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Abstract
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CONTEXT: Depression is among the most common mental health disorder in youth, results in significant impairment, and is associated with a higher risk of suicide. Screening is essential but assessment tools may not be appropriate across races or do not account for the complex interrelatedness of various demographics including gender, socio-economic status and race.
OBJECTIVES: (1) To determine the factor structure of the Patient Health Questionnaire-Adolescent (PHQ-A) for measuring depression in a group of adolescent athletes; and (2) to determine measurement invariance between Blacks and Whites on the PHQ-A.
DESIGN: Retrospective cohort design. SETTING: Data obtained from a secure database collected at a free, comprehensive, mass pre-participation physical exam (PPE) event hosted by a large health care system. PARTICIPANTS: Participants included 683 high school athletes (Black n=416; White n=267). Independent variables included somatic and affective factors contributing to the construct of depression measured by the PHQ-A and participant race (Black and White). MAIN OUTCOME MEASURES: (1) Factors upon which the construct of depression is measured and (2) measurement invariance between Blacks and Whites.
RESULTS: A two-factor model, including affective and somatic components, was specified and exhibited an adequate fit to the data (CFI>.90). All items exhibited moderate to high squared multiple correlation values (R2 =.10-.65), suggesting that these items resonated relatively well with participants. The two-factor model demonstrated noninvariance Black and White participants (RMSEA =.06-.08).
CONCLUSIONS: Overall, the structure of the PHQ-A is supported by a two-factor model in adolescent athletes, measuring both affective and somatic symptoms of depression. A two factor PHQ-A structure is not fully invariant for the adolescents sampled across participant groups, implying that the model functions differently between Blacks and Whites sampled.
Language: en |