Factor Structure and Measurement Invariance Across Gender of the Beck Depression Inventory-II in Adolescent Psychiatric Patients

Abstract

The revised version of the Beck Depression Inventory (BDI-II) is one of the most frequently applied questionnaires not only in adults, but also in adolescents. To date, attempts to identify a replicable factor structure of the BDI-II have mainly been undertaken in adult populations. Moreover, most of the studies which included minors and were split by gender lacked confirmatory factor analyses and were generally conducted in healthy adolescents. The present study therefore aimed to determine the goodness of fit of various factor models proposed in the literature in an adolescent clinical sample, to evaluate alternative solutions for the factor structure and to explore potential gender differences in factor loadings. The focus was on testing bifactor models and subsequently on calculating bifactor statistical indices to help clarify whether a uni- or a multidimensional construct is more appropriate, and on testing the best-fitting factor model for measurement invariance according to gender. The sample comprised 835 adolescent girls and boys aged 13–18 years in out- and inpatient setting. Several factor models proposed in the literature provided a good fit when applied to the adolescent clinical sample, and differences in goodness of fit were small. Exploratory factor analyses were used to develop and test a bifactor model that consisted of a general factor and two specific factors, termed cognitive and somatic. The bifactor model confirmed the existence of a strong general factor on which all items load, and the bifactor statistical indices suggest that the BDI-II should be seen as a unidimensional scale. Concerning measurement invariance across gender, there were differences in loadings on item 21 (Loss of interest in sex) on the general factor and on items 1 (Sadness), 4 (Loss of pleasure), and 9 (Suicidal Thoughts) on the specific factors. Thus, partial measurement invariance can be assumed and differences are negligible. It can be concluded that the total score of the BDI-II can be used to measure depression severity in adolescent clinical samples.

Diagnostische Performanz und Validität des deutschsprachigen BDI-II – Eine Sekundäranalyse mit Daten aus klinischen und nichtklinischen Stichproben

“…Das BDI-II wies im vorliegenden kumulierten Datensatz eine sehr hohe interne Konsistenz (> 0,90) auf und bestätigt damit Ergebnisse früherer Studien [7][8][9] und einer aktuellen Analyse an einem weiteren großen klinischen Datensatz [14]. Diese lässt auch den Summenwert der BDI-II-Items als Maß der Depressionsschwere als gerechtfertigt erscheinen, wie auch Faktorenanalysen an anderen Stichproben nahelegen [10,19,20], der Voraussetzung für die hier durchgeführten Analysen zu Schwellenwerten des Fragebogens ist.…”

“…Eine psychometrische Überprüfung an mehr als 60 000 Personen aus den Jahren 1996-2012 kommt zu dem Schluss, dass das Verfahren ein reliables, valides und kosteneffektives Instrument darstellt, um die Schwere depressiver Symptomatik im klinischen und Forschungskontext zu erfassen [6]. Die 2006 ins Deutsche übersetzte Version des BDI-II [7,8] zeigt ebenfalls gute Kennwerte gemäß der Klassischen Testtheorie [7][8][9][10].…”

Comprehensive investigation of factor structure and gender equivalence of the Beck Depression Inventory-II among nonclinical adolescents

“…Con rmatory factor analysis (CFA) represents a powerful hypothesis-testing method to compare the structure and the tness of plausible models for the underlying construct of the BDI-II. To date, there are few CFA studies of adolescents [16][17][18][19], which results varied from a unidimensional to multidimensional two-and three-factor models as the best-tting model. In addition, there is a study that revealed that none of the models tested met the adequacy-of-t criteria [16].…”

“…In addition, there is a study that revealed that none of the models tested met the adequacy-of-t criteria [16]. As a result of controversy over the factor structure of the BDI-II and the fact that most models have shown highly correlated factors, bifactor models have been recently proposed as an alternative solution in adolescent samples [17,18,20].…”

Satisfaction with in-patient child and adolescent psychiatric treatment: development and psychometric properties of the BEST questionnaires for adolescents and for parents

“…Another straightforward method to help differentiate between a general factor and remaining specific factors is the use of bifactor modelling [ 27 , 28 ]. This approach allows for new insights into the factorial structure of highly correlated dimensions and has been applied in several research areas, e.g., in the potential distinction between the two closely related cognitive and somatic symptom dimensions in the assessment of depression [ 29 , 30 ]. Although it is straightforward, these factor models have not yet been applied in satisfaction research and will be one of the key objectives in this study.…”