Christophe Maïano

Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults

BACKGROUND Previous research on the Center for Epidemiologic Studies Depression Scale (CES-D) has five main limitations. First, no study provided evidence of the factorial equivalence of this instrument across samples of depressive and community participants. Second, only one study included systematic tests of measurement invariance based on confirmatory factor analyses (CFA), and this study did not consider the higher-order factor structure of depression, although it is the CES-D global scale score that is most often used in the context of epidemiological studies. Third, few studies investigated the screening properties of the CES-D in non-English-language samples and their results were inconsistent. Fourth, although the French version of the CES-D has been used in several previous studies, it has never been systematically validated among community and/or depressed adults. Finally, very few studies have taken into account the ordered-categorical nature of the CES-D answer scale. The purpose of the study reported herein was therefore to examine the construct validity (i.e., factorial, reliability, measurement invariance, latent mean invariance, convergence, and screening properties) of the CES-D in a French sample of depressed patients and community adults. METHODS A total sample of 469 participants, comprising 163 clinically depressed patients and 306 community adults, was involved in this study. The factorial validity, and the measurement and latent mean invariance of the CES-D across gender and clinical status, were verified through CFAs based on ordered-categorical items. Correlation and receiver operator characteristic curves were also used to test the convergent validity and screening properties of the CES-D. RESULTS The present results: (i) provided support for the factor validity and reliability of a second-order measurement model of depression based on responses to the CES-D items; (ii) revealed the full measurement invariance of the first- and second-order measurement models across gender; (iii) showed the partial strict measurement invariance (four uniquenesses had to be freely estimated, but the factor variance-covariance matrix also proved fully invariant) of the first-order factor model and the complete measurement invariance of the second-order model across patients and community adults; (iv) revealed a lack of latent mean invariance across gender and across clinical and community subsamples (with women and patients reporting higher scores on all subscales and on the full scale); (v) confirmed the convergent validity of the CES-D with measures of depression, self-esteem, anxiety, and hopelessness; and (vi) demonstrated the efficacy of the screening properties of this instrument among clinical and nonclinical adults. CONCLUSION This instrument may be useful for assessing depressive symptoms or for the screening of depressive disorders in the context of epidemiological studies targeting French patients and community men and women with a background similar to those from the present study.

General Growth Mixture Analysis of Adolescents' Developmental Trajectories of Anxiety: The Impact of Untested Invariance Assumptions on Substantive Interpretations

Substantively, this study investigates potential heterogeneity in the developmental trajectories of anxiety in adolescence. Methodologically, this study demonstrates the usefulness of general growth mixture analysis (GGMA) in addressing these issues and illustrates the impact of untested invariance assumptions on substantive interpretations. This study relied on data from the Montreal Adolescent Depression Development Project (MADDP), a 4-year follow-up of more than 1,000 adolescents who completed the Beck Anxiety Inventory each year. GGMA models relying on different invariance assumptions were empirically compared. Each of these models converged on a 5-class solution, but yielded different substantive results. The model with class-varying variance–covariance matrices was retained as providing a better fit to the data. These results showed that although elevated levels of anxiety might fluctuate over time, they clearly do not represent a transient phenomenon. This model was then validated in relation to multiple predictors (mostly related to school violence) and outcomes (grade-point average, school dropout, depression, loneliness, and drug-related problems).

Prevalence and risk factors of overweight and obesity among children and adolescents with intellectual disabilities

Recent literature reviews showed that overweight and obesity represent a major health threat in adults with intellectual disability (ID). However, the current evidence around the prevalence and risk factors associated with overweight and obesity in children and adolescents with ID remains unclear. The objective of this article was thus to review the available English‐ and French‐language studies examining the prevalence and risk factors associated with overweight and obesity in youths with ID. Ten studies providing original data on this topic were identified and included in this review. Results demonstrated that (i) overweight and obesity represent a significant secondary health problem in youths with ID; and (ii) obesity risk significantly increases with age. Considering all of the limitations of the reviewed studies (i.e. heterogeneity in sample size and in overweight and obesity classification criteria; lack of comparison group; restrictive number of risk factors examined, etc.), these findings remain preliminary and highlight the need for future research in this area.

The Longitudinal Interplay of Adolescents' Self-Esteem and Body Image: A Conditional Autoregressive Latent Trajectory Analysis.

Self-esteem and body image are central to coping successfully with the developmental challenges of adolescence. However, the current knowledge surrounding self-esteem and body image is fraught with controversy. This study attempts to clarify some of them by addressing three questions: (1) Are the intraindividual developmental trajectories of self-esteem and body image stable across adolescence? (2) What is the direction of the relations between body image and self-esteem over time? (3) What is the role of gender, ethnicity, and pubertal development on those trajectories? This study relies on Autoregressive Latent Trajectory analyses based on data from a 4-year, 6-wave, prospective longitudinal study of 1,001 adolescents. Self-esteem and body image levels remained high and stable over time, although body image levels also tended to increase slightly. The results show that levels of self-esteem were positively influenced by levels of body image. However, these effects remained small and most of the observed associations were cross-sectional. Finally, the effects of pubertal development on body image and self-esteem levels were mostly limited to non-Caucasian females who appeared to benefit from more advanced pubertal development. Conversely, Caucasian females presented the lowest self-esteem and body image levels of all, although for them more advanced pubertal development levels were associated with a slight rise in body image over time.

Academic achievement and smoking initiation in adolescence : a general growth mixture analysis

AIMS This study aims to: (i) explore the relations between smoking initiation and different profiles of academic achievement trajectories in early to mid-adolescence; and (ii) to investigate whether background characteristics (gender, ethnicity, grade repetition, parental education) and proximal processes (parental practices, extra-curricular involvement) predicted class membership and smoking initiation. DESIGN Four-year longitudinal cohort study (7th-10th grade). SETTING Adolescents completed the questionnaires during school hours. PARTICIPANTS At total of 741 adolescents with no history of smoking in grade 7 participating in the Montreal Adolescent Depression Development Project. MEASUREMENTS Self-report questionnaires were used to assess predictors and previous smoking in year 1, and smoking initiation by the end of the study. Grade point average (GPA) was obtained twice yearly from school records. FINDINGS Three academic achievement trajectories were identified and found to differ significantly in rates of smoking initiation: persistently high achievers (7.1% smoking), average achievers (15.1% smokers) and unstable low achievers (49.1% smoking). Further, results showed that general parenting practices and parental education indirectly reduced the likelihood of smoking by reducing the risk of membership in classes with lower GPA. CONCLUSIONS Adolescents who do well in school are less likely to smoke and it may be cost-effective for smoking prevention to focus on the few (12%) easy to identify unstable low achievers who form 35% of smoking onsets. In addition, as parental support and democratic control reduced the likelihood of poor academic performance, promoting essential generic parenting skills from a young age may also prevent future onsets of smoking in adolescence.

The effects of social relationships and acceptance on disturbed eating attitudes in elite adolescent female athletes: The mediating role of physical self-perceptions

OBJECTIVE The purpose of the study was to examine the effects of social relationships (i.e., coach, friends, and parents) and acceptance (i.e., peers) on disturbed eating attitudes (DEAs) in elite adolescent female athletes, through the mediating role of physical self-perception (i.e., perceived physical appearance and perceived physical ability). METHOD The sample comprised 227 elite adolescent female athletes (M(age) = 15.75; SD(age) = 3.00) engaged in various esthetic sports. The data was analyzed using structural equation modeling method and mediation analysis. RESULTS They showed that peer acceptance and quality of parent-athlete relationships have a significant negative influence on DEA in elite adolescent female athletes. Moreover, the quality of relationship with the coach and sport friend has a significant positive influence on DEA in female athletes through the mediating role of perceived physical ability. DISCUSSION The quality of relationship with parents and peer acceptance would be a protective factor regarding DEA, whereas the quality of relationships with coach and friend in sport would be risk factors for the development of DEA in adolescent female athletes through the mediating role of perceived physical ability. Recommendations for future use of, and research on, activities are outlined. The effects of social relationships and acceptance on DEA in elite adolescent female athletes: the mediating role of physical self-perceptions.

The eating attitudes test-26 revisited using exploratory structural equation modeling

Most previous studies have failed to replicate the original factor structure of the 26-item version of the Eating Attitudes Test (EAT-26) among community samples of adolescents. The main objective of the present series of four studies (n = 2178) was to revisit the factor structure of this instrument among mixed gender community samples of adolescents using both exploratory structural equation modeling (ESEM) and confirmatory factor analysis (CFA). First, results from the ESEM analyses provided satisfactory goodness-of-fit statistics and reliability coefficients for a six-factor model of the EAT with 18 items (EAT-18) closely corresponding to the original seven-factor structure proposed for the 40-item version of the EAT. Second, these analyses were satisfactorily replicated among a new sample of community adolescents using CFA. The results confirmed the factor loading and intercept invariance of this model across gender and age groups (i.e., early and late adolescence), as well as the complete invariance of the EAT-18 measurement model between ethnicities (i.e., European versus African origins) and across weight categories (i.e., underweight, normal weight and overweight). Finally, the last study provided support for convergent validity of the EAT-18 with the Eating Disorder Inventory and with instruments measuring global self-esteem, physical appearance, social physique anxiety and fear of negative appearance evaluation.

Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review

Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7-22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.

A very short visual analog form of the Center for Epidemiologic Studies Depression Scale (CES-D) for the idiographic measurement of depression

BACKGROUND The experience sampling method, also referred to as ecological momentary assessment (ESM-EMA) has recently gained popularity in the study of depression. However, no psychometrically sound multidimensional depression questionnaires specifically designed for the ESM-EMA context are currently available. AIMS The main objective of the present study was to develop and validate a very short visual analog scale of the Center for Epidemiologic Studies Depression Scales (CES-D-VAS-VS) specifically designed for the ESM-EMA context. To this end, the full French version of the CES-D was adapted for the ESM-EMA context. From this full-length adapted version a very short version was then extracted from this longer instrument and validated. STUDY DESIGN A sample comprising 163 patients with a major depressive episode (MDE) and 306 participants without mental disorders was involved in this study. RESULTS The obtained results provided support for the factor validity, strong measurement invariance (invariance of the loadings and intercepts of the measurement model) across sex and clinical status groups, reliability and convergent validity of the CES-D-VAS-VS. This instrument comprises 4 items measuring positive affect, depressive affect, somatic complaints and disturbed interpersonal relationships. CONCLUSION The present results provide preliminary evidence regarding the construct validity of the CES-D-VAS-VS among patients and community adults sample but also underline the need to rely on latent variables methods in the use of this instrument to account for the differential levels of measurement errors (uniquenessess) that were observed across groups.

The prevalence and determinants of overweight and obesity among French youths and adults with intellectual disabilities attending special education schools

This study examines the prevalence of overweight and obesity and a panel of potential determinants among French youths and adults with an intellectual disability (ID). The sample used consisted of 1120 youths and adults with an ID, from 5 to 28 years old, attending a French special education school. The results indicated that 19.8% of the participants with an ID are classified as overweight and 8.6% as obese. Multivariate logistic regression analyses revealed that there are nearly three times more girls/women classified as overweight than boys/men. Additionally, they showed that there are nearly two times more participants from southern France classified as overweight than from northern France, and that the risk of being classified as overweight significantly increases with seniority in the school. Next, the interaction effects observed indicated first that there are nearly two times more boys/men on psychotropic medication classified as overweight than boys/men not on psychotropic medication. Second, they revealed that the odds of being classified as overweight for boys/men not on psychotropic medication are 47% lower than for girls/women not on psychotropic medication. Third, they indicated that there are nearly two times more boys/men from southern France classified as obese than boys/men from northern France. Fourth, they showed that the odds of being classified as obese for boys/men from northern France are 52% lower than for girls/women from northern France. In conclusion, these results should be viewed as preliminary and need to be replicated since, to our knowledge, this study is the first one to examine this topic while simultaneously controlling for all of the potential determinants and relying on a sample of youths and adults.