Further Refinement of the Center for Epidemiological Studies Depression Scale-10: Complementary Evidence from Item Response Theory and Classical Test Theory

Abstract

The assessment of mental health, particularly depression, in university student populations is crucial for effective intervention and support. This study investigates the psychometric properties of the Center for Epidemiological Studies Depression Scale-10 (CES-D10) among 322 university students in the Western Cape province of South Africa, employing both classical test theory and item response theory. Participants were also assessed using the Perceived Stress Scale, the Satisfaction with Life Scale, and a short form of the Beck Hopelessness Scale. The results reveal satisfactory reliability indices for the CES-D10 based on Cronbach’s alpha and McDonald’s omega. However, Item 8 was identified as problematic across multiple metrics, including exploratory and confirmatory factor analysis (CFA) and Rasch analysis; therefore, the exclusion of this item is recommended for improved scale performance. The 9-item version displayed superior fit in the CFA and better construct validity than the 10-item scale. Scores on the CES-D10 were positively correlated with perceived stress and hopelessness and negatively correlated with life satisfaction, supporting the criterion-related validity of the scale. The study extends the psychometric validation literature of the CES-D10 by incorporating Rasch analysis, underscoring the benefits of using multiple statistical frameworks to achieve robust findings. These results have relevance for mental health assessment among university students in developing contexts, providing an evidence-based tool for early intervention.