Department of Psychology, Hunan Key Laboratory of Cognition and Human Behavior, Center for Cultural Psychology and Behavior Research, Hunan Normal University.
Medical Psychological Center, The Second Xiangya Hospital, Central South University.
Psychol Assess. 2018 Sep;30(9):1186-1198. doi: 10.1037/pas0000559. Epub 2018 Apr 16.
We systematically examined the factor structure and criterion validity across the full scale and 10 short forms of the Center for Epidemiological Studies Depression Scale (CES-D) with Chinese youth. Participants were 5,434 Chinese adolescents in Grades 7 to 12 who completed the full CES-D; 612 of them further completed a structured diagnostic interview with the major depressive disorder (MDD) module of the Kiddie Schedule for Affective Disorder and Schizophrenia for School-age Children. Using a split-sample approach, a series of 4-, 3-, 2-, and 1-factor models were tested using exploratory structural equation modeling and cross-validated using confirmatory factor analysis; the dimensionality was also evaluated by parallel analysis in conjunction with the scree test and aided by factor mixture analysis. The results indicated that a single-factor model of depression with a wording method factor fitted the data well, and was the optimal structure underlying the scores of the full and shortened CES-D. Additionally, receiver operating characteristic curve analyses for MDD case detection showed that the CES-D full-scale scores accurately detected MDD youth (area under the curve [AUC] = .84). Furthermore, the short-form scores produced comparable AUCs with the full scale (.82 to .85), as well as similar levels of sensitivity and specificity when using optimal cutoffs. These findings suggest that depression among Chinese adolescents can be adequately measured and screened for by a single-factor structure underlying the CES-D scores, and that the short forms provide a viable alternative to the full instrument. (PsycINFO Database Record
我们系统地考察了中心流行病学研究抑郁量表(CES-D)的全量表和 10 个短式在中国青少年中的因子结构和效标效度。参与者是 5434 名中国 7 到 12 年级的青少年,他们完成了全量表的 CES-D;其中 612 名进一步完成了儿童情绪障碍和精神分裂症定式访谈,有抑郁障碍模块。使用分样本方法,使用探索性结构方程建模检验了一系列 4、3、2 和 1 因子模型,并使用验证性因子分析进行交叉验证;维度也通过平行分析结合陡度检验和因子混合分析进行评估。结果表明,具有措辞方法因子的抑郁单因子模型拟合数据良好,是全量表和缩短版 CES-D 评分的最佳结构。此外,用于 MDD 病例检测的接收者操作特征曲线分析表明,CES-D 全量表评分准确地检测到了 MDD 青少年(曲线下面积[AUC]=.84)。此外,短式评分与全量表产生可比的 AUC(.82 到.85),并且使用最佳截断值时具有相似的敏感性和特异性水平。这些发现表明,CES-D 评分所基于的单因子结构可以充分测量和筛查中国青少年的抑郁情况,并且短式提供了全量表的可行替代方案。