Computerized Adaptive Testing Provides Reliable and Efficient Depression Measurement Using the CES-D Scale.

Area of Science:

• Psychometrics
• Mental Health Assessment
• Clinical Psychology

Background:

• The Center for Epidemiologic Studies Depression Scale (CES-D) is a widely used international measure for depressive symptomatology.
• Previous efforts to shorten the CES-D scale exist, but developing a Computerized Adaptive Test (CAT) version has been less explored.

Purpose of the Study:

• To provide evidence for the efficiency and accuracy of the CES-D when administered via CAT.
• To validate the CES-D CAT using an American sample group.

Main Methods:

• A sample of 2060 US participants' responses to the CES-D was collected.
• Psychometric assessments included confirmatory factor analysis, Mokken analysis, and item response theory (IRT) using Samejima's graded response model (GRM).
• Two CAT simulations were conducted to evaluate the CES-D CAT's performance.

Main Results:

• After removing 3 non-conforming items, the remaining 17 items fit the GRM well.
• No differential item functioning (DIF) was found between age and gender groups.
• Simulated CAT algorithm scores highly correlated with original CES-D scores, with higher precision at elevated depression levels.

Conclusions:

• The CES-D CAT demonstrates high accuracy and efficiency compared to the fixed-length CES-D assessment.
• This CAT version offers a more precise method for evaluating depression, particularly in individuals with more severe symptoms.