Keller Ferdinand, Kirschbaum-Lesch Inken, Straub Joana
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy, Ruhr-University Bochum, Hamm, Germany.
Front Psychiatry. 2020 Dec 23;11:527559. doi: 10.3389/fpsyt.2020.527559. eCollection 2020.
The revised version of the Beck Depression Inventory (BDI-II) is one of the most frequently applied questionnaires not only in adults, but also in adolescents. To date, attempts to identify a replicable factor structure of the BDI-II have mainly been undertaken in adult populations. Moreover, most of the studies which included minors and were split by gender lacked confirmatory factor analyses and were generally conducted in healthy adolescents. The present study therefore aimed to determine the goodness of fit of various factor models proposed in the literature in an adolescent clinical sample, to evaluate alternative solutions for the factor structure and to explore potential gender differences in factor loadings. The focus was on testing bifactor models and subsequently on calculating bifactor statistical indices to help clarify whether a uni- or a multidimensional construct is more appropriate, and on testing the best-fitting factor model for measurement invariance according to gender. The sample comprised 835 adolescent girls and boys aged 13-18 years in out- and inpatient setting. Several factor models proposed in the literature provided a good fit when applied to the adolescent clinical sample, and differences in goodness of fit were small. Exploratory factor analyses were used to develop and test a bifactor model that consisted of a general factor and two specific factors, termed cognitive and somatic. The bifactor model confirmed the existence of a strong general factor on which all items load, and the bifactor statistical indices suggest that the BDI-II should be seen as a unidimensional scale. Concerning measurement invariance across gender, there were differences in loadings on item 21 (Loss of interest in sex) on the general factor and on items 1 (Sadness), 4 (Loss of pleasure), and 9 (Suicidal Thoughts) on the specific factors. Thus, partial measurement invariance can be assumed and differences are negligible. It can be concluded that the total score of the BDI-II can be used to measure depression severity in adolescent clinical samples.
贝克抑郁量表第二版（BDI-II）修订版是不仅在成年人中，而且在青少年中应用最频繁的问卷之一。迄今为止，识别BDI-II可重复因子结构的尝试主要在成年人群体中进行。此外，大多数纳入未成年人并按性别划分的研究缺乏验证性因子分析，且一般是在健康青少年中进行的。因此，本研究旨在确定文献中提出的各种因子模型在青少年临床样本中的拟合优度，评估因子结构的替代解决方案，并探索因子载荷中的潜在性别差异。重点是测试双因子模型，随后计算双因子统计指标，以帮助阐明单维或多维结构是否更合适，并根据性别测试最佳拟合因子模型的测量不变性。样本包括835名年龄在13 - 18岁的青少年女孩和男孩，他们分别来自门诊和住院环境。文献中提出的几个因子模型应用于青少年临床样本时拟合良好，且拟合优度差异很小。探索性因子分析用于开发和测试一个双因子模型，该模型由一个一般因子和两个特定因子组成，分别称为认知因子和躯体因子。双因子模型证实了存在一个所有项目都负荷的强大一般因子，双因子统计指标表明BDI-II应被视为一个单维量表。关于性别间的测量不变性，一般因子上的第21项（对性失去兴趣）以及特定因子上的第1项（悲伤）、第4项（失去乐趣）和第9项（自杀念头）的载荷存在差异。因此，可以假设部分测量不变性，且差异可忽略不计。可以得出结论，BDI-II的总分可用于测量青少年临床样本中的抑郁严重程度。
