Reliability and Construct Validity of the Center for Epidemiological Studies Depression Scale in a Rural Women Population

Objective To test the reliability and construct validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a rural Chinese women population. Methods To determine the propriety of positive questions in the CES-D, Cronbach's α coefficients were calculated when each of the four positive questions was deleted. Correlations between the positive affection subscale and other subscales were also tested. The four factor structure of the scale was tested using RMESA, NFI, IFI, and CFI in a confirmatory factor analysis. The internal consistency and convergent and discriminant validities of the scale were further assessed based on the four-factor structure. Results Propriety of the positive affection subscale was evident. The data fit well with the four-factor structure proposed by Radloff. The factor analysis confirmed the theoretical assumption (NFI=0.895, IFI=0.908, CFI = 0.908, RMSEA = 0.058). The Cronbach's α coefficients of the four-factor scale ranged from 0.687 to 0.735 (0.889 for the entire scale). The subscales had a correlation coefficient of 0.378-0.892 with the total score of the scale. An 85.71%-100% success rate of convergent validity experiment and 100% success rate of discriminant validity experiment was found. Conclusion CES-D is a valid scale with a four-factor structure for depression screening in Chinese rural women.