Ferreira-Maia Ana Paula, Gorenstein Clarice, Wang Yuan-Pang
Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.
Institute of Biomedical Sciences, Department of Pharmacology, University of São Paulo Medical School, São Paulo, Brazil.
Eur Child Adolesc Psychiatry. 2025 Jan;34(1):195-204. doi: 10.1007/s00787-024-02478-8. Epub 2024 Jun 7.
The Beck Depression Inventory-II (BDI-II) is a widely used tool for rating the severity of depressive symptoms. Studies on the factor structure of the BDI-II in adolescents have yielded controversial findings. Most studies have reported an oblique two-factor model that describes the 'cognitive' and 'somatic-affective' dimensions. However, there is variation in the item composition of each factor across studies. Alternative factor structures have been proposed, including one-factor, three-factor, hierarchical, and bifactor models. Additionally, there is limited data on measurement invariance across genders. This study aimed to examine hypothetical factor structures and gender equivalence of the BDI-II in a sample of Brazilian nonclinical adolescents (N = 1,184, aged 13-18 years, 59.1% females). Cross-validation of the BDI-II was performed through exploratory (EFA) and confirmatory factor analysis (CFA). Measurement invariance was evaluated using multigroup-CFA (MG-CFA). EFA suggested an oblique two-factor model depicting "affective-cognitive" and "somatic" dimensions. CFA tested competing models for the structure of BDI-II, including the simple one- and two-factor models, a bifactor model, and the EFA model along with its corresponding bifactor model. All models demonstrated adequate and similar fitness, well-defined factors, and good reliability. Bifactor analyses indicated a robust general factor with low reliable variance in total scores attributed to multidimensionality caused by the group factors in bifactor models. MG-CFA supported invariance across gender, suggesting that the same BDI-II construct could be applied to both female and male adolescents. This study provides evidence that the BDI-II could be used as a unidimensional measure of depressive symptoms in adolescents by researchers and clinicians.
贝克抑郁量表第二版(BDI-II)是一种广泛用于评估抑郁症状严重程度的工具。关于BDI-II在青少年中的因子结构研究得出了有争议的结果。大多数研究报告了一个斜交双因素模型,该模型描述了“认知”和“躯体-情感”维度。然而,各研究中每个因素的项目组成存在差异。还提出了其他因子结构,包括单因素、三因素、层次和双因素模型。此外,关于性别间测量不变性的数据有限。本研究旨在检验巴西非临床青少年样本(N = 1184,年龄13 - 18岁,59.1%为女性)中BDI-II的假设因子结构和性别等效性。通过探索性因素分析(EFA)和验证性因素分析(CFA)对BDI-II进行交叉验证。使用多组CFA(MG-CFA)评估测量不变性。EFA提出了一个斜交双因素模型,描绘了“情感-认知”和“躯体”维度。CFA测试了BDI-II结构的竞争模型,包括简单的单因素和双因素模型、双因素模型以及EFA模型及其相应的双因素模型。所有模型都显示出足够且相似的拟合度、定义明确的因子和良好的信度。双因素分析表明存在一个强大的一般因子,双因素模型中的组因子导致总分中低可靠方差的多维性。MG-CFA支持性别间的不变性,表明相同的BDI-II结构可应用于青少年男性和女性。本研究提供了证据,证明BDI-II可被研究人员和临床医生用作青少年抑郁症状的单维测量工具。