Challenges in assessing depressive symptoms in Fiji: A psychometric evaluation of the CES-D

April Opoliner, Deborah Blacker, Garrett Fitzmaurice, Anne Becker

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background and Aim: The CES-D is a commonly used self-report assessment for depressive symptomatology. However, its psychometric properties have not been evaluated in Fiji. This study aims to evaluate the reliability and validity of English language and Fijian vernacular versions in ethnic Fijian adolescent schoolgirls. Methods: As part of the HEALTHY Fiji study, ethnic Fijian female adolescents (N = 523) completed the CES-D. Participants selected to respond in English or the local vernacular. Reliability (internal consistency, item-total score correlation, and test-retest estimates), validity (associations with other proxies for depression) and factor structure were assessed. Evaluations considered differences between language versions. Results: In this sample, the CES-D had a Cronbach's α of 0.81 and item-total score correlation coefficients ranged between 0.2 and 0.63. One week test-retest reliability (ICC(2)) was 0.57. CES-D scores were higher among individuals who endorsed feelings of depression and suicidality compared to those who did not. ROC analyses of the CES-D versus binary depression and suicidality variables produced AUCs around 0.70 and did not support a discrete cut-off for significant disturbance. Findings were similar across the two language groups. Conclusions: The CES-D has acceptable reliability and validity among ethnic Fijian female adolescents in English and in the Fijian vernacular language. Findings support its utility as a dimensional measure for depressive symptomatology in this study population. Further examination of its clinical utility for case finding for depression in Fijian school-based and community populations is warranted.

Original languageEnglish
Pages (from-to)367-376
Number of pages10
JournalInternational Journal of Social Psychiatry
Volume60
Issue number4
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • CES-D
  • Fiji
  • cross-cultural
  • reliability
  • validity

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