Measuring Depression Over Time ... or not? Lack of Unidimensionality and Longitudinal Measurement Invariance in Four Common Rating Scales of Depression
Measuring Depression Over Time ... or not? Lack of Unidimensionality and Longitudinal Measurement Invariance in Four Common Rating Scales of Depression
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DOI：
10.1037/pas0000275
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发表时间：
2016-11-01
影响因子：
3.6
通讯作者：
Borsboom, Denny
中科院分区：
文献类型：
--
作者：
Fried, Eiko I.;van Borkulo, Claudia D.;Borsboom, Denny
在抑郁症研究中，症状通常通过评定量表进行评估，并添加到构建总分中。在横断面研究中，这些分数被用作抑郁严重程度的代表，随着时间的推移，总分的差异被用来反映潜在抑郁结构的变化。为了允许这样的解释，评定量表必须（a）测量一个单一的结构，（B）以相同的方式跨时间测量该结构。这些要求被称为一维性和测量不变性。我们在2项大型前瞻性研究（合并n = 3，509）中调查了这2项要求，其中总体抑郁水平降低，检查了4种常见抑郁评定量表（1种自我报告，3种临床医生报告），评估之间的时间间隔不同（6周至2年）。出现了一致的结果模式。对于所有的仪器，无论是单维性还是测量不变性似乎都站不住脚。描述每个量表至少需要3个因子，并且因子结构随着时间的推移而变化。通常情况下，随着抑郁症严重程度的降低，结构变得不那么多因素（但没有达到单维度）。总分的下降伴随着总分方差的增加和内部一致性的增加。这些研究结果挑战了通常对总分及其变化的解释，因为它们反映了1个基本结构。违反共同的测量要求是足够严重的抑郁症总分的形成，而不是反射措施的替代解释。我们讨论了这些违规行为的可能原因，如响应偏移偏差，范围的限制，回归到平均值。
In depression research, symptoms are routinely assessed via rating scales and added to construct sum-scores. These scores are used as a proxy for depression severity in cross-sectional research, and differences in sum-scores over time are taken to reflect changes in an underlying depression construct. To allow for such interpretations, rating scales must (a) measure a single construct, and (b) measure that construct in the same way across time. These requirements are referred to as unidimensionality and measurement invariance. We investigated these 2 requirements in 2 large prospective studies (combined n = 3,509) in which overall depression levels decrease, examining 4 common depression rating scales (1 self-report, 3 clinician-report) with different time intervals between assessments (between 6 weeks and 2 years). A consistent pattern of results emerged. For all instruments, neither unidimensionality nor measurement invariance appeared remotely tenable. At least 3 factors were required to describe each scale, and the factor structure changed over time. Typically, the structure became less multifactorial as depression severity decreased (without however reaching unidimensionality). The decrease in the sum-scores was accompanied by an increase in the variances of the sum-scores, and increases in internal consistency. These findings challenge the common interpretation of sum-scores and their changes as reflecting 1 underlying construct. The violations of common measurement requirements are sufficiently severe to suggest alternative interpretations of depression sum-scores as formative instead of reflective measures. We discuss the possible causes of these violations such as response shift bias, restriction of range, and regression to the mean.