Archives of Women's Mental Health

, Volume 16, Issue 2, pp 159–166 | Cite as

Factor structure and longitudinal invariance of the Center for Epidemiological Studies Depression Scale (CES-D) in adult women: application in a population-based sample of mothers of children with epilepsy

Original Article


The objective of this study was to examine the factor structure and longitudinal measurement invariance of the Center for Epidemiological Studies Depression Scale (CES-D). The population-based sample included 347 adult women who had children participating in the Health-related Quality of Life in Children with Epilepsy Study. Longitudinal confirmatory factor analysis was used to confirm the factor structure and test for measurement invariance. The original CES-D four-factor model (depressed affect, positive affect, somatic activity, and interpersonal relations) provided the best fit to the data compared to alternate models: [χ2 = 362.95 (df = 164); Comparative Fit Index (CFI) = 965; Tucker-Lewis Index (TLI) = 0.960; Weighted Root Mean Square Residual (WRMR) = 0.966; Root Mean Square Error of Approximation (RMSEA) = 0.059, 90 % confidence interval (CI), 0.051, 0.068] and was used for invariance testing. Results suggested full measurement invariance over time with the final model demonstrating adequate fit [χ2 = 2303.92 (df = 1,776); CFI = 0.957; TLI = 0.952; WRMR = 1.149; RMSEA = 0.033, 90 % CI, 0.030, 0.038]. We conclude that the four-factor structure of the CES-D is supported for adult women and that the measurement of the scale is longitudinally invariant. Clinicians and researchers can be confident that longitudinal changes in CES-D scores reflect true changes in depressive symptomatology and are not an artifact of changes in the interpretation of items in the scale over time.


Age Depression Measurement Psychometrics 


  1. Baumgartner H, Steenkamp JBEM (1998) Multi-group latent variable models varying numbers of items and factors with cross-national and longitudinal applications. Mark Lett 9:21–35CrossRefGoogle Scholar
  2. Beardslee WR, Versage EM, Gladstone TR (1998) Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Psychiatry 37:1134–1141CrossRefGoogle Scholar
  3. Bollen KA (1989) Structural equations with latent variables. Wiley, New YorkGoogle Scholar
  4. Brown TA (2006) Confirmatory factor analysis for applied research. The Guilford Press, New YorkGoogle Scholar
  5. Byrne BM (2012) Structural equation modeling with Mplus: basic concepts, applications, and programming. Taylor & Francis Group, LLC, New YorkGoogle Scholar
  6. Byrne BM, Shavelson RJ, Muthen B (1989) Testing for the equivalence of factor covariance and mean structures: the issue of partial measurement invariance. Psychol Bull 105:456–466CrossRefGoogle Scholar
  7. Canada S (2006) Census of Canada. Statistics Canada, OttawaGoogle Scholar
  8. Chen FF (2007) Sensitivity of goodness of fit indices to lack of measurement invariance. Struct Equ Model 14:464–504CrossRefGoogle Scholar
  9. Chen FF, Sousa KH, West SG (2005) Testing measurement invariance of second-order factor models. Struct Equ Model 12:471–492CrossRefGoogle Scholar
  10. Cheung GW, Rensvold RB (2002) Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Model 9:233–255CrossRefGoogle Scholar
  11. Cohen CI, Goh KH, Gustave M (2010) A prospective study of outcome and predictors of subclinical and clinical depression in an older biracial sample of psychiatric outpatients. J Affect Disord 121:204–211PubMedCrossRefGoogle Scholar
  12. Contrada RJ, Boulifard DA, Idler EL, Krause TJ, Labouvie EW (2006) Course of depressive symptoms in patients undergoing heart surgery: confirmatory analysis of the factor pattern and latent mean structure of the Center for Epidemiologic Studies Depression Scale. Psychosom Med 68:922–930PubMedCrossRefGoogle Scholar
  13. Dolgin MJ, Phipps S, Fairclough DL, Sahler OJ, Askins M, Noll RB, Butler RW, Varni JW, Katz ER (2007) Trajectories of adjustment in mothers of children with newly diagnosed cancer: a natural history investigation. J Pediatr Psychol 32:771–782PubMedCrossRefGoogle Scholar
  14. Edwards MC, Cheavens JS, Heiy JE, Cukrowicz KC (2010) A reexamination of the factor structure of the Center for Epidemiologic Studies Depression Scale: is a one-factor model plausible? Psychol Assess 22:711–715PubMedCrossRefGoogle Scholar
  15. Ferro MA, Boyle MH (2012) Longitudinal invariance of measurement and structure of global self-concept: a population-based study examining trajectories among adolescents with and without chronic illness. J Pediatr Psychol. doi:10.1093/jpepsy/jss112
  16. Ferro MA, Speechley KN (2009) Depressive symptoms among mothers of children with epilepsy: a review of prevalence, associated factors, and impact on children. Epilepsia 50:2344–2354PubMedCrossRefGoogle Scholar
  17. Ferro MA, Speechley KN (2012) Examining clinically relevant levels of depressive symptoms in mothers following a diagnosis of epilepsy in their children: a prospective analysis. Soc Psychiatry Psychiatr Epidemiol 47:1419–1428Google Scholar
  18. Ferro MA, Avison WR, Campbell MK, Speechley KN (2011a) The impact of maternal depressive symptoms on health-related quality of life in children with epilepsy: a prospective study of family environment as mediators and moderators. Epilepsia 52:316–325PubMedGoogle Scholar
  19. Ferro MA, Avison WR, Campbell MK, Speechley KN (2011b) Prevalence and trajectories of depressive symptoms in mothers of children with newly diagnosed epilepsy. Epilepsia 52:326–336PubMedGoogle Scholar
  20. Gillespie JF, Primavera J (eds) (2000) Diverse families, competent families: innovations in research and preventive intervention practice. Haworth Press, New YorkGoogle Scholar
  21. Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D (2011) Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev 14:1–27PubMedCrossRefGoogle Scholar
  22. Hertzog C, Van Alstine J, Usala P, Hultsch DF, Dixon R (1990) Measurement properties of the Center for Epidemiological Studies Depression Scale (CES-D) in older populations. Psychol Assess 2:64–72CrossRefGoogle Scholar
  23. Kim-Cohen J, Moffitt TE, Taylor A, Pawlby SJ, Caspi A (2005) Maternal depression and children’s antisocial behavior: nature and nurture effects. Arch Gen Psychiatry 62:173–181PubMedCrossRefGoogle Scholar
  24. Knight RG, Williams S, McGee R, Olaman S (1997) Psychometric properties of the Centre for Epidemiologic Studies Depression Scale (CES-D) in a sample of women in middle life. Behav Res Ther 35:373–380PubMedCrossRefGoogle Scholar
  25. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL (eds) (2006) Global burden of disease and risk factors. The World Bank and Oxford University Press, New YorkGoogle Scholar
  26. MacCallum RC, Browne MW, Sugawara HM (1996) Power analysis and determination of sample size for covariance structure modeling. Psychol Methods 1:130–149CrossRefGoogle Scholar
  27. Millsap RE, Yun-Tein J (2004) Assessing factorial invariance in ordered-categorical measures. Multivar Behav Res 39:479–515CrossRefGoogle Scholar
  28. Morin AJ, Moullec G, Maiano C, Layet L, Just JL, Ninot G (2011) Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults. Rev Epidemiol Sante Publique 59:327–340PubMedCrossRefGoogle Scholar
  29. Motl RW, Dishman RK, Birnbaum AS, Lytle LA (2005) Longitudinal invariance of the Center for Epidemiological Studies-Depression Scale among girls and boys in middle school. Educ Psychol Meas 65:90–108CrossRefGoogle Scholar
  30. Muthén BO (1989) Latent variable modeling in heterogeneous populations. Psychometrika 54:557–585CrossRefGoogle Scholar
  31. Muthén LK, Muthén BO (2010) Mplus user’s guide, 6th edn. Muthén & Muthén, Los AngelesGoogle Scholar
  32. Perreira KM, Deeb-Sossa N, Harris KM, Bollen K (2005) What are we measuring? An evaluation of the CES-D across race/ethnicity and immigrant generation. Soc Forces 83:1567–1602CrossRefGoogle Scholar
  33. Pilowsky DJ, Wickramaratne P, Nomura Y, Weissman MM (2006) Family discord, parental depression, and psychopathology in offspring: 20-year follow-up. J Am Acad Child Adolesc Psychiatry 45:452–460PubMedCrossRefGoogle Scholar
  34. Pitts SC, West SG, Tein J (1996) Longitudinal measurement models in evaluation research: examining stability and change. Eval Prog Plan 19:333–350CrossRefGoogle Scholar
  35. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRefGoogle Scholar
  36. Shafer AB (2006) Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung. J Clin Psychol 62:123–146PubMedCrossRefGoogle Scholar
  37. Singh R (2009) Does my structural model represent the real phenomenon? A review of the appropriate use of structural equation modeling (SEM) model fit indices. Mark Rev 9:199–212CrossRefGoogle Scholar
  38. Steinmetz H, Schmidt P, Tina-Booh A, Wieczorek S, Schwartz SH (2009) Testing measurement invariance using multiple group CFA: differences between educational groups in human values measurement. Qual Quant 43:599–616CrossRefGoogle Scholar
  39. Tisak J, Meredith W (1990) Longitudinal factor analysis. In: von Eye A (ed) Statistical methods in longitudinal research, volume 1: principles and structuring change. Academic, San DiegoGoogle Scholar
  40. Van Lieshout RJ, Cleverley K, Jenkins JM, Georgiades K (2011) Assessing the measurement invariance of the Center for Epidemiologic Studies Depression Scale across immigrant and non-immigrant women in the postpartum period. Arch Womens Ment Health 14:413–423PubMedCrossRefGoogle Scholar
  41. Vandenberg RJ, Lance CE (2000) A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organ Res Methods 3:4–70CrossRefGoogle Scholar
  42. Williams CD, Taylor TR, Makambi K, Harrell J, Palmer JR, Rosenberg L, Adams-Campbell LL (2007) CES-D four-factor structure is confirmed, but not invariant, in a large cohort of African American women. Psychiatry Res 150:173–180PubMedCrossRefGoogle Scholar
  43. Yu CY (2002) Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes. University of California, Los AngelesGoogle Scholar

Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonCanada
  2. 2.Offord Centre for Child StudiesMcMaster UniversityHamiltonCanada
  3. 3.Department of Paediatrics, Western UniversityLondonCanada
  4. 4.Department of Epidemiology and BiostatisticsWestern UniversityLondonCanada
  5. 5.Children’s Health Research InstituteWestern UniversityLondonCanada
  6. 6.Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child StudiesMcMaster UniversityHamiltonCanada

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