Factor Structure and Psychometric Properties of English and Spanish Versions of the Edinburgh Postnatal Depression Scale Among Hispanic Women in a Primary Care Setting

Abstract

Background Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. Objective The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Method Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. Conclusion These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States.

Subconstructs of the Edinburgh Postnatal Depression Scale in a multi-ethnic inner-city population in the U.S.

“…On the other hand, Hartley et al (2014) examined a sample of Hispanic women (n=220) in the Southeastern U.S. recruited from their child’s pediatric primary care clinic in a large pediatric hospital using CFA, and found that a two-factor model of depression and anxiety was the structure that demonstrated best fit. The difference in the findings between our study and Hartley et al (2014) for Hispanics could be partly due to geographic differences in the populations (northeastern U.S. vs. southeastern U.S.) or other factors that were not examined such as country of origin and length of time in the U.S.…”

“…Specifically, we examined the traditional overall chi-square test of model fit (which should not be statistically significant), root mean square error of approximation (RMSEA; a good fit is generally defined as RMSEA<0.08), comparative fit index (CFI; a CFI ≥0.95 is generally considered an excellent fit), and the standardized root mean square residual (SMSR; which should be ≤0.05) (Brown 2015; Hartley et al 2014; Hu and Bentler 1999). These procedures reflect the most commonly applied approaches in the literature and should thus generalize well (Briggs and MacCallum 2003; Costello and Osborne 2005).…”

“…The 10-item Edinburgh Postpartum Depression Scale (EPDS) (Cox et al 1987) is the most widely used self-report measure for the assessment of PPD across diverse racial/ethnic and cultural groups including African Americans and Hispanics (Gibson et al 2009; Hartley et al 2014; Howell et al 2012; Lau et al 2010; Lee King 2012; Montazeri et al 2007; Odalovic et al 2015; Okano et al 1996; Pop et al 1992; Small et al 2007; Toreki et al 2014; Vivilaki et al 2009). Although Cox et al (1987) originally designed the EPDS as a one-dimensional measurement tool, the recognition that depressive symptoms can be differentially experienced across cultural and racial/ethnic groups has led to studies examining structural equivalence of the measure in different populations using factor analysis (Cunningham et al 2015; Reichenheim et al 2011).…”

“…Although Cox et al (1987) originally designed the EPDS as a one-dimensional measurement tool, the recognition that depressive symptoms can be differentially experienced across cultural and racial/ethnic groups has led to studies examining structural equivalence of the measure in different populations using factor analysis (Cunningham et al 2015; Reichenheim et al 2011). Some studies suggest that items from the EPDS cluster into two factors, one generally indicating “depression” and the other indicating “anxiety” (Astbury et al 1994; Guedeney and Fermanian 1998; Hartley et al 2014; Massoudi et al 2013; Matthey 2008; Phillips et al 2009; Toreki et al 2014; Vivilaki et al 2009), whereas other studies suggest three factors indicating “depression”, “anxiety”, and “anhedonia” (Chabrol and Teissedre 2004; Lee King 2012; Montazeri et al 2007; Pop et al 1992; Ross et al 2003; Small et al 2007). Notably, some of these factors were comprised of different items across the different studies.…”

“…Variation of the factor structure remains understudied across ethnic and racial groups in the U.S. A recent study in Hispanic women drawn from a pediatric primary care setting identified a 2-factor model (depression, anxiety) as the best fitting model (Hartley et al 2014), whereas a study in postpartum African American women of low socioeconomic status showed that a 3-factor model (depression, anxiety, and anhedonia) demonstrated the best fit (Lee King 2012). No studies to date have been large and diverse enough to permit direct multi-group analyses comparing factor structures across different race and ethnicities.…”