Author | Reichenheim, Michael Eduardo | pt_BR |
Author | Moraes, Claudia L. | pt_BR |
Author | Oliveira, Alessandra S. D. | pt_BR |
Author | Lobato, Gustavo | pt_BR |
Access date | 2014-09-22T12:40:41Z | |
Available date | 2014-09-22T12:40:41Z | |
Document date | 2011 | pt_BR |
Citation | REICHENHEIM, Michael E. et al. Revisiting the dimensional structure of the Edinburgh Postnatal Depression Scale (EPDS): empirical evidence for a general factor. BMC Medical Research Methodology, London, v. 11, n. 93, p. 1-12, 2011. | pt_BR |
ISSN | 1471-2288 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/8416 | |
Sponsorship | Fundação Carlos Chagas Filho de Amparo
à Pesquisa do Estado do Rio de Janeiro. Brazilian National Research Council. Primary Health Care. | pt_BR |
Language | eng | pt_BR |
Publisher | BioMed Central | pt_BR |
Rights | open access | pt_BR |
Title | Revisiting the dimensional structure of the Edinburgh Postnatal Depression Scale (EPDS): empirical evidence for a general factor | pt_BR |
Type | Article | pt_BR |
DOI | 10.1186/1471-2288-11-93 | pt_BR |
Abstract | Background: The Edinburgh Postnatal Depression Scale (EPDS) has been proposed as a one-dimensional instrument and used as a single 10-item scale. This might be considered questionable since repeated psychometric studies have shown multi-dimensionality, which would entail using separate component subscales. This study reappraised the dimensional structure of the EPDS, with a focus on the extent of factor correlations and related factor-based discriminant validity as a foundation for deciding how to effectively scale the component items. Methods: The sample comprised 811 randomly selected mothers of children up to 5 months attending primary health services of Rio de Janeiro, Brazil. Strict Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis modeled within a CFA framework (E/CFA) were sequentially used to identify best fitting and parsimonious model (s), including a bifactor analysis to evaluate the existence of a general factor. Properties concerning the related 10-item raw-score scale were also investigated using non-parametric items response theory methods (scalability and monotonicity). Results: An initial CFA rejected the one-dimensional structure, while an E/CFA subscribed a three-dimensional solution. Yet, factors were highly correlated (0.66, 0.75 and 0.82). The ensuing CFA showed poor discriminant validity (some square-roots of average variance extracted below the factor correlations). A general bifactor CFA was then fit. Results suggested that, although still weakly encompassing three specific factors, the EPDS might be better described by a model encompassing a general factor (loadings ranging from 0.51 to 0.81). The related 10-item raw score showed adequate scalability (Loevinger’s H coefficient = 0.4208), monotonicity e partial double monotonicity (nonintersections of Item Step Response Functions). Conclusion: Although the EPDS indicated the presence of specific factors, they do not qualify as independent dimensions if used separately and should therefore not be used empirically as sub-scales (raw scores). An allencompassing scale seems better suited and continuing its use in clinical practice and applied research should be encouraged. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil / Universidade Estácio de Sá. Programa de Mestrado em Saúde da Família. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Faculdade Bezerra de Araújo. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | Edinburgh Postnatal Depression Scale | pt_BR |
Subject | Mothers | pt_BR |
Subject | Children | pt_BR |
DeCS | Depressão Pós-Parto | pt_BR |
DeCS | Mães | pt_BR |
DeCS | Ciança | pt_BR |