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Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory.

ABSTRACT: Depression is commonly seen in survivors of conflict and disaster across the world. There is a dearth of research on the validity of commonly used measures of depression in these populations. Measurements of depression that are used in multiple contexts need to meet measurement equivalence, i.e., the instrument measures the same construct in the same manner across different groups. The Beck Depression Inventory (BDI) was administered to female trauma survivors in the United States (n = 268) and female survivors of war in Sri Lanka (n = 149). Three metrics of measurement equivalence-structural, metric, and scalar-were examined. Two- and three-factor structures of the BDI that have been identified in other populations did not provide a good fit for our data. However, a bifactor model revealed a similar general distress dimension across populations, but dissimilar secondary dimensions or subfactors. The Sri Lankan subfactor comprised of predominantly somatic symptoms and the United States subfactor comprised of cognitive and somatic symptoms. While intercepts of individual BDI items differed, their differences seem to be offsetting. Total BDI scores across these two populations are roughly comparable, although caution is recommended when interpreting them. Making comparisons on subscales is not recommended.

SUBMITTER: Jayawickreme N

PROVIDER: S-EPMC5622946 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description: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.

Project description:BACKGROUND:Beck Depression Inventory (BDI-II) is a widely used valid instrument to assess the severity of depression in clinical and normal settings. To meet the necessity of a standard scale for measuring depression among above 265 million Bangla speaking population around the world, this scale was translated and validated. METHODS:Two translations of BDI-II into Bangla were prepared, and then, two back translations were done by medical and language experts in parallel. Thereafter, sentence revision followed by pretest on 20 respondents was done to finalize the Bangla version of BDI-II (BDI-II BV). Afterward, a cross-sectional, comparative, and descriptive study was conducted to validate the scale by purposive sampling technique consisting of 111 persons (both clinical and normal) in three tertiary-level hospitals in Bangladesh. Everyone was given to fill up BDI-II BV at first. Then, they were given to fill up BDI-II BV (n = 49), Bangla version of Depression Anxiety Stress Scales 21-item (DASS21-BV, n = 47) and BDI-II (n = 25) 3-7 days later. The diagnosis of depressive disorder was made according to DSM-5. Correlation study and factor analysis were completed. RESULTS:The mean age was 28.83(±8.70) years. The male-female ratio was 1:0.82. Correlation of scores for BDI-II BV with the DASS21-BV depression subscale was .920; BDI-II BV with BDI-II was .985 (Cronbach's ? .993; t test not significant) and BDI-II BV applied first and the second time was .960 (Cronbach's ? .979; z test not significant). The interitem correlation for all the items was found highly significant (p < .01). Patients having depressive disorder or episodes had significantly higher BDI-II BV scores than normal (M + SD 30.18 + 10.127 than 8.34 + 5.910; p < .001). Partial confirmatory factor analysis demonstrated two-factor loading comprising Cognitive and Somatic-affective symptoms. CONCLUSIONS:Through the translation and validation process, a validated Bangla version of BDI-II was produced to measure depression and its severity among the Bengali population.

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Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory.

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