The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: Depressed and Positive Affect in cancer patients and healthy reference subjects
Mj. Schroevers et al., The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: Depressed and Positive Affect in cancer patients and healthy reference subjects, QUAL LIFE R, 9(9), 2000, pp. 1015-1029
This study examined the reliability and validity of a two-factor structure
of the Center for Epidemiologic Studies Depression (CES-D) scale. The study
was conducted in a large group of cancer patients (n = 475) and a matched
reference group (n = 255). Both groups filled in a questionnaire at two poi
nts in time: patients 3 and 15 months after diagnosis. Factor analysis conf
irmed our hypothesis that the 16 negatively and four positively formulated
items measure two relatively independent factors, i.e. Depressed Affect and
Positive Affect. Therefore, these items should not be combined into an ove
rall sumscore. In both groups, Depressed Affect proved to be a reliable and
valid measure of depressive symptomatology, as indicated by its good inter
nal consistency, its strong correlations with other measures of psychologic
al distress and neuroticism, and its effectiveness in discriminating patien
ts from the reference group on depressive symptomatology. In contrast, the
validity of the Positive Affect factor could not be confirmed, since it was
only weakly related to other measures of psychological distress and extrav
ersion. Depressed and Positive Affect were about equally related to self-es
teem, life satisfaction, and quality of life. These findings support the us
e of a sumscore based on the 16 negatively formulated CES-D items as a more
valid measure of depressive symptomatology, in cancer patients and in heal
thy individuals from the general population.