Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon
Identifieur interne : 001509 ( Istex/Corpus ); précédent : 001508; suivant : 001510Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon
Auteurs : Shahe S. KazarianSource :
- International Journal of Social Psychiatry [ 0020-7640 ] ; 2009-09.
Abstract
Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.
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DOI: 10.1177/0020764008100548
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title><author wicri:is="90%"><name sortKey="Kazarian, Shahe S" sort="Kazarian, Shahe S" uniqKey="Kazarian S" first="Shahe S." last="Kazarian">Shahe S. Kazarian</name><affiliation><mods:affiliation>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: sk29@aub.edu.lb</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1177/0020764008100548</idno><idno type="url">https://api.istex.fr/document/DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001509</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001509</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title><author wicri:is="90%"><name sortKey="Kazarian, Shahe S" sort="Kazarian, Shahe S" uniqKey="Kazarian S" first="Shahe S." last="Kazarian">Shahe S. Kazarian</name><affiliation><mods:affiliation>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon,</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: sk29@aub.edu.lb</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Social Psychiatry</title><idno type="ISSN">0020-7640</idno><idno type="eISSN">1741-2854</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2009-09">2009-09</date><biblScope unit="volume">55</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="442">442</biblScope><biblScope unit="page" to="448">448</biblScope></imprint><idno type="ISSN">0020-7640</idno></series><idno type="istex">DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2</idno><idno type="DOI">10.1177/0020764008100548</idno><idno type="ArticleID">10.1177_0020764008100548</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0020-7640</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.</div></front></TEI><istex><corpusName>sage</corpusName><author><json:item><name>Shahe S. Kazarian</name><affiliations><json:string>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon,</json:string><json:string>E-mail: sk29@aub.edu.lb</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Armenian CES-D</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>facture structure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>depression</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>well-being</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ethnic Armenians in Lebanon</value></json:item></subject><articleId><json:string>10.1177_0020764008100548</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.</abstract><qualityIndicators><score>6.734</score><pdfVersion>1.5</pdfVersion><pdfPageSize>481.89 x 691.654 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1426</abstractCharCount><pdfWordCount>3154</pdfWordCount><pdfCharCount>20281</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>215</abstractWordCount></qualityIndicators><title>Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title><genre><json:string>research-article</json:string></genre><host><volume>55</volume><publisherId><json:string>ISP</json:string></publisherId><pages><last>448</last><first>442</first></pages><issn><json:string>0020-7640</json:string></issn><issue>5</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1741-2854</json:string></eissn><title>International Journal of Social Psychiatry</title></host><categories><wos><json:string>social science</json:string><json:string>psychiatry</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>psychiatry</json:string></scienceMetrix></categories><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1177/0020764008100548</json:string></doi><id>DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><availability><p>SAGE</p></availability><date>2009</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title><author xml:id="author-1"><persName><forename type="first">Shahe S.</forename><surname>Kazarian</surname></persName><email>sk29@aub.edu.lb</email><affiliation>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon,</affiliation></author></analytic><monogr><title level="j">International Journal of Social Psychiatry</title><idno type="pISSN">0020-7640</idno><idno type="eISSN">1741-2854</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2009-09"></date><biblScope unit="volume">55</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="442">442</biblScope><biblScope unit="page" to="448">448</biblScope></imprint></monogr><idno type="istex">DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2</idno><idno type="DOI">10.1177/0020764008100548</idno><idno type="ArticleID">10.1177_0020764008100548</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Armenian CES-D</term></item><item><term>facture structure</term></item><item><term>depression</term></item><item><term>well-being</term></item><item><term>ethnic Armenians in Lebanon</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">spisp</journal-id><journal-id journal-id-type="publisher-id">ISP</journal-id><journal-title>International Journal of Social Psychiatry</journal-title><issn pub-type="ppub">0020-7640</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/0020764008100548</article-id><article-id pub-id-type="publisher-id">10.1177_0020764008100548</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kazarian</surname><given-names>Shahe S.</given-names></name><aff>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon, <email xlink:type="simple">sk29@aub.edu.lb</email></aff></contrib></contrib-group><pub-date pub-type="ppub"><month>09</month><year>2009</year></pub-date><volume>55</volume><issue>5</issue><fpage>442</fpage><lpage>448</lpage><abstract><p><bold>Background:</bold> The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon.</p><p><bold>Method:</bold> A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated.</p><p><bold>Results:</bold> Two factors correlating <italic>r</italic> = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated <italic>r</italic> = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated <italic>r</italic> = 0.34 with Armenian CES-D scores. Depression scores correlated <italic>r</italic> = —0.39 with psychological well-being scores, <italic> r</italic> = —0.34 with mood ratings and <italic>r</italic> = —0.23 with family functioning scores; the comparable correlations for well-being scores were <italic>r</italic> = —0.46, <italic>r</italic> = —0.41, and <italic>r</italic> = —0.33, respectively.</p><p><bold>Conclusions:</bold> The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.</p></abstract><kwd-group><kwd>Armenian CES-D</kwd><kwd>facture structure</kwd><kwd>depression</kwd><kwd>well-being</kwd><kwd>ethnic Armenians in Lebanon</kwd></kwd-group><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>442 Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon SAGE Publications, Inc. 200910.1177/0020764008100548 Shahe S.Kazarian Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon, sk29@aub.edu.lb ABSTRACT Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale. Armenian CES-D facture structure depression well-being ethnic Armenians in Lebanon BACKGROUND The Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977) is a widely used self-report tool for the assessment of depressive complaints among men and women in the com- munity and clinical and primary healthcare settings. The scale was developed for the assessment of four major components of depression in white adults in the USA: depressive affect (seven items); lack of positive affect or well-being (four items); somatic and retarded activity (seven items); and interpersonal sensitivity (two items). Radloff (1977) conducted principal components factor 443 analyses of the 20-items of the CES-D in three community samples of whites and blacks in the USA and supported a four-factor solution for the scale across the groups. Since the inception of the CES-D, the measure has been translated into a variety of languages for use in North America with such ethnic groups as Armenians (Vartan, 1997), Koreans (Noh et al., 1992), Hispanics (e.g. Chiriboga et al., 2007) and Japanese (e.g. Kanazawa et al., 2007), and in western European and Asian countries including Italy (Fava, 1983), Germany (Hautzinger, 1988), France (Fuhrer & Rouillon, 1989), the Netherlands (Spijker et al., 2004), Spain (Vázquez & Blanco, 2006), Greece (Fountoulakis et al., 2007), Portugal (Goncalves & Fagulha, 2004), China (e.g. Cheung & Bagley, 1998), India (Gupta et al., 2006), and Korea (Kim et al., 2007). The studies that have examined the cultural appropriateness of the CES-D have focused on maj- ority and minority ethnicities in the pluralist North American or western European host societies. Only one study has evaluated the CES-D on a majority group in the Middle East (Ghubash et al., 2000) and reported a three-factor solution for the scale, a nding consistent with a number of studies in North America (e.g. Ying, 1998) but at variance with other studies in which two- or four-factor solutions (e.g. Boisvert et al., 2003) have been found. In view of the limited application of the CES-D in non-western cultural contexts and considering the lack of clarity regarding its cultural appropriateness to ethnic minorities in pluralistic Middle Eastern societies, the validity of an Armenian translation of the CES-D in the religiously and ethnically diverse Lebanese society was evaluated. Ethnic Armenians in the Middle Eastern Lebanon, a community estimated to be no more than 105,000 people (Tololyan, 2000), represent a distinctive culture in terms of the Indo-European Armenian language, Christian heritage, traditional loyalty to family, collective memory of persecution and displacement in the early 20th century, exposure to intermittent social strife and a protracted civil war of 15 years’ duration (1975–1990), and ongoing negotiation of not only ethnic identity among Christian and Muslim Arabs and other minority religious groups such as the Druze, but also the potential for discrimination and marginalization in host Middle Eastern communities. METHODS Setting and procedure A convenient community sample of 172 Armenians residing in the capital city of Greater Beirut participated in the study. The sample size was suf cient to enable evaluation of the factor structure of the Armenian CES-D. Students from two university settings (American University of Beirut and Haigazian University) and business owners, homemakers, skilled or blue collar workers and professionals from an Armenian neighborhood in the Bourj Hammoud district familiar to the research assistant were approached for participation in the study. The majority of the participants were female (63.5%), and their mean age was 36.08 years (SD = 15.14). In relation to marital status, 50% of the group reported being married and the remainder single or divorced. The majority of participants reported having university education (48.4%), followed by secondary education (41.4%), and elementary education (10.2%). Participants were invited to complete questionnaire booklets including the Armenian translations of the 20-item CES-D (Radloff, 1977), the single-item Mood Rating Scale (MR; Ontario Ministry of Health, 1992), the 14-item Armenian Psychological Well-Being Scale (PWB; Ontario Ministry of Health, 1992), and the 12-item General Family Functioning Scale (GFF; Epstein et al., 1983). Measures were administered in a randomized order to minimize the possibility of an order effect. 444 Measures All measures were translated from their original English versions into Armenian using back- translation methodology. Two experienced translators from a local Armenian university (Haigazian University) were involved in the translation process such that the original English version of the CES-D was translated into Armenian by one of the translators, and the Armenian version was then translated back into English by the second translator, independent of the rst translator. The two English versions were then compared and differences reconciled. The Armenian CES-D (Radloff, 1977) is a 20-item measure of depressive symptoms in the general population. Each depressive symptom requires ratings from 0 to 3 to indicate how often the com- plaint is experienced during the past week: 0, rarely or none of the time, < 1 day; 1, some or little of the time, 1–2 days; 2, occasionally or a moderate amount of time, 3–4 days; and 3, most or all of the time, 5–7 days. Thus, higher scores indicate higher levels of depressive symptoms. The Armenian MR (Ontario Ministry of Health, 1992) is a single-item measure of general de- pressive mood. The item was taken from the epidemiological study originally conducted by the Ontario Ministry of Health (1992). The item requires a four-point rating, 1 indicating satisfaction and interest in life and 4 indicating sad mood to a degree that life is not worth living. The Armenian PBW (Ontario Ministry of Health, 1992) is a 14-item measure of life satisfaction, positive mood, negative mood and energy in individuals in the community. Each item is rated on a four-point scale, higher scores indicating higher life satisfaction, positive mood and energy level. The internal consistency of the Armenian PBW in the present study was high (n = 170, α = 0.80). Finally, the Armenian GFF (Epstein et al., 1983) is a 12-item scale, each item requiring a four- point rating scale, higher scores re ecting higher perceived family health. The internal consistency of the Armenian GFF in the present study was high (n = 171, α = 0.85). RESULTS Principal factor analysis of the Armenian CES-D The 20 items of the Armenian CES-D were subjected to principal factor analysis using SPSS Version 16. The Kaiser-Meyer Olkin (KMO) value of 0.85 exceeded the required value of 0.6 suggesting sampling adequacy. Similarly, the Bartlett’s Test of Sphericity reached statistical signi cance (p < 0.0001), supporting the factoriability of the correlation matrix. Principal factor analysis with Oblimin rotation rather than principal component analysis with Varimax rotation was used, as the assumption of orthogonality of the CES-D components has been challenged in favour of component interdependence (Cole et al., 2004). Principal factor analysis revealed the presence of six factors with eigenvalues exceeding 1 (6.53, 1.87, 1.24, 1.22, 1.04 and 1.02), and explaining 32.7%, 9.3%, 6.2%, 6.1%, 5.2% and 5.1% of the variance. Inspection of the screeplot, which revealed a clear break after the second factor, and use of the scree test suggested retention of two rather than six factors for investigation. The two-factor solution explained, after extraction, a total of 36.2% of the variance, with the rst factor contributing 30.0% and the second contributing 6.2%. To aid in the interpretation of these two factors, Oblimin rotation was performed. The pattern matrix and structure matrix of the two-factor solution of Armenian CES-D items are provided in Table 1. As can be seen, the rst factor was a mixed depression factor comprising psychological, somatic and interpersonal complaints, whereas the second factor was a well-being factor comprising all four positively worded affective items. 445 Internal consistency of Armenian CES-D The internal consistency of the 20-item Armenian CES-D was high (n = 172, α = 0.87), a value comparable to the reliabilities of 0.84 and 0.85 reported by Radloff (1977). The internal consistencies of the empirically derived depression and well-being factors were α = 0.88 and α = 0.62. Armenian CES-D, Mood Rating and Psychological Well-Being Scales Armenian CES-D scores correlated r = –0.40 (p < 0.0001) with Armenian MR scores and r = –0.46 (p < 0.0001) with Armenian PWB scores. Similarly, Armenian CES-D-derived depression scores correlated r = –0.33 (p < 0.0001) with Armenian MR scores and r = –0.39 (p < 0.0001) with Armenian PWB scores, whereas Armenian CES-D-derived well-being scores correlated r = –0.41 (p < 0.0001) with Armenian MR scores and r = –0.44 (p < 0.0001) with Armenian PWB scores. Armenian CES-D and General Family Functioning Scale Armenian CES-D scores correlated r = –0.29 (p < 0.0001) with Armenian GWF scores. Similarly, Armenian CES-D-derived depression scores and Armenian CES-D-derived well-being scores correlated r = –0.23 (p < 0.003) and r = –0.33 (p < 0.0001) with Armenian GFF scores. Armenian CES-D and sociodemographic risk factors The correlation between Armenian CES-D, Armenian CES-D-derived depression and Armenian CES-D-derived well-being scores and age were non-signi cant (n = 160, r = –0.09, ns, r = –0.09, Table 1 Factor loadings of Armenian Center for Epidemiologic Studies Depression Scale items (n = 172) DA = depressed affect; I = interpersonal; PA = positive affect; S = somatic 446 Table 2 Means and standard deviation of Armenian CES-D scores (n = 172) by gender, education and marital status ns, r = –0.05, ns), suggesting the independence of age in the reporting of depressive symptoms in this group of Armenians. Comparisons between males and females on the Armenian CES-D showed that the scores of the Armenian females reached signi cance ((t(157) = 1.96, p < 0.051) and Armenian females obtained Armenian CES-D-derived depression and well-being scores comparable to those of males ((t(157) = 1.69, ns; and (t(157) = 1.79, ns, respectively). Similarly, education was not related to Armenian CES-D total scores (F(154) = 1.28, ns), or Armenian CES-D-derived depression scores (F(154) = 0.82, ns) or Armenian CES-D-derived well-being scores (F(154) = 1.69, ns). On the other hand, single Armenians reported signi cantly higher Armenian CES-D total scores (t(156) = 2.52, p < 0.02), Armenian CES-D-derived depression scores (t(156) = 2.02, p < 0.05), and Armenian CES-D-derived well-being scores (t(156) = 2.52, p < 0.02), than married Armenians (t(156) = 2.78, p < 0.006). Table 2 presents the Armenian CES-D scores in relation to sex, marital status and education. DISCUSSION To the best of our knowledge, this is the rst study that validates the Armenian CES-D among ethnic Armenian adults in the culturally and religiously pluralist Lebanon. In the present study, a two-factor solution was most appropriate for the Armenian CES-D, the rst factor re ecting a de- pression factor comprising psychological, somatic and interpersonal complaints, and the second re ecting a well-being factor comprising positive affect expressions. These ndings are consistent with a two-factor solution obtained in a study on the Arabic translation of the CES-D in Lebanon (Kazarian & Taher, manuscript submitted for publication) but they are at variance with the four-factor solution reported by Radloff (1977) for American whites and blacks. The discrepancy in ndings may be due to methodological differences in that Radloff (1977) used principal component analysis with Varimax rotation in contrast to the use of principal factor analysis with Oblimin rotation in the 447 present study. Alternatively, the discrepancy in ndings may re ect cultural differences in views regarding the mind–body relationship. In contrast to the European–American dualistic view of mind–body relations, and the consequent expression of depression primarily as psychological or primarily as somatic (Kanazawa et al., 2007), the psychologically, somatically and interpersonally mixed depressed mind of the Armenian may re ect their unitary view of the mind–body relation, a conceptualization consistent with the pristine presentation of the Armenian collectivist self, the cultural taboo associated with mental disorders, and the Armenian preoccupation with alter- native or primary healthcare for psychological distress. Further studies are required to replicate the present ndings and to rule out the competing explanations for the seeming differences between the western depressed mind and the Armenian depressed mind. The two-factor solution obtained in the present study suggests that the Armenian CES-D could be measuring two distinct dimensions of mental health: depression and well-being, a view consistent with the recent conceptualization of the CES-D as a continuous measure of depression and hap- piness (Joseph, 2006). The present ndings support the validity of the Armenian CES-D and the two empirically derived depression and well-being factors in that total Armenian CES-D scores and Armenian CES-D-derived depression and well-being scores correlated in the expected direc- tion with mood ratings, subjective well-being scores and family functioning scores. Nevertheless, the internal consistencies obtained in the present study supported the reliability of the Armenian CES-D and the empirically derived depression factor in the case of Armenians in Lebanon, but not the empirically derived well-being factor. Nevertheless, three depression items (being bothered, talking less, and being troubled) and one well-being item (being hopeful) had factor loadings of less than 0.40. A possible explanation for the low factor loadings of these items may be translation nuances. It would be important to conduct a qualitative study on Armenian adults to evaluate the face and content validity of the problematic items of depressive symptoms for the purpose of re ne- ment of the Armenian CES-D. Finally, Armenian CES-D scores were independent from the sociodemographic factors of age, sex and education but not marital status, suggesting that marital status but not age, sex and edu- cation constitutes a risk factor for depression in this community sample of Armenians. The higher reporting of depression and lack of well-being of single Armenians in Lebanon is consistent with previous research (Inaba et al., 2005) and is likely re ective of the cultural preoccupation of ethnic Armenians in Lebanon with the ideal of marriage in Lebanese society. These ndings are consistent with those reported in the pluralistic North American context and support the validity of the Armenian CES-D in the Armenian Lebanese context. In summary, the present study provides preliminary support to the value of the Armenian CES-D and its empirically derived depression factor as a valid, reliable and culturally appropriate scale for assessing the depressed mind of Armenian adults in the Lebanese context and the need for re- nement of the empirically derived well-being factor. Nevertheless, the present study is limited by its sample size and in its focus on Armenian adults in the urban city of Beirut. 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lang="en" contentType="CDATA"><title>Validation of the Armenian Center for Epidemiological Studies Depression Scale (Ces-D) Among Ethnic Armenians in Lebanon</title></titleInfo><name type="personal"><namePart type="given">Shahe S.</namePart><namePart type="family">Kazarian</namePart><affiliation>Department of Social and Behavioural Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107-2020, Lebanon,</affiliation><affiliation>E-mail: sk29@aub.edu.lb</affiliation></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>SAGE Publications</publisher><place><placeTerm type="text">Sage UK: London, England</placeTerm></place><dateIssued encoding="w3cdtf">2009-09</dateIssued><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Background: The aim of this paper is to report on the Armenian version of the 20-item Center for Epidemiological Studies Depression Scale (Armenian CES-D) and its validity and reliability when administered to a community sample of ethnic Armenians in Lebanon. Method: A total of 172 participants completed the Armenian CES-D Scale, the Mood Rating Scale, the Armenian Psychological Well-Being Scale and the General Family Functioning Scale. The factor structure and internal consistency of the Armenian CES-D and its correlation with the remaining measures were evaluated. Results: Two factors correlating r = 0.34 with each other were obtained. The depression factor comprised 16 psychological, somatic and interpersonal expressions of depressive symptoms and correlated r = 0.97 with Armenian CES-D scores. The well-being factor comprised four positive expressions of affect and correlated r = 0.34 with Armenian CES-D scores. Depression scores correlated r = —0.39 with psychological well-being scores, r = —0.34 with mood ratings and r = —0.23 with family functioning scores; the comparable correlations for well-being scores were r = —0.46, r = —0.41, and r = —0.33, respectively. Conclusions: The Armenian CES-D is likely measuring two distinct aspects of mental health, depression and well-being, and the depression factor may be as adequate in measuring the Armenian depressed mind as the 20-item Armenian CES-D Scale.</abstract><subject><genre>keywords</genre><topic>Armenian CES-D</topic><topic>facture structure</topic><topic>depression</topic><topic>well-being</topic><topic>ethnic Armenians in Lebanon</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Social Psychiatry</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0020-7640</identifier><identifier type="eISSN">1741-2854</identifier><identifier type="PublisherID">ISP</identifier><identifier type="PublisherID-hwp">spisp</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>55</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>442</start><end>448</end></extent></part></relatedItem><identifier type="istex">DA70A6C4B7AA68CA42CDAB9BA572FF7E63398FA2</identifier><identifier type="DOI">10.1177/0020764008100548</identifier><identifier type="ArticleID">10.1177_0020764008100548</identifier><recordInfo><recordContentSource>SAGE</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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