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Development and validation of a comprehensive risk warning indicator system for depression in Chinese children and
Yan Han1, Jingrong Xi, Huizhu Jiang
1Huai'an No. 3 People's Hospital, Huai'an City, Jiangsu, China.
Insights
This study developed a culturally appropriate system to detect depression in Chinese youth. The validated indicator system shows high reliability and content validity for early identification and intervention.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Screening
- Psychometric Validation
Background:
- Childhood depression is a global epidemic requiring effective early detection.
- Existing screening tools lack cultural appropriateness and comprehensive frameworks for Chinese pediatric populations.
Purpose of the Study:
- To develop and validate a comprehensive, culturally appropriate risk warning indicator system for depression detection in Chinese children and adolescents.
Main Methods:
- Mixed-methods approach: systematic literature review, expert Delphi consultations (2 rounds), and empirical validation.
- Analytic hierarchy process for indicator weighting; psychometric validation with 386 depressed youth (ages 11-18).
Main Results:
- A 5-domain, 38-indicator system developed with expert consensus (authority coefficients 0.808-0.868, consensus P < .001).
- Key domains: language (0.347), emotion (0.251), behavior (0.190), stress events (0.144), history (0.068).
- System demonstrated robust reliability (KR-20=0.811, ICC=0.832) and high content validity (S-CVI/Ave=0.995).
Conclusions:
- The developed indicator system is scientifically rigorous, culturally sensitive, and psychometrically sound.
- It offers practical applicability for early depression detection in clinical, educational, and community settings.
- Potential to improve prevention and intervention outcomes for vulnerable youth.
Abstract:
Depression among children and adolescents has reached epidemic proportions globally, necessitating systematic early detection approaches. Existing screening instruments demonstrate variable accuracy across populations and lack comprehensive and culturally appropriate frameworks for Chinese pediatric populations. This study developed and validated a comprehensive risk warning indicator system for depression detection in Chinese children and adolescents. A mixed-methods approach integrated a systematic literature review, expert consensus methodology, and empirical validation. Twenty distinguished experts from 8 tertiary psychiatric hospitals across 6 provinces participated in 2-round Delphi consultations to refine indicator selection. Psychometric validation employed data from 386 children and adolescents diagnosed with depression (ages 11-18) attending outpatient services. Analytic hierarchy process methodology determined hierarchical indicator weights, while comprehensive reliability and content validity assessments evaluated system performance. The expert consultation achieved 100% response rates with authority coefficients of 0.808 and 0.868 across rounds. The coordination coefficients demonstrated significant consensus (W = 0.131 and 0.142, both P < .001). The final system comprised 5 primary domains with 38 secondary indicators: language indicators (weight = 0.347), emotional indicators (0.251), behavioral indicators (0.190), stress event indicators (0.144), and history/genetic history (0.068). Psychometric validation revealed robust reliability (overall Kuder-Richardson Formula 20 = 0.811; split-half = 0.745; test-retest ICC = 0.832) and exceptional content validity (Item-Level Content Validity Index: 0.881-1.000; Scale-Level Content Validity Index Average = 0.995; Scale-Level Content Validity Index Universal Agreement = 0.832). This scientifically rigorous, culturally appropriate indicator system demonstrates excellent psychometric properties and practical applicability for early depression detection across clinical, educational, and community settings, potentially improving prevention and intervention outcomes in vulnerable youth populations.
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