Psychometric validation of two versions of the adolescent Depression Self-Rating Scale (DSRS-A and DSRS-A Screener)

Abstract

Aim

Examination of psychometric properties and diagnostic accuracy of the Depression Self-Rating Scale for Adolescents (DSRS-A) as well as development and evaluations of a shorter version, DSRS-A-Screener.

Methods

Analyses of component structure and internal consistency were performed in a community-based sample of adolescents N = 4,506 and among consecutive outpatients from three child psychiatric settings in Sweden (n = 137). Concurrent validity was measured as a correlation between a summation index of the scale items and the total major depressive disorder (MDD) symptom severity score from the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS). Diagnostic accuracy was examined in the clinical sample, with the K-SADS interview as the reference test, by receiver operating characteristic analysis (ROC), calculations of sensitivity, specificity among other measures. With the purpose to select items for a shorter scale, associations between scale items and MDD were examined with binary logistic regression. This shorter scale was thereafter examined similarly.

Results

Based on association with MDD, five items were selected for the brief DSRS-A Screener that showed one component structure, internal consistency Cronbach’s alpha .80 and.82, respectively. In the clinical population concurrent validity was Spearman’s rho .63 and ROC analysis showed AUC .84 (95% CI .78–.91; p < .001). The optimal cut-off for screening was 2 with sensitivity .85 and specificity of .64.

Conclusion

The DSRS-A Screener compared to the original scale, maintained or improved reliability, validity, and showed moderate diagnostic accuracy.

Keywords:

• Depression
• questionnaire
• validation study
• adolescents
• assessment

Acknowledgements

We would like to thank all the patients and parents for their participation, and all clinical staff for their help in the psychiatric clinics of Sala, Västerås and Enköping, which made this study possible. We are also grateful to Mattias Rehn for excellent data management.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the County Council of Västmanland [LTV-473811, LTV-466871, LTV-398781, LTV-379991, LTV-375811, LTV-369201, LTV-353451] and the Uppsala-Örebro Regional Research Council [RFR-475881, RFR-376361].