Factor structure and criterion validity across the full scale and ten short forms of the CES-D among Chinese adolescents.

Abstract

We systematically examined the factor structure and criterion validity across the full scale and 10 short forms of the Center for Epidemiological Studies Depression Scale (CES-D) with Chinese youth. Participants were 5,434 Chinese adolescents in Grades 7 to 12 who completed the full CES-D; 612 of them further completed a structured diagnostic interview with the major depressive disorder (MDD) module of the Kiddie Schedule for Affective Disorder and Schizophrenia for School-age Children. Using a split-sample approach, a series of 4-, 3-, 2-, and 1-factor models were tested using exploratory structural equation modeling and cross-validated using confirmatory factor analysis; the dimensionality was also evaluated by parallel analysis in conjunction with the scree test and aided by factor mixture analysis. The results indicated that a single-factor model of depression with a wording method factor fitted the data well, and was the optimal structure underlying the scores of the full and shortened CES-D. Additionally, receiver operating characteristic curve analyses for MDD case detection showed that the CES-D full-scale scores accurately detected MDD youth (area under the curve [AUC] = .84). Furthermore, the short-form scores produced comparable AUCs with the full scale (.82 to .85), as well as similar levels of sensitivity and specificity when using optimal cutoffs. These findings suggest that depression among Chinese adolescents can be adequately measured and screened for by a single-factor structure underlying the CES-D scores, and that the short forms provide a viable alternative to the full instrument. (PsycINFO Database Record