Archives of Women's Mental Health

, Volume 12, Issue 6, pp 433–440 | Cite as

Validation of Edinburgh postnatal depression scale for adolescent mothers

  • M. Cynthia Logsdon
  • Wayne M. Usui
  • Michael Nering
Original Contribution


The Edinburgh Postnatal Depression Scale has widespread use internationally with adult women, but few psychometric properties have been described for samples of adolescent mothers. The purpose of this paper is to validate the psychometric properties of the EPDS in a sample of adolescent mothers (n = 149) in a southern, urban area of the United States. Internal consistency reliability was .88. Principal components analysis supported a two factor structure accounting for 60% of variance. Results of item response theory analysis suggest that the EPDS and the Center for Epidemiologic Studies of Depression Scale have similar psychometric properties. This data can be used to provide evidence of construct validity of the EPDS. The study provides a foundation for further psychometric testing of the instrument.


Depression Adolescents Instrument validation 


  1. Allen Guttmacher Institute. US Teenage Pregnancy Statistics. Available at: report.html. Retrieved April 29, 2008.
  2. American Psychiatric Association. (1994). The diagnostic and statistical manual of mental disorders. 4th ed. American Psychiatric Association.Google Scholar
  3. Beck AT (1973) The diagnosis and management of depression. University of Pennsylvania Press, PhiladelphiaGoogle Scholar
  4. Beck CT, Gable RK (2001) Further validation of the postpartum depression screening scale. Nurs Res 50:155–164CrossRefPubMedGoogle Scholar
  5. Bernstein IH, Rush AJ, Yonkers K, Carmody TJ, Woo A, McConnell K, Trivedi MH (2008) Symptom features of postpartum depression: Are they distinct? Depress Anxiety 25:20–26CrossRefPubMedGoogle Scholar
  6. Birkeland R, Thompson JK, Phares V (2005) Adolescent motherhood and postpartum depression. J Clin Child Adolesc Psychol 34:292–300CrossRefGoogle Scholar
  7. Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res 51:659–663CrossRefPubMedGoogle Scholar
  8. Carmines EG, Zeller RA (1979) Reliability and validity assessment. Sage, Thousand Oaks, CAGoogle Scholar
  9. Carpenter JS, Andrykowski MA, Wilson J, Hall LA, Rayens MK, Sachs B, Cunningham LLC (1998) Psychometrics for two short forms of the Center for Epidemiologic Studies-Depression Scale. Issues Ment Health Nurs  19:481–494CrossRefPubMedGoogle Scholar
  10. Cassidy B, Zoccolillo M, Hughes S (1996) Psychopathology in adolescent mothers and its effects on mother-infant interactions: A pilot study. Can J Psychiatry 41:379–384PubMedGoogle Scholar
  11. Clemmens D (2003) Adolescent motherhood: a meta-synthesis of qualitative studies. Am J Matern Child Nurs 28:93–99CrossRefGoogle Scholar
  12. Clemmens D (2002) Adolescent mother’s depression after the birth of their babies: Weathering the storm. Adolescence 37:551–565PubMedGoogle Scholar
  13. Cox JL, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women. J Affect Disord 39:185–189CrossRefPubMedGoogle Scholar
  14. Cox JL, Holden JM (2003) Perinatal mental health: A guide to the Edinburgh postnatal depression scale. The Royal College of Psychiatrists, LondonGoogle Scholar
  15. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786CrossRefPubMedGoogle Scholar
  16. De Rosa N, Logsdon MC (2006) A comparison of screening instruments for depression in postpartum adolescents. J Child Adolesc Psychiatr Nurs 19:13–20CrossRefGoogle Scholar
  17. DeVon HA, Block ME, Moyle-Wright P, Ernst DM, Hayden SJ, Lazzara DJ, Savoy SM, Kostas-Polston E (2007) A psychometric toolbox for testing validity and reliability. J Nurs Scholarship 39:155–164CrossRefGoogle Scholar
  18. Eshbaugh EM (2006) Predictors of depressive symptomatology among low income adolescent mothers. Arch Women’s Ment Health 9:339–342CrossRefGoogle Scholar
  19. Evins GG, Theofrastous JP, Galvin SL (2000) Postpartum depression: A comparison of screening and routine clinical evaluation. Am J Obstet Gynecol 182:1080–1082CrossRefPubMedGoogle Scholar
  20. Figueiredo B, Pacheco A, Costa R (2007) Depression during pregnancy and the postpartum period in adolescent and adult Portugese mothers. Arch Women’s Ment Health 10:103–110CrossRefGoogle Scholar
  21. Flanagan PJ, McGrath MM, Meyer EC, Garcia Coll CT (1995) Adolescent development and transitions to motherhood. Pediatrics 96:273–277PubMedGoogle Scholar
  22. Garrison CZ, Addy A, Jackson KL, McKeown R, Waller JL (1991) The CES-D as a screen for depression and other psychiatric disorders in adolescents. J Am Acad Child Adolesc Psychiatry 30:636–41PubMedGoogle Scholar
  23. Gaynes, B.N., Gavin, N., Meltzer-Brody, S., Lohr, K.N., Swinson, T.G., Brody, S. & Miller, W.C. (2005). Perinal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report. Assessment number 119. (Prepared by the RTI-University of North Carolina Evidence Based Practice Center, under contract no. 290-02-0016.) Rockville, Md: Agency for Healthcare Research and Quality.Google Scholar
  24. Hambleton RK, Swaminathan H (1985) Item Response Theory: Principles and Applications. Kluwer-Nijhoff Publishing, BostonGoogle Scholar
  25. Harrington AR, Greene-Harrington CC (2007) Health Start screens for depression among urban pregnant, postpartum, and interconceptual women. J Natl Med Assoc 99:226–231PubMedGoogle Scholar
  26. Koniak-Griffin D, Walker DS, de Traversay J (1996) Predictors of depression symptoms in pregnant adolescents. J Perinatol 16:1–6Google Scholar
  27. Lesser J, Anderson NL, Koniak-Griffin D (1998) “Sometimes you just don’t feel ready to be an adult or a Mom”: the experience of adolescent pregnancy. J Child Adolesc Psychiatr Nur 11:7–16CrossRefGoogle Scholar
  28. Lesser J, Koniak-Griffin D, Anderson N (1999) Depressed adolescent mothers’ perceptions of their own maternal role. Issues Ment Health Nurs  20:131–149CrossRefPubMedGoogle Scholar
  29. Letourneau N (2001) Improving adolescent parent-infant interactions: A pilot study. J Pediatr Nurs 16:53–62CrossRefPubMedGoogle Scholar
  30. Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH (2000) Natural course of adolescent major depressive disorder in a community sample: Predictors of recurrence in young adults. Am J Psychiatry 157:154–1591CrossRefGoogle Scholar
  31. Linacre, M. (2009). WINSTSEPS: Multiple-choice, rating scale, and partial credit Rasch analysis (
  32. Logsdon MC, Birkimer JC, Simpson T, Looney S (2005) Postpartum depression and social support in adolescents. Journal Obstet Gynecol, Neonatal Nur 34:46–54CrossRefGoogle Scholar
  33. Logsdon MC, Cross R, Williams B, Simpson T (2004) Predictors of postpartum social support and symptoms of depression in pregnant adolescents: A pilot study. J Sch Nurs 20:36–42CrossRefPubMedGoogle Scholar
  34. Mercer R (1985) The process of maternal role attainment over the first year. Nurs Res 34:198–204CrossRefPubMedGoogle Scholar
  35. Miller L (1998) Depression among pregnant adolescents. Psychiatr Serv 49:970PubMedGoogle Scholar
  36. Morris-Rush JK, Freda MC, Bernstein PS (2003) Screening for postpartum depression in an inner city population. Am J Obst Gynecol 188:1217–1219CrossRefGoogle Scholar
  37. Munro BH (2005) Statistical methods for health care research, 4th edn. Lippincott, Williams, & Wilkins, PhiladelphiaGoogle Scholar
  38. Nunnally JC, Bernstein LH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New YorkGoogle Scholar
  39. Ostini R, Nering M (2006) Polytomous item response theory models. Sage, Thousand Oaks, CaGoogle Scholar
  40. Pallant JF, Miller RL, Tennant A (2006) Evaluation of the Edinburgh Postnatal Depression Scale Using Rasch Analysis. BMC Psychiatry 6:28–38CrossRefPubMedGoogle Scholar
  41. Panzarine S, Slater E, Sharps P (1995) Coping, social support, and depressive symptoms in adolescent mothers. J Adolesc Health 17:113–119CrossRefPubMedGoogle Scholar
  42. Paskewicz L (2001) Pregnant adolescents and their mothers: A shared experience of mothering. Am J Matern Child Nursing 26:33–38CrossRefGoogle Scholar
  43. Prescott CA, McArdle JJ, Hishinuma ES, Johnson RC, Miyamoto RH, Andrade NN, Edman JL, Makini GK Jr, Nahulu LB, Yuen NYC, Carlton BS (2004) Prediction of major depression and dysthymia from CES-D scores among ethnic minority adolescents. J Am Acad Child Adolesc Psychiatry 37:495–503Google Scholar
  44. Quinlivan JA, Luehr B, Evans SF (2004) Teenage mother’s predictions of their support levels before and actual support levels after having a child. J Pediatr Adolesc. Gynecol 17:273–278CrossRefPubMedGoogle Scholar
  45. Radloff LS (1977) The CES-D Scale: A sef-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRefGoogle Scholar
  46. Radloff LS, Locke BZ (1986) The community mental health assessment survey and the CES-D scale. In: Weissmann MM, Myers JK, Ross CE (eds) Community surveys of psychiatric disorders. Rutgers University Press, New Brunswick, NJ, pp 177–189Google Scholar
  47. Reckase MD (1985) The difficulty of test items that measure more than one ability. Appl Psychol Meas 9:401–412CrossRefGoogle Scholar
  48. Reid V, Meadows-Oliver M (2007) Postpartum depression in adolescent mothers: An integrative review of the literature. J Pediatr Health Care 21:289–298CrossRefPubMedGoogle Scholar
  49. Roberts RE, Lewinsohn PM, Seeley JR (1991) Screening for adolescent depression: A comparison of depression scales. Journal of American Academy of Adolescent Psychiatry 30:58–66CrossRefGoogle Scholar
  50. Ross LE, Gilbert Evans SE, Sellers EM, Romach MK (2003) Measurement issues in postpartum depression Part 1: Anxiety as a feature of postpartum depression. Archives of Women’s Mental Health 6:51–57CrossRefPubMedGoogle Scholar
  51. Schmidt RM, Wiemann CM, Rickert VI, Smith EO (2006) Moderate to severe depressive symptoms among adolescent mothers followed four years postpartum. J Adolesc Health 38:712–718CrossRefPubMedGoogle Scholar
  52. Shanok AF, Miller L (2005) Fighting and depression among poor pregnant adolescents. J Reprod Infant Psychol 23:207–218CrossRefGoogle Scholar
  53. Steer RA, Scholl TO, Beck AT (1990) Revised Beck Depression Inventory scores of inner-city adolescents. Pre-and postpartum. Psychol Rep 66:315–320CrossRefPubMedGoogle Scholar
  54. United States Department of Health and Human Services. (2000). Healthy People 2010. 2nd ed. With understanding and improving health and objectives for improving health. 2 vols. Washington, DC: U.S. Government Printing Office.Google Scholar
  55. Wenzel A, Haugen EN, Jackson LC, Robinson K (2003) Prevalence of generalized anxiety at eight weeks postpartum. Archives of Women’s Mental Health 6:43–49CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • M. Cynthia Logsdon
    • 1
  • Wayne M. Usui
    • 2
  • Michael Nering
    • 3
  1. 1.School of Nursing; School of MedicineUniversity of LouisvilleLouisvilleUSA
  2. 2.Department of SociologyUniversity of LouisvilleLouisvilleUSA
  3. 3.Measured ProgressDover, New HampshireUSA

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