Zung Scale Factor Invariance in Male Coronary Patients and Healthy People

Abstract

The objective of this study was, firstly, to determine the factor structure and factor invariance of the Zung Self-Rating Depression Scale (ZSDS) and, secondly, to justify its use in coronary patients (CPs) and healthy people (HP). Two comparable samples of males were studied: 217 CPs and 191 HP. Exploratory and confirmatory factor analyses (EFA and CFA) for ordinal data were carried out with Mplus. Two models obtained from all participants in this study and another two, the model of Shafer (2006) from a meta-analysis and that of Barefoot et al. (2000) with CPs, were analyzed in CFA. A two-factor structure was supported by EFA in both samples, but none of the models showed adequate goodness-of-fit for the CPs and the HP in CFA. Only the two and three-factor models obtained from the combined sample of CPs and HP showed adequate goodness-of-fit for HP. The ZSDS showed good reliability, replicated the prevalence of depressive symptoms found in other studies and was able to distinguish between CPs and HP. We conclude that the best fit is obtained from the two-factor solution in HP, that the factor structure of the ZSDS is not invariant and is linked to positively and negatively worded items.

Assessing Mental Health for China’s Police: Psychometric Features of the Self-Rating Depression Scale and Symptom Checklist 90-Revised

“…Moreover, most of the somatic symptoms of depression can be manifested in this study, except for the low factor loading of Item 7 ("losing weight"). This finding is in line with Pérez et al [34], that the two-factor model (i.e., positive and negative wording) and the substantive symptom model (i.e., affect, cognitive, and somatic symptoms) can be both supported among healthy individuals but not in unhealthy individuals. More specifically, in this study, Schotte et al's [26] two-factor model and the Shafer's [16] three-factor model both fitted the data well, and these models reflected the artifactitious factors of positively and negatively worded items.…”

Association of Excessive Daytime Sleepiness with the Zung Self-Rated Depression Subscales in Adults with Coronary Artery Disease and Obstructive Sleep Apnea

“…The National Heart, Lung, and Blood Institute (USA) had therefore recommended an investigation to address whether or not depression questionnaires used in the general population were applicable to cardiac patients [ 23 ]. In this context, a study by Perez Adel et al [ 24 ] supported the use of the Zung SDS scores with justifications such as ( A ) it was a widely used self-questionnaire [ 25 ]; ( B ) it was easy to understand [ 26 ]; and ( C ) it predicted mortality and new hospitalizations in cardiac failure patients [ 27 ] as well as the risk for cardiovascular death in adults free of CAD at baseline [ 28 ]. It has also been argued that the use of total scores of a questionnaire may be problematic since different clusters of symptoms might be underestimated [ 23 ], and it might be difficult to diagnose and treat various types of depression.…”