, each of whom completed a battery of questionnaires, including the Unconditional Self-Acceptance Questionnaire (USAQ), the Center for Epidemiological Studies Depression Inventory (CES-D) and several measures of perfectionism. Significant levels of association were found between all measures, and support was provided for the concept of perfectionism as having a neutral core, distinguishable from its consequences, and for the theory that it is the negative consequences of perfectionism, rather than perfectionism per se, that lead to depression. Path Analysis provided support for the mediator model proposed by Flett et al. [Flett, G. L., Besser, A., Davis, R. A., Hewitt, P. L. (2003). Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21, 119–138], in which unconditional self-acceptance mediates the effect of socially prescribed perfectionism on depression, and for a more generic model, in which the core construct of perfectionism can have negative consequences, which lead to low levels of unconditional self-acceptance, and thence to depression. Finally, a distinction was drawn between developmental and operational models of perfectionism.     

Bilingual computerized speech-recognition screening for clinical depression: Evaluating a cellular telephone prototype

This exploratory field study evaluated a bilingual computerized speech-recognition cellular telephone prototype of the Center for Epidemiological Studies—Depression scale (CES-D). Thirty Spanish and 22 English speakers completed both computer-telephone and face-to-face CES-D methods and an oral depression checklist in counterbalanced order. Both language groups reported high positive ratings for the computer-telephone method, with the English sample preferring the computer-telephone over the face-to-face method. In both samples, the computer-telephone method yielded high internal consistency estimates, strong alternate form reliabilities, and similar high correlations to the depression checklist. Both groups reported significantly elevated scores with the computer-telephone method, but total score variances for both methods did not differ. Computer-telephone limitations included occasional misrecognitions and template training constraints.     

Adolescent depression and risk factors

Seventy-nine high school seniors were administered the Center for Epidemiological Studies Depression Scale (CES-D), as well as a questionnaire on parent relationships, peer relationships, positive and negative feelings including suicidal thoughts, and lifestyle variables including academic performance, exercise, and drug use. The group of adolescents who scored above the clinical cutoff for depression on the CES-D (n = 29) had poorer relations with parents. Further, the incidence of paternal depression in that group was greater. The depressed adolescents also had less optimal peer relationships, fewer friends, and were less popular. They experienced less happiness and more frequent suicidal thoughts. They spent less time doing homework, had a lower grade point average, and spent less time exercising. The depressed group also reported more use of marijuana and cocaine. A stepwise regression indicated that physical affection with parents, homework, well-being, exercise, happiness, and parent relations explained 55% of the variance.     

Summed-score linking using item response theory: application to depression measurement

An item response theory (IRT) approach to test linking based on summed scores is presented and demonstrated by calibrating a modified 23-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to the standard 20-item CES-D. Data are from the Depression Patient Outcomes Research Team, II, which used a modified CES-D to measure risk for depression. Responses (N = 1,120) to items on both the original and modified versions were calibrated simultaneously using F. Samejima's (1969, 1997) graded IRT model. The 2 scales were linked on the basis of derived summed-score-to-IRT-score translation tables. The established cut score of 16 on the standard CES-D corresponded most closely to a summed score of 20 on the modified version. The IRT summed-score approach to test linking is a straightforward, valid, and practical method that can be applied in a variety of situations.     

Symptoms of depression and related factors among Spanish university students

A 554-member stratified random sample of students at a Spanish university (65.9% women; aged 18-34 years) was screened for symptoms of depression using a new Castilian Spanish translation of the Center for Epidemiologic Studies Depression Scale (CES-D) that had been validated by back-translation. Mean CES-D score was 14.2 (SD = 10.3, range 0-54), with a significant difference between the scores of women (M = 15.5; SD = 10.9) and men (M = 11.8; SD = 8.4; t552 = 4.06, p < .0005). Some 33%, of the sample screened positive with the usual CES-D screening threshold of 16, and 16% with the threshold of 24 recommended by Clarke and coworkers. The symptoms most commonly experienced all or most of the time were hopelessness, given the maximum rating by 18.8% of students, difficulty in concentration (17.7%), fatigue (13.9%), inadequacy (13.0%), and disturbance of sleep (12.4%).     

Prenatal cortisol, prematurity and low birthweight

Three hundred depressed pregnant women were recruited at approximately 20 weeks gestation. They were then divided by a median split into high and low urinary cortisol level groups. The high cortisol group had higher CES-D depression scores and higher inhibition (BIS) scores prenatally. Their fetuses had smaller head circumference, abdominal circumference, biparietal diameter and fetal weight. The high cortisol group neonates were shorter gestational age and lower birthweight and they had lower Brazelton habituation and higher Brazelton reflex scores. Discriminant function analyses suggested that cortisol levels more accurately classified short gestation and low birthweight groups than CES-D depression scores.     

A Comparison of Normals and Subnormals in Mirror Drawing

A sample of 75 mothers between 15 and 19 years of age was used to investigate the relationship between depression and the maternal behavior of young mothers. Depression, as measured by the Center for Epidemiologic Studies of Depression (CES-D) Scale, varied with marital status, education, and maternal age and was related to hostile, indifferent and rejecting patterns of mother-child interaction. Levels of depression increased in relation to the amount of stress faced by the young mother and decreased when the mother was involved in a supportive social network.     

Longitudinal changes in the contribution of genetic and environmental influences to symptoms of depression in older male twins

Genetically informative longitudinal data on self-reported symptoms of depression allow for an investigation of the causes of stability and change in depression symptoms throughout adult life. In this report, the authors investigated the relative contribution of genetic and environmental influences to symptoms of depression in 83 monozygotic and 84 dizygotic male twin pairs from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study. Participants first completed the Center for Epidemiologic Studies-Depression (CES-D) scale in 1985-1986 and again during 1995-1997. Mean age of twins at baseline was 63 years, range 59 to 70. From cross-sectional genetic analyses we estimated the heritability of CES-D to be 25% (95% confidence interval [CI], 11%-39%) at baseline and 55% (95% CI, 40%-71%) at follow-up. Fitting longitudinal genetic models to the two-wave data, we found that stability of symptoms over the 10-year follow-up was due primarily to continuity of genetic influences.