Unidimensionality and bandwidth in the Center for Epidemiologic Studies Depression (CES-D) Scale

Comparison of the 10-, 14- and 20-Item CES-D Scores as Predictors of Cognitive Decline

The association between depressive symptomatology and cognitive decline has been examined using the Centre for Epidemiologic Studies-Depression Scale (CES-D); however, concerns have been raised about this self-report measure. Here, we examined how the CES-D total score from the 14- and 10-item versions compared to the 20-item version in predicting progression to cognitive decline from a cognitively unimpaired baseline. Data from 1054 participants were analysed using ordinal logistic regression, alongside moderator and receiver-operating characteristics curve analyses. All baseline total scores significantly predicted progression to cognitive decline. The 14-item version was better than the 20-item version in predicting consensus diagnosis, as shown by their AICs, while also showing the highest accuracy when discriminating between participants by diagnosis at last visit. We did not find sex to moderate the relationship between CES-D score and cognitive decline. Current findings suggest the 10- and 14-item versions of the CES-D are comparable to the 20-item version, and that the 14-item version may be better at predicting longitudinal consensus diagnosis compared to the 20-item version.

Effectiveness of museum-based participatory arts in mental health recovery

The World Health Organization encourages mental health services to adopt a strategic intersectoral approach by acknowledging the potential of the arts and the value of culture on the process of mental health recovery. The aim of this study was to evaluate the impact of participatory arts in museums on mental health recovery. A quasi-experimental, pre-post and multicentre study was carried out. By using a mixed methods evaluation at baseline and at 3 months, quantitative outcome measures were used to assess the changes in recovery and social support and qualitative interviews to explore the self-perceived impact on five processes of recovery. One hundred mental health service users participated for 3 years in the face-to-face programme RecuperArte, of which the data of 54 were analysed. The results indicate a significant increase in recovery measured with the QPR-15-SP (42 vs. 44; p = 0.034) and almost significant in functional social support measured with the DUKE-UNC (41.50 vs. 43.50; p = 0.052), with almost large (r = 0.29) and medium (r = 0.26) effect sizes, respectively. Participants perceived mostly an impact on the recovery process of Meaning in life 30/54 (55.56%), Hope and optimism about the future 29/54 (53.7%) and Connectedness 21/54 (38.89%), followed by Identity 6/54 (11.11%) and Empowerment 5/54 (9.26%). The findings contribute to the growing evidence of the potential of the arts as a therapeutic tool, the value of museums as therapeutic spaces and the role of nurses in intersectoral coordination, between the mental health and cultural sectors, as facilitators and researchers of these evidence-based practices.

Psychometric validation of the 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP)

Introduction

Reliable and valid instruments are needed to measure the impact of mental health services and programs on the journeys of recovery of service users. The aim of this study was to explore the psychometric properties of the cross-culturally adapted 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP).

Methods

One hundred and ten participants from three locations in Spain (Málaga, Barcelona and Madrid), who were users of primary and specialized mental health services, were interviewed from October 2021 to June 2022.

Results

The internal consistency obtained was excellent: ω  =.93 and α =.92. Temporal reliability using intraclass correlation coefficients was moderate (ICC=.684, p <.000). Regarding convergent validity, the QPR-15-SP had a moderate correlation with the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) (ρ =-.500, p <.000), a Visual Numeric Recovery Scale (VNRS) (ρ =.591, p <.000), and the Stages of Recovery Instrument (STORI) (r =.566, p <.000). Correlations between advanced stages of recovery and higher QPR-15-SP scores were found (Moratorium: ρ  =-.579, p <.000; Awareness: ρ =-.130, p =.189; Preparation: r =-.043, P=.665; Rebuilding: r =.460, p <.000; Growth: ρ  =.697, p <.000). In terms of divergent validity, the QPR-15-SP had low correlation with the DUKE-UNC Functional Social Support Scale (ρ =.273, p <.005). The confirmatory factor analysis of the 1-factor structure obtained reasonable goodness of fit indexes.

Discussion

The QPR-15-SP has acceptable psychometric properties, providing support for measuring recovery in Spain and allowing international comparison research.

Mental Health Disparities Between Lesbian Mothers and Heterosexual Parents: the Mediating Role of Positivity

Introduction

Previous evidence has shown better mental health outcomes for lesbian mothers, in comparison with heterosexual parents. The present study explored the mediating role of positivity (i.e., the tendency to view life with a positive outlook) in determining these mental health differences.

Methods

Seventy-two Israeli lesbian mothers by donor insemination (from 36 families) were compared with 72 Israeli heterosexual parents by assisted reproduction (without donated gametes; from 36 families) on positivity, life satisfaction, and depressive symptomatology. All parents were cisgender and had at least one child born through assisted reproduction, aged 3-10 years. Data were collected between December 2019 and February 2021.

Results

Mediational analyses indicated that lesbian mothers reported greater positivity, which was, in turn, associated with greater life satisfaction and less depressive symptomatology.

Conclusions

The results pinpoint the possible protective and strengthening role of positivity for lesbian mothers in the pronatalist and familistic environment of Israel. The research contributes to the literature on the mental health of parents with diverse sexual orientations living outside of the USA and Europe. Policy Implications Policymakers and mental health professional should be knowledgeable about the importance of improving positivity as a strategy for reducing depressive symptomatology and promoting life satisfaction among lesbian mothers. Moreover, policy makers and legislators are called to ease the access of sexual minority individuals to parenthood, as in this population parenthood associates with heightened mental health outcomes.

A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services

Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.

Depressive Symptoms as Mediator on the Link between Physical Activity and Cognitive Function: Longitudinal Evidence from Older Adults in China

OBJECTIVES

This study examines the extent to which depressive symptoms mediate the link between physical activity and cognitive function among older adults in China.

METHODS

This study utilizes the 2013-18 China Health and Retirement Longitudinal Study (CHARLS) dataset, of which 3,658 subjects over the age of 50 satisfied inclusion criteria. Degree of physical activity, prevalence of depressive symptoms, and performance in cognitive function are measured by the International Physical Activity Questionnaire (IPAQ), Center for Epidemiological Studies Depression Scale (CESD), the Mini-Mental State Examination (MMSE) instruments. A structural mediation model was built to assess the degree to which depressive symptoms act as mediator between physical activity and cognitive function.

RESULTS

Physical activity is positively and significantly associated with cognitive function (std β = 0.034, p-value = .007), while physical activity is negatively and significantly associated with prevalence of depressive symptoms (std β = -0.088, p-value < .001). Results indicate that depressive symptoms partially and significantly mediate the relationship between physical activity and cognitive function (std β = 0.003, p-value = .035). Total influence of physical activity on cognitive performance is evaluated to be 0.037 standard deviations (p-value = .035).

CONCLUSIONS

Findings uncover an underexamined mental well-being channel through which physical activity can positively influence late adulthood cognition.

CLINICAL IMPLICATIONS

In recommending behavioral modifications to reduce risks of late adulthood cognitive decline, encouraging physical activity for older individuals is key, since it is both directly associated with better cognitive performance, as well as indirectly through lowering prevalence of depressive symptoms.

Measuring mental health recovery: Cross-cultural adaptation of the 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP)

Mental health services need reliable and valid instruments to measure mental health recovery outcomes, and the only available one in Spanish is arduous. Adapting an instrument is more efficient than creating a new one as it enables international comparison research. The aim of this study was to conduct a cross-cultural adaptation of the 15-item Questionnaire about the Process of Recovery. Fifty-four participants engaged in a five-stage systematic and standardized process carried out from November 2019 to November 2020. Professional translators (n = 4) from the Translation Service Center for Foreign Languages of the Universidad de Alcalá participated in the direct translation, synthesis and back translation stages, and mental health professionals (n = 33) and service users (n = 17) from the Hospital Regional Universitario de Málaga and the Hospital Universitario Virgen de la Victoria in Andalucía (Spain), with an average of 19.2 (SD 12.86) years of experience in mental health, participated in the committee of experts and pilot debriefing stages. Additionally, legibility was assessed. Out of the 15-items of the questionnaire, three (20%) were equal amongst translations, three items (20%) of the back translations matched the original questionnaire and discrepancies identified were adapted accordingly. Seven items (46.7%) were approved online by experts and consensus of alternative translations was reached for the rest. The average time spent completing the questionnaire by service users during the face-to-face pilot was 4.12 min (SD 2.25). Internal consistency obtained was ω = 0.95 and α = 0.91. Debriefing findings reported the questionnaire as comprehensible (97.1%), adequate in wording (91.2%), formal in language (55.9%) and adequate in terms of length (100%). The questionnaire scored 65.53, 'normal' readability, on the Inflesz scale. The adapted instrument has conceptual, linguistic, cultural and metric equivalence to the original instrument.

Exploring Deeper Causes Linking Adolescents' Mental Disorders to Mobile Phone Use Problems: Grounded Theory Approach

BACKGROUND

Evidence from a variety of studies link mobile phone use with an increase in mental health problems, with the situation being particularly prevalent in China and exacerbated by the COVID-19 quarantine.

OBJECTIVE

This study aims to reveal underlying connections between mobile phone use and mental disorders of adolescents, and to develop a theory to help parents and counseling psychologists better understand and intervene in future cases.

METHODS

A total of 37 teenagers having both mental health and mobile phone use problems, along with their parents, were included for individual interviews. These interviews were transcribed, coded, and analyzed using qualitative methods of grounded theory.

RESULTS

The grades-ranking-first mentality is one of the main factors causing problems such as defective family bonding and peer influences, pushing teenagers with mental disorders to seek comfort in the virtual world through their cellphones.

CONCLUSIONS

The idea proposed in this study is not only inspiring for psychological counseling and therapy on adolescents with mental problems but also beneficial for school educators and parents to better understand the adolescents. The findings of the study are also particularly noteworthy in the postpandemic age, where parents whose work locations and schedules are substantially affected due to any emergencies should try to build a relaxing and cozy atmosphere at home to avoid possible conflicts with adolescents.

Factor structure of the Chinese CES-D and invariance analyses across gender and over time among Chinese adolescents

BACKGROUND

Research findings on the factor structure and invariance of the Center for the Epidemiological Studies Depression Scale (CES-D) are inconclusive. Besides, very few studies have examined factorial invariance of the scale over time. Related studies based on Chinese adolescents are also sparse. This study attempted to examine the factor structure of the CES-D and its invariance across gender and time over a one-year period among adolescents in mainland China.

METHOD

A total of 3,010 adolescents (mean age = 13.16 years, 1,730 boys) completed a questionnaire including the CES-D at Wave 1 and 2,648 of them completed the same survey one year later. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure of the CES-D. Factorial invariance of the resultant factor structure was tested using cross-sectional multi-group CFA (girls vs. boys) at Wave 1 and Wave 2 and longitudinal CFA (Wave 1 vs. Wave 2).

RESULTS

EFA and CFA revealed a three-factor model of the CES-D, including "somatic complaints," "depressed affect," and "positive affect." Additionally, findings supported the factorial invariance across gender and over time for the three-factor model.

LIMITATIONS

Limitations of the present study included a lack of adolescents from different areas in mainland China (particularly rural areas) and only a one-year follow-up.

CONCLUSIONS

This pioneering study suggests that there are three stable dimensions of the CES-D in Chinese adolescents in mainland China which are invariant across gender and over time.

Direct and Indirect Associations between Family Residential Mobility, Parent Functioning, and Adolescent Behavioral Health

Residential mobility and caregiver social support are two key factors influencing adolescents' and their caregivers' health status. However, few studies have examined whether these factors vary across developmental periods. The present study therefore adopted a life course perspective to investigate the longitudinal effects of residential mobility and caregiver social support on a range of individual health outcomes (i.e., caregiver depression, adolescent internalizing problems, and adolescent externalizing problems) among families exposed to disadvantaged social and economic conditions. Data were obtained from the Longitudinal Studies in Child Abuse and Neglect, and 425 children and their caregivers who completed the age 12, 14, 16, and 18 interviews were included in this study. Structural equation modeling was conducted to test the measurement and structural models. The results showed that greater residential mobility was significantly associated with higher levels of caregiver depression, which in turn led to more adolescent internalizing and externalizing problems. Alternatively, higher levels of caregiver social support mitigated the levels of caregiver depression, which in turn resulted in fewer adolescent internalizing and externalizing problems. Highly mobile children and their caregivers were found to be vulnerable to several negative health outcomes and in high need of mental and behavioral health support and services. These findings inform important policy and practice implications on social support for mobile caregivers to address their children's behavioral problems.

Subjective well-being and month-long LF/HF ratio among deskworkers

The importance of workers’ well-being has been recognized in recent years. The assessment of well-being has been subjective, and few studies have sought potential biomarkers of well-being to date. This study examined the relationship between well-being and the LF/HF ratio, an index of heart rate variability that reflects sympathetic and parasympathetic nerve activity. Pulse waves were measured using photoplethysmography through a web camera attached to the computer used by each participant. The participants were asked to measure their pulse waves while working for 4 weeks, and well-being was assessed using self-reported measures such as the Satisfaction With Life Scale (SWLS), the Positive and Negative Affect Schedule (PANAS), and the Flourishing Scale (FS). Each of the well-being scores were split into two groups according to the median value, and the LF/HF ratio during work, as well as the number of times an LF/HF ratio threshold was either exceeded or subceeded, were compared between the high and low SWLS, positive emotion, negative emotion, and FS groups. Furthermore, to examine the effects of the LF/HF ratio and demographic characteristics on well-being, a multiple regression analysis was conducted. Data were obtained from 169 participants. The results showed that the low FS group had a higher mean LF/HF ratio during work than the high FS group. No significant differences were seen between the high and low SWLS groups, the high and low positive emotion groups, or the high and low negative emotion groups. The multiple regression analysis showed that the mean LF/HF ratio during work affected the FS and SWLS scores, and the number of times the mean LF/HF ratio exceeded +3 SD had an effect on the positive emotion. No effect of the LF/HF ratio on negative emotions was shown. The LF/HF ratio might be applicable as an objective measure of well-being.

Depression and substance use: The CES-D's utility in predicting treatment outcomes in a longitudinal multi-site study of residential treatment centers

This investigation utilized a large sample of individuals undergoing substance use treatment to examine the CES-D's structural validity and establish its predictive utility relative to treatment discharge. The sample included 5750 individuals who were receiving substance abuse treatment at 19 different residential treatment facilities. The CES-D was administered to participants over the course of their time in a residential inpatient substance use treatment program. The present study used a split sample method to conduct both exploratory (EFA) and confirmatory (CFA) factor analyses. Results of both the EFA and CFA indicated that the CES-D contains three first order factors measuring negative mood, positive affect, and interpersonal interactions as well as a second-order high score factor which can be used to guide interpretation and symptom monitoring. Individuals receiving residential treatment fell into one of three distinct groups based on their CES-D scores, and that their scores (and subsequent trajectories of scores over time) were differentially related to discharge status. Implications for practice and the utility of the CES-D within substance use populations are discussed.

The Mediating Role of Attachment Avoidance in the Association between Sexual Orientation and Mental Health

The current study examined whether attachment avoidance mediates the association between being a sexual minority (gay men or lesbian women) and poorer mental health outcomes. For this purpose a community-dwelling sample of 350 gay men and lesbian women (M = 30.39, SD = 6.82) and 445 heterosexual men and women (M = 26.95, SD = 3.11) completed measures of attachment avoidance, depressive symptoms, anxiety symptoms and life satisfaction. Results showed that gay men and lesbians reported poorer mental health. Moreover, attachment avoidance had a mediating effect on the association between being a sexual minority and depressive symptoms, anxiety symptoms and life satisfaction. These findings are some of the first to suggest empirical support for the role of attachment avoidance in accounting for the mental health vulnerability of gay men and lesbians. The results contribute to a better understanding of the minority stress model and should be addressed by practitioners.

Exploring the psychometric properties of the CES-D-10 and its practicality in detecting depressive symptomatology in 27 low- and middle-income countries

The Center for Epidemiological Studies Depression-10 (CES-D-10) scale is known for its good psychometric properties in measuring depressive symptoms, however, some researchers question its applicability across various settings. This study explored the factor structure of the CES-D-10 in low- and middle-income countries (LMICs). This cross-sectional survey consisted of 16,723 university students across 27 LMICs that completed self-report instruments assessing socio-demographic information and depressive symptoms using the CES-D-10. Data analysis included: exploratory factor analysis, item response theory and differential item functioning. Results indicate that a two-factor model (depressive affect and positive affect) had the best fit for this population and accounted for 52% of the total observed variance with an internal consistency, α = .77 for the depressive affect items and α = .57 for the positive affect items. The graded response model (GRM), however, indicated that the depressive affect factor had a good fit, unlike the positive affect factor. The depressive affect factor was found to consistently model depression for females better than males. Relative to their Asian counterparts, African, Caribbean and South American participants of similar depressive affect responded differently on all items of the depressive affect factor. The depressive affect factor seems most ideal for LMICs and shows gender and cross-cultural variability.

Latent structure of the Centre for Epidemiologic Studies Depression Scale (CES-D) in older adult populations: a systematic review

Objective: The Center for Epidemiologic Studies Depression Scale (CES-D) is a 20-item, self-report metric intended to measure depression. Despite being one of the most popular depression scales, the psychometric properties, specifically the underlying factor structure of the scale, have come under scrutiny. The latent structure of a scale is a key indicator of its construct validity, i.e. the degree to which the intended variable is captured. To date, a comprehensive review of the latent structure of the CES-D in older adult populations (≥65 years old) has not been conducted. We aimed to examine the latent structure of the CES-D in samples of older adults to assess its ability to capture depressive symptoms.Methods: A systematic review across Scopus, Web of Science, and PsycINFO databases was conducted. Original studies conducting latent variable analysis of the 20-item CES-D in samples aged ≥65 years old were included.Results: Included studies (n = 6) were primarily conducted with community-dwelling older adults in the United States. Studies that conducted exploratory and confirmatory factor analysis (n = 2) revealed two latent factors, whereas those conducting confirmatory factor analysis of previously identified structures (n = 4) revealed four-factor structures in line with the original four-factor structure.Conclusions: A general alignment with the original four-factor structure of the CES-D provides tentative support for continued use amongst older adults; however, further research is required to provide conclusive evidence for these psychometric properties.

Pathways to Fatherhood: Psychological Well-Being Among Israeli Gay Fathers Through Surrogacy, Gay Fathers Through Previous Heterosexual Relationships, and Heterosexual Fathers

This study explored differences in psychological well-being as assessed by life satisfaction, parenthood satisfaction, depressive symptoms and the Big Five personality dimensions among 219 Israeli fathers; 76 gay men who had become fathers through a heterosexual relationship, 63 gay men who had become fathers through surrogacy, and 78 heterosexual men. After controlling for sociodemographic characteristics, gay fathers through surrogacy reported greater satisfaction with parenthood, greater satisfaction with their lives, and reported higher levels of extraversion when compared to heterosexual fathers. No significant differences emerged between the three groups on depressive symptoms, neuroticism, conscientiousness, agreeableness, and openness to experience. These findings emphasize the predominant similarities and some possible differences on psychological well-being between the different paths to fatherhood. This study is one of the first to compare several paths to fatherhood on psychological well-being, thus illuminating the contribution of fatherhood route to psychological well-being in an era where gay men are increasingly becoming fathers in diverse ways.

Differential Item Functioning by HIV Status and Sexual Orientation of the Center for Epidemiological Studies-Depression Scale: An Item Response Theory Analysis

The Center for Epidemiological Studies-Depression Scale (CES-D) is the most widely used instrument to assess depressive symptoms in people living with HIV. However, its differential item functioning (DIF) by HIV status and sexual orientation has yet to be explored. This study examined DIF and measurement invariance of the CES-D using an item response theory (IRT) framework, and a more traditional factor analytic approach. Data from 841 HIV-infected and HIV-uninfected individuals, from Miami, Florida, were analyzed. Uniform DIF by HIV status was detected in Items 4, 12, and 16 from the Positive Affect factor. Nonuniform DIF was detected in Items 13 and 17. Uniform DIF by sexual orientation was detected in Items 2, 15, and 19, two of them from the Interpersonal factor. Nonuniform DIF was detected in Item 2. Using a factor analytic approach, the CES-D was invariant at the configural and metric levels by HIV and sexual orientation. These findings indicate that overall, however, using IRT, the magnitudes of DIF were negligible, the CED-D was somewhat invariant using factor analytic methods; the CES-D may be reliably used to compare by HIV status or sexual orientation.

Rapid Assessment of Reward-Related Eating: The RED-X5

OBJECTIVE

The prevalence of obesity has created a plethora of questionnaires characterizing psychological aspects of eating behavior, such as reward-related eating (RRE). The Reward-based Eating Drive questionnaires (RED-9, RED-13) broadly and deeply assess the RRE construct. However, large-sample research designs require shorter questionnaires that capture RRE quickly and precisely. This study sought to develop a brief, reliable, and valid version of the RED questionnaire.

METHODS

All-subset correlation was used to find a subset that maximally associated with the full RED-13 in two separate samples. Results were validated in a third independent sample. Internal consistency, test-retest reliability, and ability to explain variance in external outcomes were also assessed.

RESULTS

A five-item questionnaire (RED-X5) correlated strongly with RED-13 in the independent sample (r = 0.95). RED-X5 demonstrated high internal consistency (omega total ≥ 0.80) and 6-month test-retest reliability (r = 0.72). RED-X5 accurately reproduced known associations between RED-13 and BMI, diabetes status, and craving for sweet and savory foods. As a novel finding, RED questionnaires predicted laboratory intake of chips.

CONCLUSIONS

RED-X5 is a short, reliable, and valid measure of the RRE construct and can be readily implemented in large-sample research designs in which questionnaire space is limited.

Self-Perceived Parental Role and Mental Health Concomitants Among Israeli Gay and Heterosexual Fathers

In this study we examined the association between self-perceived parental role and adverse mental health (indicated by depressive symptoms, neuroticism, and negative affect) in a sample of 82 Israeli gay fathers (Mean age = 39.57, SD = 6.70) that were individually matched with 82 heterosexual fathers (Mean age = 39.11, SD = 7.88). Results showed that although self-perceived parental role was associated with adverse mental health, this association was moderated by sexual orientation, such that a significant negative association between self-perceived parental role and adverse mental health was evident only among gay fathers. The findings are understood by features of gay fatherhood, which is intentional and purposeful, and usually achieved after contending with particular difficulties in the journey to fatherhood. These features presumably shape the perceived parental role, and thus may link more strongly with lower levels of adverse mental health among gay fathers, compared to heterosexual fathers.

The Reliability and Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese University Students

Aims: Depression is prevalent among university students worldwide, and the prevalence appears to be increasing. As an intermediate stage between being healthy and having depression, students with subthreshold depression could develop worsening depression or recover with intervention to prevent depression. The Center for Epidemiologic Studies Depression Scale (CES-D) is a useful tool to assess subthreshold depression. The primary purpose of the current study was to evaluate the psychometric characteristics of CES-D in Chinese university students. Secondly, we aimed to describe the prevalence of subthreshold depression among the student sample and examine its demographic correlates. Methods: A total of 2,068 university students participated in the study, and they were asked to respond to the Chinese CES-D, Beck Depression Inventory-II (BDI-II), and Positive and Negative Affect Schedule (PANAS). The factor structure was evaluated by conducting exploratory (EFA) and confirmatory factor analysis (CFA) using a structural equation modeling approach. The reliability was assessed by calculating Cronbach's alpha, inter-item correlation, and item-total correlation coefficients. The prevalence of subthreshold depression was calculated and demographic correlates of gender, grade, and major were examined by multiple regression. Results: The final sample included 1,920 participants. The EFA results suggested extraction of three factors (somatic symptoms, negative affect, and anhedonia) that account for 52.68% of total variance. The CFA results suggested that the newly derived model with 14 items was the best fit for our data. Six items were removed from the original scale (item 9, 10, 13, 15, 17, and 19). The Cronbach's alpha of the 14-item CES-D was 0.87. The prevalence of subthreshold depression among university students reached 32.7% for the 20-item CES-D and 31% for the 14-item CES-D, although there was no significant difference of prevalence in gender, grade, and major. Conclusions: The CES-D has good reliability and validity for assessing subthreshold depression in Chinese university students.

The Effect of Alternative Scoring Procedures on the Measurement Properties of a Self-Administered Depression Scale

Abstract. To investigate the effect of response alternatives/scoring procedures on the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D) which has the four response alternatives, a polytomous item response theory (IRT) model was applied to the responses of 2,061 workers and university students (1,640 males, 421 females). Test information functions derived from the polytomous IRT analyses on the CES-D data with various scoring procedures indicated that: (1) the CES-D with its standard (0-1-2-3) scoring procedure should be useful for screening to detect subjects with “at high-risk” of depression if the θ point showing the highest information corresponds to the cut-off point, because of its extremely higher information; (2) the CES-D with the 0-1-1-2 scoring procedure could cover wider range of depressive severity, suggesting that this scoring procedure might be useful in cases where more exhaustive discrimination in symptomatology is of interest; and (3) the revised version of CES-D with replacing original positive items into negatively revised items outperformed the original version. These findings have never been demonstrated by the classical test theory analyses, and thus the utility of this kind of psychometric testing should be warranted to further investigation for the standard measures of psychological assessment.

Perceived Helicopter Parenting and Korean Emerging Adults' Psychological Adjustment: The Mediational Role of Parent-Child Affection and Pressure from Parental Career Expectations

Examining helicopter parenting in a Confucian culture that values parental authority and involvement can extend previous helicopter parenting research that has mostly focused on a U.S. college student context. In this study, we aim to help clarify the mixed results in the literature regarding the psychological outcomes of helicopter parenting in emerging adulthood by examining the processes underlying the relationship between helicopter parenting and psychological adjustment in the Korean context. Using a diverse sample of Korean emerging adults, we investigated the relationships among perceived helicopter parenting, parent-child affection, pressure from parental career expectations, and psychological adjustment (depressive symptoms and life satisfaction). The data came from 562 Korean emerging adults (269 women and 293 men) aged 19-34 years who were either full-time students or unemployed and unmarried and had at least one living parent. The structural equation modeling used in this study revealed that higher levels of helicopter parenting were directly associated with greater depressive symptoms. Higher levels of helicopter parenting also had an indirect relationship with greater depressive symptoms through higher levels of pressure from parental career expectations. However, higher levels of helicopter parenting were indirectly linked to better psychological adjustment (fewer depressive symptoms, greater satisfaction with life) through higher levels of parent-child affection. Our results indicate that in the East Asian context, helicopter parenting could be related to both negative and positive psychological outcomes depending on the mediating factors.

Development and Validation of an Item Bank for Depression Screening in the Chinese Population Using Computer Adaptive Testing: A Simulation Study

With the increasing prevalence of depression, creating a simple and precise tool for measuring depression is becoming more important. This study developed a computer adaptive testing for depression (CAT-Depression) from a Chinese sample. The depression item bank was constructed from a sample of 1,135 participants with or without depression using the Graded Response Model (GRM; Samejima, 1969). The final depression item bank with strict unidimensionality comprised 68 items, which had local independence, good item-fit, high discrimination, no differential item functioning (DIF), and each item measured at least one symptom of diagnostic criteria for depression in ICD-10. In addition, the mean IRT discrimination of the item bank reached 1.784, which clearly showed that the item bank of CAT-Depression was high-quality. Moreover, a simulation CAT study with real response data was conducted to investigate the characteristics, marginal reliability, criterion-related validity, and predictive utility (sensitivity and specificity) of CAT-Depression. The results revealed that the proposed CAT-Depression had acceptable and reasonable marginal reliability, criterion-related validity, and sensitivity and specificity.

Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models

Objectives

The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one.

Methods

The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied.

Results

While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants’ gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results.

Conclusions

While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.

The association between negative attitudes toward aging and mental health among middle-aged and older gay and heterosexual men in Israel

OBJECTIVES

The association between negative attitudes toward aging and mental health (indicated by depressive symptoms, neuroticism, and happiness) was explored among Israeli middle-aged and older gay and heterosexual men.

METHOD

In a community-dwelling sample, 152 middle-aged and older gay men and 120 middle-aged and older heterosexual men at the age range of 50-87 (M = 59.3, SD = 7.5) completed measures of negative attitudes toward aging, depressive symptoms, neuroticism, and happiness.

RESULTS

After controlling for socio-demographic characteristics, the association between negative attitudes toward aging and mental health was moderated by sexual orientation, demonstrating that negative attitudes toward aging were more strongly associated with adverse mental health concomitants among middle-aged and older gay men compared to middle-aged and older heterosexual men.

CONCLUSIONS

The findings suggest vulnerability of middle-aged and older gay men to risks of aging, as their mental health is markedly linked with their negative attitudes toward aging. This vulnerability should be addressed by clinicians and counselors who work with middle-aged and older gay men.

Interpersonal vulnerability among offspring of Holocaust survivors gay men and its association with depressive symptoms and life satisfaction

The aim of the current study was to examine whether offspring of Holocaust survivors (OHS) gay men report higher interpersonal vulnerability in comparison to non-OHS gay men, and to further assess whether that vulnerability mediates the association between having a Holocaust background and mental health outcomes (depressive symptoms and life satisfaction). For this purpose, a community-dwelling sample of 79 middle-aged and older OHS and 129 non-OHS gay men completed measures of hostile-world scenario (HWS) in the interpersonal domain, satisfaction from current steady relationship, depressive symptoms and life satisfaction. Results indicated that OHS reported higher HWS interpersonal vulnerability and lower satisfaction from current relationship in comparison to non-OHS gay men. Also, having a Holocaust background had an indirect effect on depressive symptoms and life satisfaction through HWS interpersonal vulnerability as well as through satisfaction from current relationship. These findings are the first to suggest interpersonal vulnerability of older OHS, in comparison to non-OHS, gay men, and an association between this vulnerability and adverse psychological outcomes. This interpersonal vulnerability, possibly representing HWS threats of both early family-based trauma and current sexual minority stress, along with its implications, should be addressed by practitioners who work with older gay men having a Holocaust background.

Positive affect predicts cerebral glucose metabolism in late middle-aged adults

Positive affect is associated with a number of health benefits; however, few studies have examined the relationship between positive affect and cerebral glucose metabolism, a key energy source for neuronal function and a possible index of brain health. We sought to determine if positive affect was associated with cerebral glucose metabolism in late middle-aged adults (n = 133). Participants completed the positive affect subscale of the Center for Epidemiological Studies Depression Scale at two time points over a two-year period and underwent 18F-fluorodeoxyglucose-positron emission tomography scanning. After controlling for age, sex, perceived health status, depressive symptoms, anti-depressant use, family history of Alzheimer’s disease, APOE ε4 status and interval between visits, positive affect was associated with greater cerebral glucose metabolism across para-/limbic, frontal, temporal and parietal regions. Our findings provide evidence that positive affect in late midlife is associated with greater brain health in regions involved in affective processing and also known to be susceptible to early neuropathological processes. The current findings may have implications for interventions aimed at increasing positive affect to attenuate early neuropathological changes in at-risk individuals.

A comparison of self-report measures of psychopathy among nonforensic samples using item response theory analyses

This study investigated how well components of the psychopathy trait are measured among college students with the Levenson Self-Report Psychopathy Scale (LSRP), the Personality Assessment Inventory-Antisocial Features Scale (PAI ANT), the Psychopathic Personality Inventory-Short Form (PPI-SF), and the Self-Report Psychopathy Scale-II (SRP-II). Using Samejima (1969)'s graded response model (GRM), the subscales were found to vary in their ability to measure the corresponding latent traits. The LSRP primary psychopathy factor is more precise in measuring the latent trait than the secondary psychopathy factor. The PAI ANT items show coherent psychometric properties, whereas the PPI-SF factors differ in their precision to measure the corresponding traits. The SRP-II factors are effective in discriminating among individuals with varying levels of the latent traits. Results suggest that multiple self-report measures should be used to tap the multidimensional psychopathy construct. However, there are concerns with respect to using negatively worded items to assess certain aspects of psychopathy. (PsycINFO Database Record

Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters

The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27-76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18-84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p < 0.0001; PSS p < 0.0001; BIPQ p < 0.0001; and CES-D p < 0.0001; and at 1 month (S1:S3) for STAI-Trait p < 0.001; all changes were sustained (S3 through S5). This FBEP produced statistically and clinically significant changes; these lasted in those followed up >1 year.

Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine

The task of developing a new questionnaire or translating an existing questionnaire into a different language might be overwhelming. The greatest challenge perhaps is to come up with a questionnaire that is psychometrically sound, and is efficient and effective for use in research and clinical settings. This article provides guidelines for the development and translation of questionnaires for application in medical fields, with a special emphasis on perioperative and pain medicine. We provide a framework to guide researchers through the various stages of questionnaire development and translation. To ensure that the questionnaires are psychometrically sound, we present a number of statistical methods to assess the reliability and validity of the questionnaires.

Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW)

We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35–1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24–5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09–4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09–1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services.

Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis

The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D's validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22-77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D's rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D's substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups.

The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: a longitudinal study before and during the financial crisis

The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment.

An assessment of the measurement equivalence of English and French versions of the Center for Epidemiologic Studies Depression (CES-D) Scale in systemic sclerosis

Objectives

Center for Epidemiologic Studies Depression (CES-D) Scale scores in English- and French-speaking Canadian systemic sclerosis (SSc) patients are commonly pooled in analyses, but no studies have evaluated the metric equivalence of the English and French CES-D. The study objective was to examine the metric equivalence of the CES-D in English- and French-speaking SSc patients.

Methods

The CES-D was completed by 1007 English-speaking and 248 French-speaking patients from the Canadian Scleroderma Research Group Registry. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess differential item functioning (DIF).

Results

A two-factor model (Positive and Negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 CES-D items, including items 3 (Blues), 10 (Fearful), and 11 (Sleep). Prior to accounting for DIF, French-speaking patients had 0.08 of a standard deviation (SD) lower latent scores for the Positive factor (95% confidence interval [CI]−0.25 to 0.08) and 0.09 SD higher scores (95% CI−0.07 to 0.24) for the Negative factor than English-speaking patients. After DIF correction, there was no change on the Positive factor and a non-significant increase of 0.04 SD on the Negative factor for French-speaking patients (difference = 0.13 SD, 95% CI−0.03 to 0.28).

Conclusions

The English and French versions of the CES-D, despite minor DIF on several items, are substantively equivalent and can be used in studies that combine data from English- and French-speaking Canadian SSc patients.

Performance of the 10-item Center for Epidemiologic Studies Depression scale for caregiving research

OBJECTIVES

The Center for Epidemiologic Studies Depression (CESD) scale has been useful in a broad spectrum of health research on patient and population outcomes. A brief version is used when depressive symptoms are not the primary focus. Rasch (item response) analysis previously demonstrated potential problems with positively worded items. We tested the 10-item CESD (CESD-10) scale and considered an 8-item version with both psychometric and Rasch analyses.

METHODS

This was a special sample of 2067 caregivers from three existing US databases. We describe item response patterns and internal constancy in addition to Rasch scale results.

RESULTS

There were few problems with missing data, and internal consistency was high (alpha = 0.86-0.88) for both CESD versions. Rasch analysis indicated that one of the positive items ("hopeful about future") could be dropped.

CONCLUSIONS

We partly confirmed prior work that suggested dropping positive items for the CESD-10. Among caregivers, item-level problems and scaling problems seem minimal. At present, there is not a strong rationale for dropping the CESD-10 positive items: the one poorly performing positive item might be explained by the special caregiver sample.

Rasch scalability of the somatosensory amplification scale: a mixture distribution approach

OBJECTIVE

Somatosensory amplification refers to a person's tendency to experience somatic sensations as inappropriately intense and involves hypervigilance concerning bodily sensations. We applied the Somatosensory Amplification Scale (SSAS) in an Internet sample of young adults (N=3031) to test whether the SSAS is Rasch scalable.

METHODS

We applied mixture distribution extensions of the partial credit and rating scale models to identify possible subgroups that use the response set of the SSAS in different ways.

RESULTS

A partial credit model, with two latent classes, showed a superior fit to all other models. Still, one of the SSAS items had to be removed because it showed severe underfit. Overall fit of the remaining items was acceptable, although the differentiation between at least two of the five item categories was questionable in both classes. Class 1 was characterized by a higher SSAS sum score, female gender, more somatic complaints, more anxiety, more psychosocial stress, and slightly higher depressiveness. Further exploratory analyses showed that the three mid categories of the SSAS can be collapsed without a large loss of information.

CONCLUSIONS

Our results show that a shortened version of the SSAS is Rasch scalable but also reveal that there is a lot of room for further improvements of the scale. Based on our results, Item 1 should be removed from the scale and a reduction of the number of response categories is probably warranted.

The center for epidemiologic studies depression scale: a review with a theoretical and empirical examination of item content and factor structure

BACKGROUND

The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) is a commonly used freely available self-report measure of depressive symptoms. Despite its popularity, several recent investigations have called into question the robustness and suitability of the commonly used 4-factor 20-item CES-D model. The goal of the current study was to address these concerns by confirming the factorial validity of the CES-D.

METHODS AND FINDINGS

Differential item functioning estimates were used to examine sex biases in item responses, and confirmatory factor analyses were used to assess prior CES-D factor structures and new models heeding current theoretical and empirical considerations. Data used for the analyses included undergraduate (n = 948; 74% women), community (n = 254; 71% women), rehabilitation (n = 522; 53% women), clinical (n =84; 77% women), and National Health and Nutrition Examination Survey (NHANES; n = 2814; 56% women) samples. Differential item functioning identified an item as inflating CES-D scores in women. Comprehensive comparison of the several models supported a novel, psychometrically robust, and unbiased 3-factor 14-item solution, with factors (i.e., negative affect, anhedonia, and somatic symptoms) that are more in line with current diagnostic criteria for depression.

CONCLUSIONS

Researchers and practitioners may benefit from using the novel factor structure of the CES-D and from being cautious in interpreting results from the originally proposed scale. Comprehensive results, implications, and future research directions are discussed.

The effect of birth cohort on well-being: the legacy of economic hard times

In the present research, we examined the effects of age, cohort, and time of measurement on well-being across adulthood. Cross-sectional and longitudinal analyses of two independent samples-one with more than 10,000 repeated assessments across 30 years (mean assessments per participant = 4.44, SD = 3.47) and one with nationally representative data-suggested that well-being declines with age. This decline, however, reversed when we controlled for birth cohort. That is, once we accounted for the fact that older cohorts had lower levels of well-being, all cohorts increased in well-being with age relative to their own baseline. Participants tested more recently had higher well-being, but time of measurement, unlike cohort, did not change the shape of the trajectory. Although well-being increased with age for everyone, cohorts that lived through the economic challenges of the early 20th century had lower well-being than those born during more prosperous times.

The importance of modeling method effects: resolving the (uni)dimensionality of the loneliness questionnaire

This study sought to resolve the dimensionality of the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) by applying recommended confirmatory factor analytic procedures that control for method effects (Brown, 2003). This study was needed given that inconsistent findings have been reported recently regarding the structure of this instrument (Bagner, Storch, & Roberti, 2004) and all models to date have not accounted for method effects due to the non-reversed-worded and reversed-worded items of this instrument. Using a large sample of youth in Grades 2 through 12 (N = 11,725), we compared the previously reported 1- and 2-factor models with a newly posited 1-factor model that incorporated correlated error terms to account for method effects. We found that the 1-factor model that included correlated error terms fit the data best, and that this factor structure evidenced measurement invariance across boys and girls in childhood, but not in adolescence. The meaning of the LQ indicators was also consistent for boys across development, but evidenced differences for girls in childhood versus adolescence. More generally, it was demonstrated that modeling method effects is vital to accurately understanding the dimensionality of loneliness when reversed-worded and non-reversed-worded items are used as indicators. The measurement and clinical implications of these findings are discussed.

The Loneliness Questionnaire-Short Version: an evaluation of reverse-worded and non-reverse-worded items via item response theory

Although reverse-worded items have often been incorporated in scale construction to minimize the effects of acquiescent reporting biases, some researchers have more recently begun questioning this approach and wondering whether the advantages associated with incorporating reverse-worded items is worth the complexities that they bring to measures (e.g., Brown, 2003 ; Marsh, 1996 ). In this study, we used item response theory (IRT) to determine whether there is statistical justification to eliminate the reverse-worded items (e.g., "I have lots of friends") from the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) and retain only the non-reverse-worded items (e.g., "I'm lonely") to inform the provision of a shortened LQ version. Using a large sample of children (Grades 2-7; n = 6,784) and adolescents (Grades 8-12; n = 4,941), we examined the psychometric properties of the 24-item LQ and found support for retaining the 9 non-reverse-worded LQ items to make up a shortened measure of loneliness in youth. We found that the non-reverse-worded items were associated with superior psychometric properties relative to the reverse-worded items with respect to reliability and IRT parameters (e.g., discrimination and item information). A 3-point Likert-type scale was also found to be more suitable for measuring loneliness across both children and adolescents compared to the original 5-point scale. The relative contributions of reverse-worded and non-reverse-worded items in scale development for youth instruments are also discussed.

Rumination mediates the prospective effect of low self-esteem on depression: a five-wave longitudinal study

Previous research supports the vulnerability model of low self-esteem and depression, which states that low self-esteem operates as a prospective risk factor for depression. However, it is unclear which processes mediate the effect of low self-esteem. To test for the mediating effect of rumination, the authors used longitudinal mediation models, which included exclusively prospective effects and controlled for autoregressive effects of the constructs. Data came from 663 individuals (aged 16 to 62 years), who were assessed 5 times over an 8-month period. The results indicated that low self-esteem predicted subsequent rumination, which in turn predicted subsequent depression, and that rumination partially mediated the prospective effect of low self-esteem on depression. These findings held for both men and women, and for both affective-cognitive and somatic symptoms of depression. Future studies should test for the mediating effects of additional intrapersonal and interpersonal processes.

Measuring depression using item response theory: an examination of three measures of depressive symptomatology

Evaluations of assessment instruments using classical test theory typically rely on indices of internal consistency, test-retest reliability, and construct validity. However, the use of models from item response theory (IRT) allows comparison of instruments (and items) in terms of the information they provide and where they provide it along the continuum of severity of the construct being assessed. Such results help to identify the measures most appropriate for specific clinical and research contexts. The present study examined the functioning of the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies-Depression (CES-D) scale, and the nine primary symptoms from the depression module of the Schedule for Affective Disorders and Schizophrenia-Children (K-SADS) using IRT methods. A large sample of adolescents (n = 1709) completed the BDI, CES-D scale, and K-SADS. IRT calibration analyses demonstrated that the BDI and CES-D scale performed well in similar ranges of depressive severity (approximately -1 to +3 standard deviations [SDs]), although the BDI provided more information at higher severity levels and the CES-D scale at lower severity levels. The K-SADS depression items, which are dichotomous and focused on clinical disorder, provided the least information that was restricted to the narrowest range (approximately +1 to +3 SDs). This work finds consistency between past rationale for the use of the BDI in clinical samples while using the CES-D scale in epidemiological studies. The results for the K-SADS suggest that interview measures may benefit from increasing the number of items and/or response options to collect more psychometric information.