Ernst-Abbe-Hochschule Jena - University of Applied Sciences, Jena, Germany.
Department of Medical Sociology, Hannover Medical School.
Psychiatry Res. 2020 Aug;290:113132. doi: 10.1016/j.psychres.2020.113132. Epub 2020 May 29.
The "Center for Epidemiological Studies Depression Scale" (CES-D; Radloff, 1977) is a questionnaire used world-wide to measure depressive symptoms. Although the original four-factor-structure has been widely accepted and replicated, some studies point to other factor-structures like a one- and two-factor-structure. The goal of the current study was to evaluate the factor structure of the CES-D (one-, two- and four-factor-structure), which was found using classical test theory (CTT), with two non-parametric item-response-theory-models (Mokken-Scaling; Monotone-homogeneity-model; MHM and Double-monotonicity-model; DMM). To this end, a representative German sample was analyzed (N = 2,507). Regarding the one-factor-model, neither the MHM nor the DMM were supported; the two-factor-model and the four-factor-model, however, satisfied the assumptions of the MHM but not of the stricter DMM. Sum scores therefore constitute ordinal scales for the two-factor and four-factor-structure. This justifies, for example, the use of percentile ranks or medians and associated statistical techniques. Especially the use of the 16 negative formulated items seems appealing. Further studies should explore, whether the use of these 16 instead of the original 20 items is of advantage regarding the practical validity of the CES-D (e.g. higher sensitivity and specificity in screening applications and better temporal stability).
“流行病学研究抑郁量表”（CES-D；Radloff，1977 年）是一种在全球范围内用于测量抑郁症状的问卷。尽管最初的四因素结构已被广泛接受和复制，但一些研究指出了其他因素结构，如单因素和双因素结构。本研究的目的是使用经典测试理论（CTT）评估 CES-D 的因素结构（单因素、双因素和四因素结构），并用两种非参数项目反应理论模型（Mokken 量表；单调同质性模型；MHM 和双重单调性模型；DMM）进行评估。为此，对一个具有代表性的德国样本进行了分析（N=2507）。关于单因素模型，无论是 MHM 还是 DMM 都不支持；然而，双因素模型和四因素模型满足了 MHM 的假设，但不满足更严格的 DMM 的假设。因此，总和得分构成了双因素和四因素结构的有序量表。这证明了例如使用百分位数或中位数以及相关统计技术的合理性。特别是使用这 16 个负面表述的项目似乎很有吸引力。进一步的研究应该探讨，使用这 16 个项目而不是原始的 20 个项目是否会提高 CES-D 的实际有效性（例如，在筛查应用中具有更高的敏感性和特异性，以及更好的时间稳定性）。
