(PS4-14) Improved Scoring of the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R): An Item Response Theory Analysis

The Center for Epidemiologic Studies Depression Scale – Revised (CESD-R) is a popular self-report screening measure for depression that has been validated in various populations and demonstrated configural, metric, and scalar measurement invariance between biological males and females in large, racially diverse samples. A 20-item questionnaire with scores ranging from 0 to 4 for each item, the CESD-R can produce total scores ranging from 0 to 80. However, the typical scoring protocol for the CESD-R collapses the two most severe response options and restricts the range of possible total scores to 0 to 60 to retain the same range and clinical cutoff scores as the original CES-D. Surprisingly, despite the widespread adoption of this practice, the psychometric impact of this scoring approach has never been systematically examined. In an undergraduate and community adult sample (n = 869), item response theory analyses, including examination of test and item information curves as well as item thresholds, indicated that scoring the CESD-R with all 5 response options (which we refer to as the CESD-R5) provided nearly twice as much information about a person’s latent depression for individuals with high levels of depression than did scoring the CESD-R conventionally, with 4 response options per item (i.e., the CESD-R4). The CESD-R5 retained the strong reliability and factor structure of the CESD-R4 and was more sensitive to individual differences for participants at high levels of depression compared to the CESD-R4. Finally, we conducted comparisons of percentile scores for the CESD-R4 and CESD-R5 to estimate the scaling differences and ascertain whether different clinical cutoff scores would be needed for the CESD-R5. Results provide preliminary evidence that researchers and clinicians should score the CESD-R using the full 0 to 80 scale and provide initial guidance for adjusting previously established CESD-R clinical cutoffs scores for use with the CESD-R5.