The Measurement Structure of the Center for Epidemiologic Studies Depression Scale

This study examined the temporal stability of the measurement structure of the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) in 813 individuals with rheumatoid arthritis. Participants completed the CES-D (Radloff, 1977) on three occasions 1 year apart. Structural equation models and polyserial correlations were used to address methodological limitations of previous studies. Four competing measurement structures were tested with one factor, three factors, four factors, and a single second-order factor underlying the four-factor model. The four-factor and the second-order-factor models provided the best fit at Time t. When cross-validated at Times 2 and 3, the four-factor and the second-order-factor models remained invariant. Researchers can now more confidently use the CES-D to examine how distress changes in chronic physical disorders.     

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.     

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.     

Assessment of depression in college students: Geriatric Depression Scale versus Center for Epidemiological Studies Depression Scale.

103 college students took the Geriatric Depression Scale and Center for Epidemiological Studies Depression Scale along with five measures of life satisfaction. The correlation between scores on the first scales was .66. Both depression scales had moderate negative correlations (-.34 to -.71) with each measure of life satisfaction. However, on every measure of life satisfaction, the correlation with scores on the Geriatric Depression Scale was higher than with those on the CES-Depression Scale.     

Factor Structure of the Center for Epidemiological Studies Depression Scale in Hong Kong Adolescents

E. A. Southwell &; M. Merbaum (Eds.). Personality: Readings in Theory and Research. (2nd ed.) Belmont, Calif.: Brooks/Cole, 1971, 422 pages. Reviewed by Benjamin Beit-Hallahmi     

Factor structure of the Center for Epidemiological Studies Depression Scale in Hong Kong adolescents

We present data from the Center for Epidemiological Studies-Depression Scale (CES-D; Radloff, 1977) for 2 samples of Hong Kong community adolescents (combined N = 1,385). The 4 positive affect items related poorly to the remainder of the scale. Using 16 items, the data were consistent with 2 models with highly correlated factors: (a) a 2-factor model, 1 of which merged somatic and affective items, and (b) a 3-factor model separating somatic, depressed, and interpersonal items. Correlations with related constructs provide preliminary support of validity. Hong Kong adolescents are influenced both by traditional concepts of mind-body holism and Western psychological models separating psychological and somatic symptoms.     

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。     

Measurement properties of the Center for Epidemiologic Studies-Depression Scale in a homeless population

The measurement properties of the Center for Epidemiologic Studies--Depression Scale (CES-D; L. S. Radloff, 1977) were evaluated in a probability sample of homeless adults residing in a large and demographically diverse community. The findings from this investigation suggest that the CES-D is a reliable measure of depressive symptoms among homeless adults and that the factor structure of the scale replicates the factor structure found in the general population. Change in the CES-D scores was associated with change in residential status, with participants who had made a transition from homelessness to regular domicile, reporting significantly lower levels of depressive symptomatology. This result indicates the scale's sensitivity to current depressive mood, as affected by significant life events encountered by homeless persons.     

Unidimensionality of the Brief Symptom Inventory (BSI) in Adult and Adolescent Inpatients

This study investigated the factor structure of the Brief Symptom Inventory (BSI; Derogatis, 1992) for adult and adolescent psychiatric inpatients. The BSI was administered to 217 adults and 188 adolescents at admission, and discharge from a private psychiatric hospital. Principal components factor analyses revealed that most variance among dimension scores was accounted for by one unrotated factor. Factorial invariance was evident across adult and adolescent samples for admission and discharge scores. Our findings are consistent with previous research on the BSI and Symptom Checklist-90-R (Derogatis, 1977), suggesting that both instruments measure primarily a unidimensional construct of general psychological distress.     

The Behavioral Activation for Depression Scale (BADS): Psychometric Properties and Factor Structure

In Behavioral Activation (BA) for depression (Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001)), which has recently received empirical support in a large randomized trial, therapists pay close attention to the function of behavior and the role of aversive controlling stimuli and escape and avoidance behavior in depression. A key variable to measure in studies of BA is when and how clients become more activated over the course of treatment. This study sought to develop an initial set of items for the Behavioral Activation for Depression Scale (BADS), submit these items to an exploratory factor analysis in an initial administration (Study 1, N = 391), and submit the resulting scale to a confirmatory factor analysis in a second administration (Study 2, N = 319). Results indicated four factors (Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment) with good factor structure, internal consistency, and test-retest reliability. Evidence for construct and predictive validity is presented.     

Association among items from the self-report version of the Hamilton Depression Scale (Carroll Rating Scale) and respondents' sex

The association among items of the self-reported version of the Hamilton Depression Scale (Carroll Rating Scale), answered according to a memory of a maximally disturbing event experienced, and respondents' sex was examined in a nonclinical sample of 320 college students, 164 women (M age=21.7 yr., SD=3.6) and 156 men (M age=23.5 yr., SD=5.8). An assessment of sex bias was also evaluated. Multiple regression analysis showed that statements regarding unhappiness, urge to cry, dizziness and faintness, and waking in the middle of the night were significantly associated with women. Removal of these items from the Carroll Rating Scale Total scores eliminated the sex differences in depression rates. Items that displayed significant sex bias were those regarding behavior and emotions commonly attributed to women within the general population.     

Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients

The Beck Depression Inventory (BDI) and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were used with 300 outpatients diagnosed with DSM-III major depression disorders. A principal-components analysis was performed on the intercorrelations among the 21 BDI and 24 HRSD symptoms. Three orthogonal components were found and interpreted as reflecting differences in self-report and clinical rating methods for measuring the severity of depression. The importance of using both self-reports and clinical ratings for evaluating depression in psychiatric outpatients was discussed.     

Validation of the Behavioral Activation for Depression Scale (BADS) in a Community Sample with Elevated Depressive Symptoms

The Behavioral Activation for Depression Scale (BADS) was previously developed to measure changes in avoidance and activation over the course of Behavioral Activation for depression. Initial scale development, definition of the factor structure and confirmation of the factor structure was performed with a non-depressed undergraduate sample. These prior results revealed four factors (Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment) with good factor structure, internal consistency, and test–retest reliability. The purpose of the current study was to evaluate the psychometric properties, factor structure and construct validity of the BADS with a community sample with elevated depressive symptoms (N = 193). Results indicated good psychometric properties, additional evidence for construct validity of the total scale and subscales, and adequate fit of the data to the original factor structure. Normative data are also provided separately for depressed men and women, and for Caucasians and African Americans.     

Psychometric Properties and Factor Structure of the French Version of the Behavioral Activation for Depression Scale (BADS) in Non-Clinical Adults

Behavioral activation (BA) is a well-established empirical treatment for depression that aims to improve depressive mood by increasing activation and reducing avoidance. Therefore, it is essential to evaluate activation and avoidance when a BA treatment is applied. The Behavioral Activation for Depression Scale (BADS) was developed to measure the changes in activation and avoidance over the course of BA treatment of depression. This study aims to validate the French version of this scale. In a first study, 131 bilingual adults were recruited to explored internal consistency, test-retest reliability and construct validity of the final French version. In a second study, 409 non-clinical adults completed an online survey assessing concurrent measures. Results of the first study suggested good internal consistency, test-retest reliability and construct validity. The second study revealed a confirmatory factor analysis supporting the original four-factor structure, with Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment subscales. Results also revealed that a 5-factor model distinguishing Behavioral Avoidance and Rumination had a better fit than the original four-factor structure. All subscales showed adequate internal consistency and good construct validity with evidence of convergent validity with depressive symptoms, brooding, psychological flexibility, negative automatic thought, behavioral inhibition and activation system. Furthermore, the French BADS total scale and subscales showed a good ability to predict depressive symptoms. The French version of the BADS appears to be a reliable tool for clinician and researchers to assess mechanisms of change in BA interventions.     

Using the Depression Anxiety Stress Scale 21 (DASS‐21) across cultures

The DASS‐21 is a well‐established instrument for measuring depression, anxiety, and stress with good reliability and validity reported from Hispanic American, British, and Australian adults. However, the lack of appropriate validation among Asian populations continues to pose concerns over the use of DASS‐21 in Asian samples. Cultural variation may influence the individual's experience and emotional expression. Thus, when researchers and practitioners employ Western‐based assessments with Asian populations by directly translating them without an appropriate validation, the process can be challenging. We conducted a series of rigorous statistical tests and minimized any potential confounds from the demographic information. Following factor analyses, we performed multigroup analysis across six nations to demonstrate consistency of our findings. The advantages of this revised DASS‐18 stress scale are twofold. First, it possesses fewer items, which results in a cleaner factorial structure. Second, it has a smaller interfactor correlation. With these justifications, the revised DASS‐18 stress scale is potentially more suitable for Asian populations. Nonetheless, given limitations, findings should be considered preliminary.     

Comparison of the Hamilton Depression Rating Scale and the Geriatric Depression Scale: detection of depression in dementia patients.

The present longitudinal prospective study compared results from the Geriatric Depression Scale with those from the Hamilton Depression Rating Scale for 30 dementia patients. The criterion measure was presence of depression as indicated by the psychiatric diagnosis. The psychiatrist and physician's assistant made the Hamilton ratings while the psychology staff administered the Geriatric Depression Scale. The two measures were statistically unrelated from Times 1 and 2 (rs = .26 and .41). Eleven (37%) patients were depressed and nine received antidepressant medications. Sensitivity ratings were 82% and 9%, respectively, and specificity ratings were 88% and 92%, respectively. Possible explanations for the success of the Geriatric Depression Scale and lack of success of the Hamilton ratings in detecting depression in this population are discussed.     

Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample

In this study the psychometric properties of the Geriatric Depression Scale (GDS) and the Zung Self-Rating Depression Scale (SDS) were evaluated and compared, using a relatively large elderly community sample. The GDS generally performed well, replicating earlier findings from a different population. Also, as hypothesized, the SDS, which has a multiple-choice format, had a higher non-completion rate than the GDS, which has a true-false format. Finally, no significant differences between the responses of young-old and old-old subjects were observed.     

Depression and unemployment: Panel findings from the Epidemiologic Catchment Area study

Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed. The research described in this paper was supported by Grant #5 RO1 AA08379-02 from the National Institute of Alcohol Abuse and Alcoholism. The authors appreciate the suggestions provided by members of the Consortium for Research Involving Stress Processes sponsored by the W. T. Grant Foundation and by two anonymous journal reviewers.     

The Latent Structure of the Center for Epidemiological Studies-Depression Scale

Taxometric analyses were used to assess the latent structure of depressive symptoms as measured by the Center for Epidemiological Studies Depression (CES-D) scale. Participants were 3,395 college students enrolled in Introductory Psychology classes at a mid-size university. Analyses included data simulation strategies to assure that the data was appropriate for interpreting skewed indicators and small putative taxa. Four indicators (depressed mood, positive affect, somatic, and interpersonal symptoms) were derived from principal components analysis. Taxometric analyses indicated that distributions of the four CES-D factor based indicators were dimensional. Results are consistent with a continuity model of the latent structure of questionnaire measures of depressive symptoms in this young adult population, of which approximately 15% scored above the clinical cut-point for the CES-D scale.