Unidimensionality and Measurement Invariance of the 11-Item Korean CES-D Scale among Examining Parents of Individuals with Cerebral Palsy

Parents of children with disabilities are more likely to experience depressive symptoms and other issues associated with poor mental health than parents of children without disabilities. A lack of measurement invariance in a depression scale could produce inconsistencies in study results and limit the generalizability of findings. The present study aimed to investigate the unidimensionality of the 11-item Korean version of the Center for Epidemiologic Studies Depression scale (CES-D-11) and confirm its measurement invariance among parents of individuals with cerebral palsy (CP).

Data were collected from the 2012 Korea Welfare Panel Study and from research examining support services and policies for people with brain lesions. Comparative fit index values were compared to verify the fit of the measurement invariance models.

The unidimensionality of the CES-D-11 was supported based on principal component analysis, the factor loadings of each item, and fit index (NFI = 0.932, TLI = 0.967; CFI = 0.981, RMSEA = 0.048). The invariance analysis confirmed configural invariance, metric invariance, scalar invariance, and uniqueness invariance. Internal consistency reliabilities were acceptable.

Our findings indicated that the CES-D-11 is unidimensional, and that comparisons can be made between the general population and parents of individuals with CP. Additionally, this study supplements prior literature on invariance and strengthens the validity of the CES-D-11 as a useful screening tool, particularly for comparing measurements across groups to establish measurement invariance for outcome measures.