Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in Eritrean refugees living in Ethiopia

Abstract

BackgroundDepression is among the top mental health problems with a major contribution to the global burden of disease. This study aimed at identifying the latent factor structure and construct validity of the Center for Epidemiologic Studies Depression (CES-D) Scale.Participants and settingA cross-sectional survey of 562 adults aged 18 years and above who were randomly selected from the Eritrean refugee community living in the Mai-Aini refugee camp, Ethiopia.MeasuresThe CES-D Scale, Primary Care PTSD (PC-PTSD) screener, premigration and postmigration living difficulties checklist, Oslo Social Support Scale (OSS-3), Sense of Coherence Scale (SoC-13), Coping Style Scale and fast alcohol screening test (FAST) were administered concurrently. Confirmatory factor analysis was employed to test prespecified factor structures of CES-D.ResultFirst-order two factors with second-order common factor structure of CES-D (correlated error terms) yielded the best fit to the data (Comparative Fit Index =0.975; root mean square error of approximation=0.040 [90% CI 0.032 to 0.047]). The 16 items defining depressive affect were internally consistent (Cronbach’s α=0.932) and internal consistency of the 4 items defining positive affect was relatively weak (Cronbach’s α=0.703). These two latent factors have a weaker standardised covariance estimate of 33% (24% for women and 40% for men), demonstrating evidence of discriminant validity. CES-D is significantly associated with measures of adversities, specifically, premigration living difficulties (r=0.545, p<0.001) and postmigration living difficulties (r=0.47, p<0.001), PC-PTSD (r=0.538, p<0.001), FAST (r=0.197, p<0.001) and emotion-oriented coping (r=0.096, p˂0.05) providing evidence of its convergent validity. It also demonstrated inverse association with measures of resilience factors, specifically, SoC-13 (r=−0.597, p<0.001) and OSS-3 (r=−0.319, p<0.001). The two correlated factors model of CES-D demonstrated configural, metric, scalar, error variance and structural covariance invariances (p>0.05) for both men and women.ConclusionsUnlike previous findings among Eritreans living in USA, second-order two factors structure of CES-D best fitted the data for Eritrean refugees living in Ethiopia; this implies that it is important to address culture for the assessment and intervention of depression.

An Adaptation and Validation of Students’ Satisfaction Scale: The Case of McGraw–Hill Education Connect

“…Convergent validity is achieved when all items in a measurement model are significantly correlated with the respective latent constructs [30,35,38]. It could also be verified by using the average variance extracted (AVE) for every construct.…”

“…e survey results are usually used to make recommendations for intervention curriculum, faculty training, and products directed at developing teaching methods. at is why it is essential to rely on welldesigned and validated instruments [29,30].…”

“…Instruments that have been initially developed in a particular language for use in some contexts could be made appropriate to use in one or more other languages or contexts [31,32]. In such cases, the translation/adaptation process aims to produce an instrument with comparable psychometric qualities as the original following a specific procedure [30,31,[33][34][35], and the instrument developer should evaluate the target population's validity [31].…”

“…If given items did not load on the intended construct, they should be eliminated, as they were not an adequate measure of that construct [37]. In confirmatory factor analysis (CFA), construct validity is achieved when the fitness indices for a construct are satisfied [30].…”

“…Discriminant validity indicates that the measurement model of a construct is free from redundant and unnecessary items. It checks if items within a construct intercorrelate higher than they correlate with other items from other constructs theoretically supposed not to relate [30,37,38,41].…”