In an earlier post I discussed methodology designed to create a measurement instrument which combines ethnographic and quantitative methods aimed at recognizing idioms of distress among individuals within a specific population. In today’s post I will discuss a measurement designed to work in various contexts to measure depression. This measure is called The Center for Epidemiologic Studies Depression Scale (CES-D). This scale was created in 1977 by Lenore Radloff. Radloff created the scale using items derived from previous depression scales. The items reflect components which were gleaned from studies of depression and include; depressed mood, feelings of hopelessness and helplessness, loss of appetite, sleep disturbance, and reduced psychomotor functioning. The CES-D uses a Likert scale ranging from 0 to 3, reflecting the frequency of occurrence of the items in the scale. There are 20 items in the scale, therefore the scores range from 0 to 60. A score of 16 or above is usually considered a marker for people who are at risk for clinical depression. Scores of 16 to 26 are usually considered indicative of mild depression and scores of 27 or more indicate major depression.
The scale has been used throughout the world and there have also been short form 10 item and 4 item scales developed. Of particular interest to me are short form versions of the scale which I intend to use in the Bribri village of Yorkin. Grzywacz et al. (2014) tested several versions of the 10 item CES-D among seven Mexican immigrant communities within the United States. They found consistent reliability of the scales among the various populations. Also of interest, Kim et al. (2011) found that Hispanics tend to endorse positive items in the scale more frequently than whites or blacks in the United States. Grzywacz et al. (2010) used the 4 item form among Latino farm workers in the U.S. and found a mean score of 6.17
To my knowledge there have been no studies published reporting the use of the scale among indigenous communities in Costa Rica and Panama, where the Bribri currently reside. It is my intention to use the scale in Yorkin and compare its results to a scale which I will develop using the methods previously described and published by Weaver and Kaiser (2014). By comparing the two scales I will be able to determine if what the Bribri are describing as “depresión” is the same as the concept of depression that the CES-D scale is measuring.
You can check out an online version of the scale here: http://cesd-r.com/
Below I have included the full 20 item scale.
Center for Epidemiologic Studies Depression Scale (CES-D), NIMH
Below is a list of the ways you might have felt or behaved. Please tell me how often you have felt this way during the past week.
Rarely or none of the time (less than1 day ) Some or a little of the time (1-2 days)Occasionally or a moderate amount of time (3-4 days) Most or all of the time (5-7 days)
- I was bothered by things that usually don’t bother me.
- I did not feel like eating; my appetite was poor.
- I felt that I could not shake off the blues even with help from my family or friends.
- I felt I was just as good as other people.
- I had trouble keeping my mind on what I was doing.
- I felt depressed.
- I felt that everything I did was an effort.
- I felt hopeful about the future.
- I thought my life had been a failure.
- I felt fearful.
- My sleep was restless.
- I was happy.
- I talked less than usual.
- I felt lonely.
- People were unfriendly.
- I enjoyed life.
- I had crying spells.
- I felt sad.
- I felt that people dislike me.
- I could not get “going.”
SCORING: zero for answers in the first column, 1 for answers in the second column, 2 for answers in the third column, 3 for answers in the fourth column. The scoring of positive items is reversed. Possible range of scores is zero to 60, with the higher scores indicating the presence of more symptomatology.