流行病学研究中心在六项不同干预试验中对抑郁量表的测量不变性。

IF 3.3 2区 心理学 Q1 PSYCHOLOGY, CLINICAL Psychological Assessment Pub Date : 2023-10-01 Epub Date: 2023-08-24 DOI:10.1037/pas0001262
Irina Bergenfeld, Nadine J Kaslow, Kathryn M Yount, Yuk Fai Cheong, Erin R Johnson, Cari Jo Clark
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引用次数: 0

摘要

抑郁症是造成全球疾病负担的主要因素,也是临床试验中关注的结果。研究人员和临床医生注意到,抑郁症在不同文化中的表现往往不同,这对准确测量不同人群的抑郁症状提出了挑战。流行病学研究中心抑郁量表(CES-D)是一种常用的测量抑郁症状的自我管理筛查工具,已被翻译成数十种语言,并在数千项研究中使用,但我们对其因子结构的理解以及在不同研究和干预背景下随时间变化的不变性仍存在差距。在这项二次分析中,我们对来自中低收入国家的六项最新试验进行了抽样,以(a)建立CES-D的因子结构,(b)评估CES-D在治疗组与对照组之间以及随着时间的推移的测量不变性,(c)检查交叉研究的不变性,以及(D)确定可能驱动潜在非方差的项目。我们进行了探索性/验证性因素分析,以在每次试验中建立CES-D的因素结构,并使用多组验证性分析来评估研究内跨臂/跨时间和跨研究的不变性。在去除积极影响项目后,一个一维模型在试验中随时间和跨组的表现相当,但在试验中表现出非方差,支持了先前描述不同人群的量表因子结构差异的文献。虽然我们的研究结果表明,在我们样本的试验中,没有阳性影响项目的CES-D是衡量抑郁症状的有效指标,但在使用CES-D作为结果指标来解释荟萃分析和多站点/多国研究的结果时,需要谨慎。(PsycInfo数据库记录(c)2023 APA,保留所有权利)。
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Measurement invariance of the Center for Epidemiologic Studies Scale-Depression within and across six diverse intervention trials.

Depression, a major contributor to the global burden of disease, is an outcome of interest in clinical trials. Researchers and clinicians note that depression often presents differently across cultures, posing challenges in the accurate measurement of depressive symptoms across populations. A commonly used self-administered screening tool to measure depressive symptoms, the Center for Epidemiologic Studies Scale-Depression (CES-D), has been translated into dozens of languages and used in thousands of studies, yet gaps remain in our understanding of its factor structure and invariance across studies and over time in the context of interventions. In this secondary analysis, we sampled six recent trials from lower- and middle-income countries to (a) establish the factor structure of the CES-D, (b) assess measurement invariance of the CES-D across treatment versus control arms and over time, (c) examine cross-study invariance, and (d) identify items that may be driving potential noninvariance. We performed exploratory/confirmatory factor analysis to establish the factor structure of the CES-D within each trial and used multiple group confirmatory analysis to assess within-study cross-arm/cross-time and cross-study invariance. After removal of positive affect items, a unidimensional model performed equivalently over time and across arms within trials, but exhibited noninvariance across trials, supporting prior literature describing differences in factor structure of the scale across populations. While our findings suggest that the CES-D without positive affect items is a valid measure of depressive symptoms within trials in our sample, caution is warranted in interpreting the findings of meta-analyses and multisite/multicountry studies using the CES-D as an outcome measure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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来源期刊
Psychological Assessment
Psychological Assessment PSYCHOLOGY, CLINICAL-
CiteScore
5.70
自引率
5.60%
发文量
167
期刊介绍: Psychological Assessment is concerned mainly with empirical research on measurement and evaluation relevant to the broad field of clinical psychology. Submissions are welcome in the areas of assessment processes and methods. Included are - clinical judgment and the application of decision-making models - paradigms derived from basic psychological research in cognition, personality–social psychology, and biological psychology - development, validation, and application of assessment instruments, observational methods, and interviews
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