de Sá Junior Antonio Reis, Liebel Graziela, de Andrade Arthur Guerra, Andrade Laura Helena, Gorenstein Clarice, Wang Yuan-Pang
Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.
Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.
Front Psychiatry. 2019 Feb 12;10:50. doi: 10.3389/fpsyt.2019.00050. eCollection 2019.
Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-II is investigated, by gender and age, to compare across sub-groups of students. The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity ( ) and discrimination () parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. The BDI-II presented good reliability (α = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. "Guilty feelings," "suicidal thoughts," and "loss of interest in sex" were the items that most likely indicated depression severity ( ≥ 3.60). However, all BDI-II items showed moderate-to-high discrimination ( ≥ 1.32) for depressive state. While two items were flagged for DIF, "crying" and "loss of interest in sex," respectively for gender and age, the global weight of these items on the total score was negligible. Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.
大学生自我报告的抑郁症状可能表明抑郁状态的严重程度不同。通过项目反应理论框架,我们旨在根据认可概率和抑郁连续体上的区分度来描述贝克抑郁量表第二版(BDI-II)项目的反应模式。通过性别和年龄对BDI-II量表项目的潜在差异项目功能进行研究,以比较不同学生亚组。对12677名巴西大学生的代表性样本进行了BDI-II的21个项目的横断面施测。基于克朗巴赫α系数评估信度。通过分级反应模型计算每个BDI-II项目的严重程度( )和区分度( )参数。在基于项目反应理论的方法中,测试了性别和年龄对差异项目功能(DIF)的影响。BDI-II表现出良好的信度(α = 0.91)。与男性和年龄较大的学生相比,女性和较年轻的学生出现抑郁(临界值> 13)的可能性显著更高。总体而言,参与者对量表中认知-躯体项目的认可比情感项目更容易。“内疚感”、“自杀念头”和“对性失去兴趣”是最能表明抑郁严重程度(≥ 3.60)的项目。然而,所有BDI-II项目对抑郁状态都显示出中等到高的区分度(≥ 1.32)。虽然有两个项目被标记为存在DIF,分别是“哭泣”和“对性失去兴趣”,分别针对性别和年龄,但这些项目在总分上的总体权重可以忽略不计。尽管受访者的性别和年龄可能会对抑郁症状的反应模式产生影响,但自我报告症状的测量并未夸大严重程度得分。这些发现为在学术背景下使用BDI-II评估抑郁症的有效性提供了进一步支持,并强调了考虑与性别和年龄相关的常见抑郁症状的价值。