流调中心抑郁量表（CESD）是一种广泛使用的抑郁情绪的测量工具。以往使用CESD检验老年人抑郁影响因素的研究已经揭示，不同性别、经济状况和文化背景下老年人抑郁情绪水平存在显著差异。在这些研究中，CESD总分的平均分是群体差异研究关注的主要焦点。然而，在不同文化背景中，老年抑郁情绪的成分是否相同？不同文化背景老年人对抑郁测量工具项目的理解和解释的方式是否具有一致性？这两个问题是决定研究者所观察到的平均分差异具有意义前提条件。也就是说，研究者所观察到的CESD分数的差异只有在能够如实反映所要测量概念水平上的差异，而不是由于社会文化差异（如与西方人相比，中国人更倾向于避免报告出极端的积极情绪）所导致的反应偏差的条件下才具有意义。尽管以往的研究证实CESD是一种有效可靠的抑郁情绪测量工具，但是还没有研究关注在不同文化背景的老年人群中，CESD是否以相同的方式测量到了相同的概念，即还没有研究检验CESD跨文化群体的恒等性。

中科院心理研究所李娟研究员课题组以全国取样的中国（n=4903）和荷兰（n=1903）老年人为被试，检验CESD在两种完全不同社会文化背景中的跨文化恒等性，以探讨在完全不同文化背景中，CESD是否具有相同的因素结构并且个体是否以相同的方式理解和解释量表的项目。结果显示：1）CESD由躯体症状、抑郁情绪、积极情绪和人际问题四个维度构成的因素结构同时适合于中国老年人和荷兰老年人；2）在项目水平，部分项目的平均数和残差在两个群体中不一致：中国老年人的在两个项目（“感觉和别人一样好”和“感觉自己很失败”）上的平均数高于荷兰老年人，意味着中国老年人对两个项目的认同倾向强于荷兰老年人；中国老年人在三个项目（“感觉抑郁”，“感到害怕”和“别人不喜欢我”）上的残差也高于荷兰老年人，意味着在中国老年人中这些项目预测抑郁情绪的能力要低于荷兰老年人。这些结果表明，中国老年人和荷兰老年人有着相似的抑郁成分，但是在具体的表达形式和程度上却存在着一定的差异（即在某些项目上存在着反应偏差）。

该研究为使用CESD总分比较中国和荷兰老年人抑郁情绪水平的有效性提供了证据支持。但是，在使用CESD某些维度或单个项目比较两国老年人抑郁水平时，所观测到的差异可能是反映偏差所致，在作相应推论时需要谨慎对待。论文发表在《BMC医学研究方法学》（BMC Medical Research Methodology）（生物谷Bioon.com）

生物谷推荐原文出处：

BMC Medical Research Methodology DOI： 10.1186/1471-2288-11-74

Measurement invariance of the center for epidemiological studies depression scale (CES-D) among chinese and dutch elderly

Baoshan Zhang, Marjolein Fokkema, Pim Cuijpers, Juan Li, Niels Smits, Aartjan Beekman

Although previous studies using non- elderly groups have assessed the factorial invariance of the Center for Epidemiological Studies Depression Scale (CES-D) across different groups with the same social-cultural backgrounds, few studies have tested the factorial invariance of the CES-D across two elderly groups from countries with different social cultures. The purposes of this study were to examine the factorial structure of the CES-D, and test its measurement invariance across two different national elderly populations. Methods A total of 6806 elderly adults from China (n = 4903) and the Netherlands (n = 1903) were included in the final sample. The CES-D was assessed in both samples. Three strategies were used in the data analysis procedure. First, a confirmatory factor analysis (CFA) was carried out to determine the factor structures of the CES-D that best fitted the two samples. Second, the best fitting model was incorporated into a multi-group CFA model to test measurement invariance of the CES-D across the two population groups. Third, latent mean differences between the two groups were tested. Results The results of confirmatory factor analysis (CFA) showed: 1) in both samples, Radloff's four-factor model resulted in a significantly better fit and the four dimensions (somatic complaints, depressed affect, positive affect, and interpersonal problems) of the CES-D seem to be the most informative in assessing depressive symptoms compared to the single-, three-, and the second-order factor models; and 2) the factorial structure was invariant across the populations under study. However, only partial scalar and uniqueness invariance of the CES-D items was supported. Latent means in the partial invariant model were lower for the Dutch sample, compared to the Chinese sample. Conclusions Our findings provide evidence of a valid factorial structure of the CES-D that could be applied to elderly populations from both China and the Netherlands, producing a meaningful comparison of total scores between the two elderly groups. However, for some specific factors and items, caution is required when comparing the depressive symptoms between Chinese and Dutch elderly groups.