Reevaluating positive affect in the Center for Epidemiologic Studies-Depression scale

Area of Science:

• Psychological assessment
• Psychometric evaluation
• Mental health research

Background:

• The Center for Epidemiologic Studies-Depression (CES-D) scale is widely used to measure depressive symptoms.
• Prior research suggested a two-factor structure (Positive Affect and Depressed Affect) for the Dutch CES-D, recommending the removal of positively worded items.
• The validity and factor structure of the English CES-D require further investigation, particularly concerning the positively worded items.

Purpose of the Study:

• To examine the factor structure and concurrent validity of the English version of the CES-D.
• To compare the fit of a two-factor structure against the original four-factor structure in English-speaking samples.
• To assess the utility of positively worded items (Positive Affect) in the CES-D scale.

Main Methods:

• Analysis of the factor structure of the English CES-D using university student and community samples.
• Concurrent validity was assessed using similar analytical methods to previous studies.
• Exploration of the relationship between Positive Affect items and depression versus other psychopathology.

Main Results:

• The four-factor structure showed a better fit to the data than the two-factor structure across both samples.
• Validity analyses indicated no issues with the Positive Affect items.
• Positive Affect items appeared more specifically related to depression than other forms of psychopathology.

Conclusions:

• The original 20-item, four-factor structure of the English CES-D is recommended for use.
• The exclusion of Positive Affect items is not supported for the English version.
• Clinicians and researchers should continue using the full English CES-D scale.