Comparing four competing models of depressive symptomatology: A confirmatory factor analytic study of 986,647 US veterans

被引:15
作者
Tsai, Jack [1 ,2 ]
Elhai, Jon D. [3 ,4 ]
Pietrzak, Robert H. [2 ,5 ]
Hoff, Rani A. [2 ,6 ]
Harpaz-Rotem, Ilan [2 ,5 ]
机构
[1] US Dept Vet Affairs, New England Mental Illness Res Educ & Clin Ctr, West Haven, CT 06516 USA
[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06510 USA
[3] Univ Toledo, Dept Psychol, Toledo, OH 43606 USA
[4] Univ Toledo, Dept Psychiat, Toledo, OH 43606 USA
[5] VA Connecticut Healthcare Syst, US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, Clin Neurosci Div, West Haven, CT 06516 USA
[6] Vet Affairs Northeast Program Evaluat Ctr, West Haven, CT 06516 USA
关键词
Depression; Veterans; Confirmatory factor analyses; OF-FIT INDEXES; MAJOR DEPRESSION; SYMPTOMS; EPIDEMIOLOGY; ANXIETY; VALIDITY; DISORDER; PHQ-9;
D O I
10.1016/j.jad.2014.04.075
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Few rigorous studies have examined the factor structure of major depression symptoms as assessed by current diagnostic systems. This study evaluated four competing models of depressive symptomatology among a large, heterogeneous sample of U.S. veterans. Methods: To determine the best fitting model of major depressive symptoms among four competing models, this study conducted a series of confirmatory factor analyses on a national sample of 986,647 U.S. veterans. Results: A two-factor model first reported by Krause, Reed, and McArdle (2010) provided superior fit to symptom-level data compared to three other models. The optimal model consists of a somatic factor including anhedonia, sleep difficulties, fatigue, appetite changes, concentration difficulties, and psychomotor agitation; and a non-somatic factor including depressed mood, feelings of worthlessness, and thoughts of death. Factorial invariance testing found this model to be invariant by gender and major depression diagnosis. Limitations: A widely used self-report measure of depression was used and the sample consisted solely of veterans so further study is needed with clinician-administered measures and non-veteran samples. Conclusions: Together, these findings support separating symptoms of major depression into somatic and non-somatic factors which may have clinical relevance, and help clarify debates about the factor structure of depressive symptoms. Published by Elsevier B.V.
引用
收藏
页码:166 / 169
页数:4
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