Harris Cheryl A, D'Eon Joyce L
University of Ottawa, School of Psychology, Ottawa, Ontario, Canada The Ottawa Hospital, Department of Psychology, and the University of Ottawa, School of Psychology, Ottawa, Ontario, Canada.
Pain. 2008 Jul 31;137(3):609-622. doi: 10.1016/j.pain.2007.10.022. Epub 2008 Feb 20.
Given the high prevalence of depression in individuals with chronic pain and the negative outcomes associated with such comorbidity, the importance of assessing depressive symptoms is widely acknowledged by chronic pain specialists. The BDI-II is a commonly employed measure of depressive symptomatology at pain centres; however, little is known about its psychometric properties in this population. This study evaluated factorial validity, internal consistency, and gender invariance of the BDI-II in 481 patients with chronic pain. Four competing models of the BDI-II factor structure were examined and confirmatory factor analysis supported the conceptualization of depression as a singular latent construct, within a hierarchical factor structure consisting of three first-order factors--Negative Attitude, Performance Difficulty, and Somatic Elements. Factor structure, item-total correlations, and correlations between subscale means and subjective pain experience support the inclusion of somatic items despite concerns regarding their overlap with pain symptoms. Internal consistency was good. Mean total scores were in the moderately severe range. Given the evidence of partial measurement invariance, an examination of mean gender differences was warranted. In contrast to the general population, the average scores of women and men were similar. Overall, results support the construct validity and internal consistency of the BDI-II for assessing depressive symptoms in both women and men with chronic pain. Results support the appropriateness of computing a total score and/or subscale scores. These results impact chronic pain researchers and clinicians, particularly given current trends toward empirically supported assessment.
鉴于慢性疼痛患者中抑郁症的高患病率以及这种共病所带来的负面后果，慢性疼痛专家广泛认可评估抑郁症状的重要性。贝克抑郁量表第二版（BDI-II）是疼痛中心常用的抑郁症状测量工具；然而，对于其在该人群中的心理测量特性知之甚少。本研究评估了BDI-II在481例慢性疼痛患者中的因子效度、内部一致性和性别不变性。研究考察了BDI-II因子结构的四种竞争模型，验证性因子分析支持将抑郁概念化为一个单一潜在结构，该结构存在于一个由三个一阶因子——消极态度、表现困难和躯体症状组成的层次因子结构中。尽管存在与疼痛症状重叠的担忧，但因子结构、项目总分相关性以及分量表均值与主观疼痛体验之间的相关性均支持纳入躯体项目。内部一致性良好。平均总分处于中度严重范围内。鉴于部分测量不变性的证据，有必要对平均性别差异进行考察。与一般人群不同，女性和男性的平均得分相似。总体而言，结果支持BDI-II在评估慢性疼痛的女性和男性抑郁症状方面的结构效度和内部一致性。结果支持计算总分和/或分量表分数的合理性。这些结果对慢性疼痛研究人员和临床医生具有重要意义，特别是考虑到当前实证支持评估的趋势。
