Cited by 837Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

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Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung

Shafer, Alan B.·2006·Journal of Clinical Psychology

DOI 10.1002/jclp.20213

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Abstract

Four separate metaanalyses of factor analyses were conducted for the Beck Depression Inventory (BDI), the Center for Epidemiological Studies Depression Scale (CES-D), the Hamilton Rating Scale for Depression (HRSD), and the Zung Self-Rating Depression Scale (SDS). The total number of participants (N) and studies (k) included in each of the metaanalyses were the following: BDI (N = 13,643, k = 33), CES-D (N = 22,340, k = 28), HRSD (N = 2,606, k = 17), and SDS (N = 12,621, k = 13). Metaanalysis results suggest that the specific depression symptom factors within each test appear to be relatively robust and well established and match fairly closely previously hypothesized factor structures. A general Depression Severity factor and a small Somatic Symptoms factor are found in all four tests and two tests had a small Positive Affect factor. There were fewer common specific depression symptom factors across tests than expected.

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The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
A rating scale for depression
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
Psychometric theory (2nd ed.).
Sitgreaves, R. (1979) · Contemporary Psychology · doi:10.1037/018882 · Cited by 14,384
Journal of Clinical Psychiatry
(2018) · Journal of Clinical Psychiatry · doi:10.5505/kpd · Cited by 13,703
Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988) · Clinical Psychology Review · doi:10.1016/0272-7358(88)90050-5 · Cited by 11,696
A self-rating depression scale
ZUNG, W. W. K. (1965) · Archives of General Psychiatry · doi:10.1001/archpsyc.1965.01720310065008 · Cited by 9,813
Development of a Rating Scale for Primary Depressive Illness
Hamilton, M. (1967) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1967.tb00530.x · Cited by 8,410
Meta-Analytic Procedures for Social Research
Rosenthal, R. (1991) · doi:10.4135/9781412984997 · Cited by 4,635
Simultaneous Factor Analysis in Several Populations
Jöreskog, K. G. (1971) · Psychometrika · doi:10.1007/bf02291366 · Cited by 2,051

Show all 111 references

Research works printed but not linked: 3

Hedlund, 1979, Journal of Operational Psychiatry, 10, 51
National Institute of Mental Health. ( 2003). Breaking ground, breaking through: The Strategic Plan for Mood Disorders Research (NIH Publication No. 03-5121). Washington, DC: National Institutes of Health.
von Giesen, 2001, Journal of Neuropsychiatry & Clinical Neurosciences, 13, 88, 10.1176/appi.neuropsych.13.1.88 · DOI

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Vrieze, E., Demyttenaere, K., Bruffaerts, R., Hermans, D., Pizzagalli, D. A., Sienaert, P., Hompes, T., de Boer, P., Schmidt, M., & Claes, S. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.10.020 · Cited by 138
“The most commonly identified factors in MDD are a depression severity factor and a somatic factor (Shafer, 2006).”
Determining the quality and effectiveness of surgical spine care: patient satisfaction is not a valid proxy
Godil, S. S., Park, P., Zuckerman, S. L., Mendenhall, S. K., Devin, C. J., Asher, A. L., & McGirt, M. J. (2013) · The Spine Journal · doi:10.1016/j.spinee.2013.04.008 · Cited by 148
A randomized controlled trial of internet-based therapy in depression
Moritz, S., Schilling, L., Hauschildt, M., Schröder, J., & Treszl, A. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.006 · Cited by 140
The association between internet addiction and self-injurious behaviour among adolescents
Lam, L. T.-M., Peng, Z., Mai, J., & Jing, J. (2009) · Injury Prevention · doi:10.1136/ip.2009.021949 · Cited by 140
Impaired theory of mind in first-episode schizophrenia: comparison with community, university and depressed controls
Kettle, J. W. L., O'Brien-Simpson, L., & Allen, N. B. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2007.11.011 · Cited by 134
The mediating role of Internet addiction in depression, social anxiety, and psychosocial well-being among adolescents in six Asian countries: a structural equation modelling approach
Lai, C. M., Mak, K. K., Watanabe, H., Jeong, J., Kim, D., Bahar, N., Ramos, M., Chen, S., & Cheng, C. (2015) · Public Health · doi:10.1016/j.puhe.2015.07.031 · Cited by 145
Stress-related anhedonia is associated with ventral striatum reactivity to reward and transdiagnostic psychiatric symptomatology
Corral-Frías, N. S., Nikolova, Y. S., Michalski, L. J., Baranger, D. A. A., Hariri, A. R., & Bogdan, R. (2015) · Psychological Medicine · doi:10.1017/s0033291715000525 · Cited by 132
Measurement equivalence of the CES-D 8 in the general population in Belgium: a gender perspective
de Velde, S. V. V., Levecque, K., & Bracke, P. (2009) · Archives of Public Health · doi:10.1186/0778-7367-67-1-15 · Cited by 140
“International literature shows the CES-D 20 to have good psychometric properties (17, 36, 49).”
Background
Ventral striatum reactivity to reward and recent life stress interact to predict positive affect
Nikolova, Y. S., Bogdan, R., Brigidi, B. D., & Hariri, A. R. (2012) · Biological Psychiatry · doi:10.1016/j.biopsych.2012.03.014 · Cited by 130
Interaction between Oxytocin Genotypes and Early Experience Predicts Quality of Mothering and Postpartum Mood
Mileva‐Seitz, V. R., Steiner, M. S., Atkinson, L. R., Meaney, M. J., Levitan, R. D., Kennedy, J. L., Sokolowski, M. B., & Fleming, A. S. (2013) · PLoS ONE · doi:10.1371/journal.pone.0061443 · Cited by 134
Longitudinal Study on Poor Sleep and Life Dissatisfaction in a Nationwide Cohort of Twins
Paunio, T., Korhonen, T., Hublin, C., Partinen, M., Mika Kivimaki, B., Koskenvuo, M. J., & Kaprio, J. A. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn305 · Cited by 128
Positive Psychotherapy for Smoking Cessation: A Pilot Randomized Controlled Trial
Kahler, C. W., Spillane, N. S., Day, A. M., Cioe, P. A., Parks, A. C., Leventhal, A. M., & Brown, R. A. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv011 · Cited by 124
Race/ethnicity and the factor structure of the Center for Epidemiologic Studies Depression Scale: A meta-analysis.
Kim, G., DeCoster, J., Huang, C.-H. S., & Chiriboga, D. A. (2011) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/a0025434 · Cited by 125
Caught in a bad romance: Perfectionism, conflict, and depression in romantic relationships.
Mackinnon, S. P., Sherry, S., Antony, M. M., Stewart, S. H., Sherry, D. L., & Hartling, N. (2012) · Journal of Family Psychology · doi:10.1037/a0027402 · Cited by 140
Anhedonia as a component of the tobacco withdrawal syndrome.
Cook, J. W., Piper, M. E., Leventhal, A. M., Schlam, T. R., Fiore, M. C., & Baker, T. B. (2014) · Journal of Abnormal Psychology · doi:10.1037/abn0000016 · Cited by 123
“However, substantial psychopathology symptom data show that anhedonia is psychometrically distinct from negative affect forms of distress (Cook, Spring, McChargue, & Hedeker, 2004; Leventhal, Chasson, Tapia, Miller, & Pettit, 2006; Shafer, 2006).”
Background
Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China
Yang, L., Jia, C.-X., & Qin, P. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0458-1 · Cited by 134
Assessment of late-life depression via self-report measures: a review
Balsamo, M., Cataldi, F., Carlucci, L., Padulo, C., & Fairfield, B. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s178943 · Cited by 137
Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life
Park, P., Godil, S. S., Mendenhall, S. K., Zuckerman, S. L., Shau, D. N., & McGirt, M. J. (2014) · Journal of Neurosurgery Spine · doi:10.3171/2014.3.spine1320 · Cited by 120
Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy?
Dombrovski, A. Y., Cyranowski, J. M., Mulsant, B. H., Houck, P. R., Buysse, D. J., Andreescu, C., Thase, M. E., Mallinger, A. G., & Frank, E. (2008) · Depression and Anxiety · doi:10.1002/da.20467 · Cited by 116
“the HRSD-17 factor structure.([20]) We chose the above cutoffs rather than continuous subscale scores because of the limited internal consistency of the HRSD-17 subscales,([9,19]) probably reflecting insufficient unidimensionality of the scale as a whole.”
Background
Factors of PTSD: Differential specificity and external correlates
Gootzeit, J., & Markon, K. E. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.06.005 · Cited by 118
Factor Structures of the Rosenberg Self-Esteem Scale
Huang, C., & Dong, N. (2011) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000101 · Cited by 114
The German version of the Centre for Epidemiological Studies Depression Scale for Children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents – results of the BELLA study
The BELLA Study Group, Barkmann, C., Erhart, M., & Schulte‐Markwort, M. (2008) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-1013-0 · Cited by 113
Treatment resistant depression as a failure of brain homeostatic mechanisms: Implications for deep brain stimulation
Giacobbe, P., Mayberg, H. S., & Lozano, A. M. (2009) · Experimental Neurology · doi:10.1016/j.expneurol.2009.04.028 · Cited by 112
Co‐morbid OSA and insomnia increases depression prevalence and severity in men
Lang, C. J., Appleton, S. L., Vakulin, A., McEvoy, R. D., Wittert, G. A., Martin, S. A., Catcheside, P. G., Antic, N. A., Lack, L., & Adams, R. J. (2017) · Respirology · doi:10.1111/resp.13064 · Cited by 111
Development of the CAT-ANX: A Computerized Adaptive Test for Anxiety
Gibbons, R. D., Weiss, D. J., Pilkonis, P. A., Frank, E., Moore, T., Kim, J. B., & Kupfer, D. J. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13020178 · Cited by 110
Twelve-year depressive symptom trajectories and their predictors in a community sample of older adults
Andreescu, C., Chang, C.-C. H., Mulsant, B. H., & Ganguli, M. (2007) · International Psychogeriatrics · doi:10.1017/s1041610207006667 · Cited by 110
“We note that profiles 1 to 3 above – core mood, anhedonia/vegetative symptoms, and self-esteem/interpersonal difficulties – derived from the mCESD, are consistent with those described recently by Shafer (2006) in a metaanalysis of factor analyses of the original CES-D (Radloff, 1977).”
Method
PROMIS Pediatric Anger Scale: an item response theory analysis
Irwin, D. E., Stucky, B. D., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J., Yeatts, K. B., Varni, J. W., & DeWalt, D. A. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9969-5 · Cited by 106
“These results of unidimensionality are consistent with a recent meta-analysis [34] and other published studies [35– 40].”
Result
Life satisfaction and happiness associated with depressive symptoms among university students: a cross-sectional study in Korea
Seo, E. H., Kim, S.-G., Kim, S. H., Kim, J. H., Park, J. H., & Yoon, H. (2018) · Annals of General Psychiatry · doi:10.1186/s12991-018-0223-1 · Cited by 113
Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care
Romera, I., Delgado-Cohen, H., Pérez, T., Caballero, L., & Gilaberte, I. (2008) · BMC Psychiatry · doi:10.1186/1471-244x-8-4 · Cited by 106
“There is evidence that patients with different depressive symptom profiles are likely to have different prognosis and therefore might require a different therapeutic approach [9].”
Factor Structure of the Center for Epidemiological Studies Depression Scale in Hong Kong Adolescents
Lee, S. W., Stewart, S. M., Byrne, B. M., Wong, J. P. S., Ho, S. Y., Lee, P. W. H., & Lam, T. (2008) · Journal of Personality Assessment · doi:10.1080/00223890701845385 · Cited by 105
“The findings have been inconsistent, although Shafer (2006) found the four-factor structure described by Radloff (1977) to be the most common.”
Background
Response shifts in mental health interventions: An illustration of longitudinal measurement invariance.
Fokkema, M., Smits, N., Kelderman, H., & Cuijpers, P. J. (2013) · Psychological Assessment · doi:10.1037/a0031669 · Cited by 104
Predictors of residual sleepiness in adequately treated obstructive sleep apnoea patients
Koutsourelakis, I., Perraki, E., Economou, N.-T., Dimitrokalli, P., Vagiakis, E., Roussos, C., & ZAKYNTHINOS, S. G. (2009) · European Respiratory Journal · doi:10.1183/09031936.00124708 · Cited by 105
Character Strengths – Stability, Change, and Relationships with Well-Being Changes
Gander, F., Hofmann, J., Proyer, R. T., & Ruch, W. (2019) · Applied Research in Quality of Life · doi:10.1007/s11482-018-9690-4 · Cited by 113
“The CES-D is one of the most frequently used measures for depressive symptoms and has good psychometric properties (Shafer, 2006).”
Method
Depressive Symptoms, Race, and Circulating C-Reactive Protein: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Deverts, D. J., Cohen, S., DiLillo, V. G., Lewis, C. E., Kiefe, C. I., Whooley, M. A., & Matthews, K. A. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181ec4b98 · Cited by 104
“a recent meta-analysis of 28 studies (33).”
Morningness–eveningness, depressive symptoms, and emotional eating: A population-based study
Konttinen, H. M., Kronholm, E., Partonen, T., Kanerva, N., Männistö, S., & Haukkala, A. (2014) · Chronobiology International · doi:10.3109/07420528.2013.877922 · Cited by 107
“The structure of the CES-D scale has been widely studied, and a metaanalysis of 28 studies (Shafer, 2006) concluded that the 4-factor structure (negative affect, somatic and retarded activity, lack of positive affect, and interpersonal difficulties) proposed by Radloff (1977) best described the…”
Background
Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial
Pagoto, S., Schneider, K. L., Whited, M. C., Oleski, J. L., Merriam, P. A., Appelhans, B. M., Ma, Y., Olendzki, B. C., Waring, M. E., Busch, A. M., et al. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.25 · Cited by 106
“One reason for the discrepancy is that the HRSD has a larger number of items pertaining to somatic symptoms relative to cognitive and behavioral symptoms compared to the BDI.[43] Obesity and its comorbid physical conditions (e.”
Background
Toward a Better Understanding of What Makes Positive Psychology Interventions Work: Predicting Happiness and Depression From the Person × Intervention Fit in a Follow‐Up after 3.5 Years
Proyer, R. T., Wellenzohn, S., Gander, F., & Ruch, W. (2015) · Applied Psychology: Health and Well-Being · doi:10.1111/aphw.12039 · Cited by 101
“The CES-D is frequently used in research (for an overview see Shafer, 2006).”
BackgroundMethod
Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape Town, South Africa: a cross-sectional association model
TUCKER, A. M., Liht, J., de Swardt, G., Jobson, G. A., Rebe, K. B., McIntyre, J. A., & Struthers, H. E. (2013) · AIDS Care · doi:10.1080/09540121.2013.859652 · Cited by 100
“Nevertheless, our preliminary checks for the congeneric measurement model indicated that the structure of the CES-D was not unidimensional (not unlike other research; see for example: Edwards, Cheavens, Heiy, & Cukrowicz, 2010; Giyeon, DeCoster, Chao-Hui, & Chiriboga, 2011; Shafer, 2006).”
A national evaluation of parenting programs in Sweden: The short-term effects using an RCT effectiveness design.
Stattin, H., Enebrink, P., Özdemir, M., & Giannotta, F. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0039328 · Cited by 104

Authors: Shafer, A. B.
Corresponding author: Shafer, Alan B.
Venue: Journal of Clinical Psychology
Publisher: Wiley
Published: 2005
Volume: 62
Issue: 1
Pages: 123-146
ISSN: 0021-9762 (ISSN-L)
1097-4679
DOI: 10.1002/jclp.20213
OpenAlex: W2170701421
Cited by: 837
References: 111
Citations by year: 2026: 31 · 2025: 23 · 2024: 34 · 2023: 35 · 2022: 25 · 2021: 28 · 2020: 49 · 2019: 51 · 2018: 76 · 2017: 58 · 2016: 49 · 2015: 51 · 2014: 61 · 2013: 69 · 2012: 45
FWCI: 2.17
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm, 3895 d)
Locations: Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: factor structure, Beck Depression Inventory, CES-D, Hamilton Depression Rating Scale, Zung Self-Rating Depression Scale, depression severity, somatic symptoms, positive affect
MeSH terms: Depressive Disorder, Factor Analysis, Statistical, Humans, Psychological Tests, Surveys and Questionnaires

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Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung

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