Second-order Factor Research Articles

Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald’s omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Measurement model of readiness for online testing of undergraduate students in Thailand’s distance education programs

PurposeThis study aims to develop a model for readiness measurement and to study readiness levels for online testing of undergraduate students in Thailand’s distance education programs.Design/methodology/approachIn total, 870 undergraduate students enrolled in the 2022 academic year of a Thai university were sampled for the study. The samples were divided into two groups: Group 1 comprised 432 students who underwent exploratory factor analysis (EFA) and Group 2 comprised 438 students who underwent second-order confirmatory factor analysis (CFA). Both were multi-stage random samples. Descriptive statistics, item-total correlations (ITCs), coefficient correlations, EFA and second-order CFA were used.FindingsThe readiness for the online testing model comprised 5 factors and 33 indicators. These included self-efficacy (SE) in utilizing technology (nine indicators), self-directed learning (SL) for readiness testing (six indicators), adequacy of technology (AT) for testing (five indicators), acceptance of online testing (AC) (seven indicators) and readiness training for testing (six indicators). The model was congruent with empirical data, and the survey results indicated that students were highly prepared at the “high” level.Practical implicationsThis study disclosed several factors and indicators involved in the readiness for online testing. The university may use these findings in preparing its students for online testing for better achievement.Originality/valueThese findings may serve as a framework for the analysis of the readiness issues for online testing of undergraduate students and also offer guidance to the universities preparing to offer online testing.

Exploring the Components of Multicultural Competence among Pre-Service Teacher Students in Thailand: An Approach Utilizing Confirmatory Factor Analysis.

The aim of this study is to examine the components of multicultural competence among pre-service teacher students in Thailand and to develop and assess the reliability of a model of multicultural competence for pre-service teacher students in Thailand. Multistage stratified random sampling was utilized to recruit 600 pre-service teacher students from undergraduate education programs at the Faculty of Education in Thailand. Data were collected through self-report questionnaires. The data analysis employed descriptive statistics and second-order confirmatory factor analysis (CFA). The findings indicate that multicultural competence among pre-service teacher students comprises three components: cultural awareness, cultural knowledge, and personal skills. Furthermore, this study identified that the model of multicultural competence among pre-service teacher students demonstrated good fit indices for the modified model (χ2 = 30.902, df = 21, p-value = 0.0753, χ2/df = 1.472; root mean square error of approximation (RMSEA) = 0.028; standardized root means square residual (SRMR) = 0.013; Tucker-Lewis index (TLI) = 0.996; comparative fit index (CFI) = 0.999). Based on these findings, effective teaching in diverse environments necessitates a thorough understanding of multicultural competence.

Evolution of the Masked Pearcey beams array with the second-order chirp factor in Kerr medium

We introduce the evolution characteristics of the Masked Pearcey beams array (MPBA) with the second-order chirp factor in Kerr medium, and discuss the evolution characteristics of the MPBA with different absolute values of the second-order chirp factor and the initial plane energy structure in detail. The results show that the MPBA with the second-order chirp factor can form a stable breath-like structure under appropriate input power, and eventually form a filament with the increase of input power. Meanwhile, increasing the absolute value of the second-order chirp factor can help us to obtain a shorter distance filament. In addition, with the increase of the number of superposition, the critical power of the formation of the breath-like structure gradually decreases. It is worth noting that by adding a circular aperture and choosing a suitable input power, the MPBA with the second-order chirp factor will form multiple breath-like structures in Kerr medium.

The Impact of Social Media and Emotional Intelligence on Investment Decision: A Fuzzy Set Delphi Study Among Investors in Thailand's Stock Market

The economic condition of Thailand and the rate of return observed on the stock exchange of Thailand (SET) surpasses the profits generated through savings. This has resulted in SET gaining popularity among individuals seeking a substantial rate of return. Understanding the elements investors consider when investing in Thailand's stock exchange is crucial due to its increasing popularity. This research utilizes a second-order confirmatory factor analysis (CFA) method to examine the impact of social media and emotional intelligence on investors' investment decisions in Thailand's stock market. The research method employed a combination of qualitative and quantitative data collection and analysis. Step 1 involved qualitative research utilizing the e-fuzzy set Delphi technique, which entailed sending an online questionnaire to 19 experts. The questionnaire included both open-ended and closed-ended questions on a 7-point scale. Step 2 involved conducting quantitative research using simple random sampling. To gather information from investors in SET, 600 investors were surveyed. It was found that emotional intelligence, social media, risk perception, and financial literacy influence investors’ investment decisions in SET, respectively. This research will provide new insights into the impact of social media and emotional intelligence on investors' decision-making in Thailand's stock market.

Student's Priorities When Selecting Web Conferencing Tools in Sri Lankan Tertiary Education

A properly selected web conferencing tool can significantly enhance student engagement, motivation, and learning outcomes in online education. Hence, this study aims to produce a framework ordering the key features and associated sub-factors of web conferencing tools that Sri Lankan tertiary sector students prioritize for their online learning experience. A quantitative research method is deployed to get the student's opinions on the factors discovered in a previous study on “Expert opinion on selecting a web conferencing tool for synchronous online tertiary education in Sri Lanka”. The research hypothesis was tested using the Pearson Chi-square test, followed by exploratory and second-order factor analysis to rank the importance of sub-factors and main characteristics. The findings revealed that students prioritize collaboration features the most, followed by online event features, pricing, user-friendliness, customer support, security, online evaluation, performance, and screen-sharing. This framework offers valuable insights for Sri Lankan tertiary institutions to select web conferencing tools that truly align with student preferences. By incorporating these student-centric considerations, institutions can optimize the online learning experience, leading to improved engagement, learning outcomes, and ultimately, greater student satisfaction.

UAdam: Unified Adam-Type Algorithmic Framework for Nonconvex Optimization.

Adam-type algorithms have become a preferred choice for optimization in the deep learning setting; however, despite their success, their convergence is still not well understood. To this end, we introduce a unified framework for Adam-type algorithms, termed UAdam. It is equipped with a general form of the second-order moment, which makes it possible to include Adam and its existing and future variants as special cases, such as NAdam, AMSGrad, AdaBound, AdaFom, and Adan. The approach is supported by a rigorous convergence analysis of UAdam in the general nonconvex stochastic setting, showing that UAdam converges to the neighborhood of stationary points with a rate of O(1/T). Furthermore, the size of the neighborhood decreases as the parameter β1 increases. Importantly, our analysis only requires the first-order momentum factor to be close enough to 1, without any restrictions on the second-order momentum factor. Theoretical results also reveal the convergence conditions of vanilla Adam, together with the selection of appropriate hyperparameters. This provides a theoretical guarantee for the analysis, applications, and further developments of the whole general class of Adam-type algorithms. Finally, several numerical experiments are provided to support our theoretical findings.

The Early Pretending Survey (EPS): A reliable parent-report measure of pretense type development for 4- to 47-month-olds

We present a new 18-item parent-report measure of pretense development for 4- to 47-month-olds: the Early Pretending Survey (EPS). Study 1 (N = 231) demonstrated good internal reliability, and a strongly correlated 2-factor structure for 4- to 47-month-olds. Study 2 (N = 587) also showed good internal reliability, and found the two factors loaded onto a latent second-order Pretend Play factor. Study 3 (N = 84) found the EPS correlated with a researcher-led pretense experiment, however it no longer correlated when controlling for age. Additional analyses using subsamples of parents from Studies 2 and 3 showed good inter-observer reliability between parents (N = 29), and good longitudinal stability after 6 months (N = 196). Additional analyses combining Study 1–3 participants (N ≤ 902) found no item functioning differences across demographic variables, including child age, country, and socio-economic factors. Children’s EPS scores increased as they aged; girls had higher scores than boys; and children of younger parents had higher scores. Finally, we examined the age patterns of each EPS item, demonstrating when 25 %, 50 %, and 75 % of children were predicted to pass each pretense type. The EPS is useful for researchers to better understand how pretending relates to other areas of development (e.g., cognition, language). The EPS could also help parents, early years educators, and children’s media professionals decide which pretense types to use with children of different ages.

Dimensionality and cross-language invariance of Pittsburgh Sleep Quality Index among Indian adolescents and adults.

Sleep quality, key to physical and mental health, requires regular assessment in clinical and non-clinical settings. Despite widespread use, the dimensionality of the Pittsburgh Sleep Quality Index (PSQI) is debated, and its Hindi version's factor structure remains unexplored. Our study evaluates the PSQI's dimensionality among Indian adolescents and adults aiming to demonstrate cross-language (Hindi and English) invariance of its factor structure. The PSQI showed satisfactory item reliability, and a best-fitting two-factor model: "sleep efficiency" (comprising sleep duration and habitual sleep efficiency), and "perceived sleep quality" (comprising remaining five PSQI components). This model showed configural invariance across age groups, sexes, and languages. Metric invariance was noted across age groups, but a partial metric non-invariance was observed across languages and sexes as reflected by differences in factor loadings. The second-order factor structure model had an excellent fit indicating the usefulness of aggregate scores of the two factors as a single index of sleep quality. Our findings better support a two-factor structure of sleep quality (both for English and Hindi versions of PSQI) in India. However, further validation in diverse clinical and non-clinical samples is warranted.

Development and Validation of a Servant Leadership Scale in Indonesian Christian Higher Education: Pretest and Post-Test

The Servant Leadership Scale has been developed in the context of the university. This scale has seven dimensions: behaving ethically, development, emotional healing, empowerment, pioneering, relationship building, and wisdom. Furthermore, this scale was modified into six dimensions: authenticity, behaving ethically, development, emotional healing, humility, and wisdom. To date, this scale has only been tested in universities and the public sector, while it has never been studied in Indonesian Christian higher education. This study aimed to validate the scale of servant leadership of Christian education leaders in Indonesia. The method is quantitative, with second-order confirmatory factor analysis. This study used a survey of 180 lecturers in Christian higher education in East Java, Indonesia. The analysis was carried out with the help of SmartPLS 4. The analysis employing pretest, first and second-order (post-test) indicates that all indicators of servant leadership are valid, reliable, and constitute a multidimensional construct with nine dimensions. These dimensions include behaving ethically, development, emotional healing, empowerment, pioneering, relationship building, wisdom, transcendental spirituality, and motivation to serve. This study concludes that the Servant Leadership Scale suits Indonesian culture and can be used for research in religious universities.

Exploring the Influence of Thai Government Policy Perceptions on Electric Vehicle Adoption: A Measurement Model and Empirical Analysis

This study explores the influence of Thai government policy perceptions on the adoption of electric vehicles (EVs). Transitioning to EVs is vital for reducing greenhouse gas emissions and combating climate change, aligning with global sustainability goals. This study addresses gaps in understanding how multidimensional perceptions of government policies influence EV adoption intentions in emerging markets, particularly in Thailand. A questionnaire was distributed to 3770 respondents across Thailand between January and March 2024. The survey assessed multiple dimensions of government policy, including commitment and efficiency, welfare, communication, policy effectiveness, and tax benefits. Using statistical techniques such as Exploratory Factor Analysis (EFA), second-order confirmatory factor analysis (CFA), and structural equation modeling (SEM), this study validated the constructs of government support perception and examined their influence on EV adoption intentions. The findings highlight that tangible government policies, particularly those improving EV infrastructure and providing clear regulatory support, alongside effective communication about these policies, significantly influence public willingness to adopt EVs. The results also emphasize the critical role of perceived government commitment and fiscal incentives in shaping consumer decisions. Based on these insights, this study recommends prioritizing the expansion of EV infrastructure, enhancing the visibility of government commitment, and improving direct financial incentives to accelerate EV adoption. These findings contribute to the growing body of knowledge on EV adoption in emerging markets and offer practical implications for policymakers seeking to promote sustainable transportation solutions.

Cultural adaptation and psychometric evaluation of the Italian version of the Active-Empathic Listening Scale among undergraduate nursing students: a three phase validation study

AimTo translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing. BackgroundActive and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients’ needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients’ needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context. DesignA three-phase cross-sectional validation study. MethodsThe tool was first translated into Italian and adapted according to the recommendations of Beaton et al. (2000). A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods. ResultsA total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach’s α (0.877) and Composite-ω (0.875). ConclusionsThe Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.

Psychometric Properties of the Chinese Version of the Gratitude at Work Scale in Employed Nurses: A Cross-Sectional Study.

The Gratitude at Work Scale, originally developed by American scholars, has been widely administered to mental health professionals and human service workers to explore gratitude in the workplace. No Chinese-language instrument is currently available for assessing workplace gratitude. The aims of this study were to (a) translate the original English version of the Gratitude at Work Scale into a traditional Chinese version (TC-GAWS), confirm its factor structure, and analyze its psychometric properties among newly employed nurses and (b) develop and evaluate the psychometric properties of the TC-GAWS short form. A psychometric study using a cross-sectional web-based design was conducted in Taiwan. Three hundred twenty-two employed nurses completed a battery of self-administered online questionnaires that included a demographic datasheet, the Gratitude Questionnaire-Six-Item Form, the Connor-Davidson Resilience Scale-10, and the Thoughts of Quitting Scale. IBM SPSS 24.0 and AMOS 28.0 were used for data analysis, and Cronbach's alpha and Pearson's correlation were used to assess reliability and concurrent validity. Exploratory factor analysis and confirmatory factor analysis (CFA) were conducted. The internal consistency and stability of the TC-GAWS total scale were .88 and .91, respectively. The exploratory factor analysis showed a satisfactory Kaiser-Meyer-Olkin value of .88 and a Bartlett's test value of 654.01 ( p < .001), suggesting that 64.55% of the total variance was explained by the two-factor TC-GAWS. After item reduction, the CFA of the six remaining items of the TC-GAWS short form revealed adequate fit statistics for a two-factor structure and a second-order factor. Strong correlations were found between the 10-item and six-item TC-GAWS ( r > .94) in the two samples, suggesting good concurrent validity. The overall scores for the 10-item and six-item TC-GAWS had similar convergent validity, with moderate-to-strong correlations for the Gratitude Questionnaire-Six-Item Form ( r = .45 and .540), Connor-Davidson Resilience Scale-10 ( r = .49 and .51), and Thoughts of Quitting Scale ( r = -.57 and -.53). The CFA yielded a two-factor, six-item model that exhibited good fit with the latent constructs of χ 2 / df = 11.06/8 = 1.38, p = .198, comparative fit index = .996, goodness-of-fit index = .979, root mean square error of approximation = .045, root mean square residual = .030, and standardized root mean squared residual = .023. Both the 10- and six-item TC-GAWS instruments demonstrated good reliability and validity in nurse participants. The TC-GAWS may be used to measure gratitude in nurses in the workplace. This instrument has the potential to facilitate a better understanding of gratitude in nurses, which may be applied to the improvement of nursing management, research, and education.

Unique versus shared neural correlates of externalizing psychopathology in late childhood.

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Polish Version of the Spirituality Index of Well-Being Scale (SIWB): Development and Adaptation of a Measure

The purpose of this study was to adapt the Polish version of the Spirituality Index of Well-Being Scale (SIWB). Our survey included 392 Polish Catholics, mostly women (N = 267). The factor analyses confirmed the two-factor nature of the SIWB. A model including a second-order factor with two first-order factors similar to the original version proposed by Frey and colleagues (2005) obtained satisfactory values of goodness-of-fit indices. The Polish version of the scale showed high internal consistency. Our study also confirmed the validity of the scale. SIWB scores were positively and strongly related to existential well-being, moderately positively related to resilience and spiritual well-being, and positively and weakly related to religious well-being. The SIWB is a tool for measuring spiritual quality of life with good psychometric properties. The tool can be used to diagnose an index of psychological well-being in the general population.

How Motives to Use Short Video Platforms Drive Negative Effects: A Second-Order Factor Structural Model

How Motives to Use Short Video Platforms Drive Negative Effects: A Second-Order Factor Structural Model

Building a composite score for patient self-report of flare in osteoarthritis: a comparison of methods with the Flare-OA-16 questionnaire

ObjectivesThis study aims to compare methods of constructing a composite score for the Flare-OA-16 self-reported questionnaire. MethodsParticipants with knee and hip osteoarthritis (OA) completed a validated 16-item questionnaire assessing five domains of flare. Three estimation methods were compared: (i) second-order confirmatory factor analysis (CFA); (ii) logistic regression, according to the participant's self-report of flare (yes/no); and (iii) Rasch method, with weighted scores in each dimension. The distribution (floor effect [FF] and ceiling effect [CF]) were described and the known-group validity (by self-reported flare) tested by Wilcoxon rank-sum test. Similarity between the scores was analyzed by intraclass correlation coefficient (ICC) and their performance against self-report compared by areas under ROC curves (AUC). Intrascore test-retest reliability at 14 days was assessed by ICC. ResultsIn a sample of 381 participants, 247 reported having a flare. CFA showed fit indices (comparative fit index [CFI] = 0.95; root mean square error of approximation [RMSEA] = 0.08) and estimated composite mean score = 4.33(SD = 2.85) (FF = 14.9%, CF = 0%). For the logistic regression estimation, the mean composite score was 6.48 (SD = 3.13) (FF = 0%; CF = 0%). With Rasch model, the mean composite score was 4.35 (SD = 2.60) (FF = 14.9%; CF = 0%). Similarity analysis indicated a greater concordance between CFA and Rasch scores (ICC = 0.98) than between logistic regression score and the two others (ICC = 0.88 with Rasch score and 0.90 with CFA score). The AUC indicated similar performance of all methods: logistic model (AUC = 0.89 [0.85–0.92]), CFA, and Rasch model (AUC = 0.86 [0.82–0.90]). The difference between groups was significant (P < .05) for scores estimated by CFA (3.98), Rasch model (4.95), and logistic regression (4.30). The reproducibility was ICC = 0.84 (0.75–0.90) for Rasch and CFA scores and ICC = 0.78(0.66–86) for logistic model. ConclusionThree alternatives explored to build a composite score showed similar construct validity. Some metric superiority (better score distribution and reproducibility) of the Rasch model is promising for the detection of occurrence and assessment of severity of a flare in OA.

The mediating effect of team trust on shared leadership and team performance

PurposeAs team members temporarily assume the role of leader, a system of shared leadership emerges. This study had three purposes: (a) to test the underlying three dimensions of shared leadership behaviors, (b) to examine the relationship between shared leadership behaviors and team performance, and (c) to examine the mediating effect of trust between team members’ perceptions of shared leadership and performance.Design/methodology/approachWe used the sub-dimensions of shared leadership: relation-oriented shared leadership (ROSL), task-oriented shared leadership (TOSL), and creativity-oriented shared leadership (COSL). We collected survey data from college student teams at two different time points.FindingsThis study’s factor analysis results supported a second-order factor model that explains shared leadership with TOSL, ROSL, and a new COSL construct. Additionally, we discovered that shared leadership behaviors predicted team performance both directly and indirectly through team trust.Originality/valueThis study confirms the role of the new sub-dimension of COSL originally discovered by video analysis of project teams (Leight et al., 2018), thereby adding value to shared leadership research. This quantitative study supports the COSL with TOSL and ROSL in a second-order model where each component contributes unique input into the team dynamics. Our findings underscore the significance of shared leadership in elevating team trust, ultimately resulting in improved team performance. This insight holds particular relevance for educational management and leadership, offering a framework for understanding how shared leadership practices can positively influence team dynamics within academic contexts.

Self-directed Learning Behavior among Communication Arts Students in a HyFlex Learning Environment at a Government University in Thailand

Abstract Purpose As the HyFlex learning environment becomes increasingly popular, the role of self-directed learning (SDL) cannot be ignored. Therefore, this study aimed to find the levels of SDL behavior among communication arts undergraduate students learning in a HyFlex learning environment, to compare the levels of SDL behavior between gender and year of study at a government university in Thailand, and to confirm the dimensions of SDL among communication arts students. Design/methodology/approach Through a stratified random sampling, a total of 560 participants from the communication arts program at a government university were selected. SPSS was used for the descriptive statistics, t-test and one-way analysis of variance were used to compare gender and year of study, and Amos was used to report the constructs of the SDL. Findings Although the levels of SDL were at a medium level among the respondents, the creativity (M = 3.91) dimension was higher than the other dimensions in SDL. Among the constructs of SDL, love of learning was higher among female respondents (M = 3.54) compared to that among male students (M = 3.40). When compared among the different years of study, SDL showed no significant differences. The confirmatory factor analysis showed that the dimensions of SDL had a second-order factor loading score of 0.42–0.57. Implications The results of the study would be beneficial for educational administrators and lecturers in enhancing students’ SDL behavior in a HyFlex learning environment.

Longitudinal measurement invariance and psychometric properties of the Patient Health Questionnaire-Four in China

BackgroundDepression and anxiety symptoms among medical students are often a concern. The Patient Health Questionnaire-Four (PHQ-4), an important tool for depression and anxiety screening, is commonly used and easy to administer. This study aimed to assess and update the longitudinal measurement invariance and psychometric properties of the simplified Chinese version.MethodsA three-wave longitudinal survey was conducted among healthcare students using the PHQ-4. Structural validity was based on one-factor, two-factor, and second-order factor models, construct validity was based on the Self-Rated Health Questionnaire (SRHQ), Sleep Quality Questionnaire (SQQ), and Rosenberg Self-Esteem Scale (RSES), and longitudinal measurement invariance (LMI), internal consistency, and test–retest reliability were based on structural consistency across three time points.ResultsThe results of the confirmatory factor analysis indicated that two-factor model was the best fit, and LMI was supported at three time points. Inter-factor, factor-total, and construct validity correlations of the PHQ-4 were acceptable. Additionally, Cronbach’s alpha, McDonald’s omega, and the intraclass correlation coefficient demonstrated acceptable/moderate to excellent reliability of the PHQ-4.ConclusionsThis study adds new longitudinal evidence that the Chinese version of the PHQ-4 has promising LMI and psychometric properties. Such data lends confidence to the routine and the expanded use of the PHQ-4 for routine screening of depression and anxiety in Chinese healthcare students.