Preliminary Study of the Reliability and Validity of the Center for Epidemiologic Studies Depression Scale in Lao PDR

Abstract

Different cultures often express the same symptoms of physical and mental disorders in different ways. Therefore, the original four-factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) may not be appropriate in all cultural contexts. This study aimed to develop a Laotian version of the CES-D, investigate the reliability and validity of the Laotian CES-D, and examine its factorial properties. This study was conducted in Laos PDR in February 2010. Data were collected from 189 staff members and teachers from the Faculty of Education, National University of Laos using the Laotian CES-D. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to determine the structure of the Laotian CES-D. We tested whether the Laotian CES-D differed from a single factor model of the 20-item CES-D, and from Radloff’s original four-factor solution. CFA results indicated that neither the single factor model nor the four-factor solution was a good fit for a Laotian sample. EFA was conducted to determine a Laotian-specific model, which was tested using CFA. Five items that had low commonality and low factor loadings were excluded in the CFA. Next, we determined a best fit structure comprising three factors: “Sadness/loneliness”, “Psychosomatic symptoms”, and “Lack of positive affect”. This Laotian CES-D model showed high reliability (alpha = 0.81). “Dislike” items loaded on the “Interpersonal” factor in Radloff’s model, but loaded on the “Sadness/loneliness” factor in the Laotian model. Items indicating depressive feelings, somatic complaints, and interpersonal relationships were combined into one factor (“Sadness/loneliness”) in the Laotian model. Moreover, items indicating depressive feelings and somatic complaints were combined into the “Psychosomatic symptoms” factor in the Laotian model.