Validity of a 12-item version of the CES-D used in the National Longitudinal Study of Children and Youth

Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada.
Chronic diseases in Canada (Impact Factor: 1.6). 03/2005; 26(2-3):65-72.
Source: PubMed


This validation study assessed the degree of confidence that can be placed on inferences from depressive symptoms among adolescents, based on a 12-item version of the Centre for Epidemiological Studies Depression scale (CES-D). This short version of the scale had been developed for application in the National Longitudinal Study of Children and Youth and we refer to it as the CES-D-12-NLSCY. The major data source for the present validation study was a 2002/2003 survey of 12,990 students in junior and senior high school in the Atlantic provinces of Canada. Receiver operating characteristic curve analyses for two different proxy gold standards yielded adequate areas under the curve (AUCs) of .84 and .80, allowing us to establish cut points for three categories of depressive symptoms in the general adolescent population: Minimal (CES-D-12-NLSCY total score 0 to 11), Somewhat Elevated (total score 12 to 20) and Very Elevated (total score 21 to 36). The CES-D-12-NLSCY was found to have acceptable internal consistency (Cronbach=s alpha .85). All but one of the 12 items of the CES-D-12-NLSCY were found to have acceptable discrimination ability. The prevalence of Minimal, Somewhat and Very Elevated depressive symptoms in the adolescent student population of the Atlantic provinces was estimated to be 72.3, 19.5 and 5.5 percent, respectively. A further 2.6 percent of students who responded to fewer than 11 items of the scale were classified as Indeterminate with regards to depressive symptom category. The major threat to the accuracy of the CES-D-12-NLSCY is its lack of inquiry about irritability, which is a key symptom of depression in youth.

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    • "Using the cut-off scores provided by Poulin et al. (2005), 10% of the children had mild to severe depressive symptoms, which is in line with the prevalence of depression in middle childhood (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). Poulin et al. (2005) found a Cronbach alpha of .85 in a sample of 12990 youngsters. In the current sample, Cronbach " s alpha was .69. "
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    • "The reliability coefficient for this study was 0.70. A 12-item version of the Centre for Epidemiological Studies Depression Scale, (CES-D-12-NLSCY; α=0.85; Poulin et al. 2005) was included to measure risk levels for depression. Items such as " I had crying spells " , " I had trouble keeping my mind on what I was doing " , and " I felt like I was too tired to do things " are rated on a 4-point 1 Prioritised ethnicity was used in the study "
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    • "Externalising risk was also assessed using the Conduct Problems subscale of the Strengths and Difficulties Questionnaire (SDQ,Goodman, 1997Goodman, , 2001), which includes shortness of temper and inclination for aggressive responses, lying, theft and bullying. Items are measured on a 3- point scale from 0 = not true to 2 = certainly true with some item being reverse scored.Internalising risk was measured using the 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D-12-NLSCY;Poulin et al., 2005). Participants rated each item on a 4-point scale from 0 = rarely or none of the time to 3 = all of the time with some items being reverse scored. "
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