The factor structure of major depressive symptoms in a sample of Chinese earthquake survivors

Yajie Bi; Li Wang; Chengqi Cao; Ruojiao Fang; Gen Li; Ping Liu; Shu Luo; Haibo Yang; Brian J Hall

doi:10.1186/s12888-020-02993-3

The factor structure of major depressive symptoms in a sample of Chinese earthquake survivors

BMC Psychiatry. 2021 Jan 28;21(1):59. doi: 10.1186/s12888-020-02993-3.

Authors

Yajie Bi^{1

2}, Li Wang^{3

4}, Chengqi Cao^{1

5}, Ruojiao Fang^{1

2}, Gen Li^{1

2}, Ping Liu⁶, Shu Luo⁶, Haibo Yang⁷, Brian J Hall⁸

Affiliations

¹ Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China.
² Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
³ Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China. wangli1@psych.ac.cn.
⁴ Department of Psychology, University of Chinese Academy of Sciences, Beijing, China. wangli1@psych.ac.cn.
⁵ Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China.
⁶ People's Hospital of Deyang City, Deyang, Sichuan, China.
⁷ Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.
⁸ Global and Community Mental Health Research Group, New York University (Shanghai), Pudong, Shanghai, China.

Abstract

Background: Experiencing natural disasters is associated with common mental disorders including major depressive disorder (MDD). However, the latent structure of MDD is widely debated, and few studies tested the MDD factor structure in Chinese natural disaster survivors. Therefore, the aim of the current study was to evaluate the factorial validity of the Patient Health Questionnaire-9 (PHQ-9) for DSM-5 major depressive disorder (MDD) symptoms in Chinese earthquake survivors.

Method: Participants were 1058 Chinese earthquake survivors. Self-reported measures included the PHQ-9 and the Short-Form Health Survey (SF-36). Confirmatory factor analysis (CFA) and structural equation modelling (SEM) was used to examine the latent structure of MDD and the associations between latent factors of MDD and different domains of health-related quality of life (HRQoL), respectively.

Results: In the current sample, the model consisted of somatic and cognitive/affective (non-somatic) factors demonstrated significantly better fit than the other competing MDD models (χ² = 173.89, df = 26, CFI = 0.986, TLI = 0.981, RMSEA = 0.073, BIC = 18,091.13). Further SEM analyses indicated that the non-somatic factor was significantly related to both physical (β = - 0.362, p < .01) and psychosocial HRQoL (β = - 0.773, p < .01), while the somatic factor was a uniquely predictor of physical HRQoL (β = - 0.336, p < .01). Furthermore, we found the somatic factor partially mediated the relationship between the cognitive/affective factor and physical HRQoL (all ps < .05).

Conclusions: The MDD symptoms was best captured by a two-factor model comprised of somatic and cognitive/affective factors in Chinese natural disaster survivors. The two MDD factors were differentially associated with physical and psychosocial HRQoL, and the cognitive/affective factor associated physical HRQoL partially through the somatic factor. The current findings increase our understanding of latent structure of MDD symptoms, and carry implications for assessment and intervention of post-disaster mental health problems.

Keywords: Chinese; Confirmatory factor analysis; Disaster; Health-related quality of life; Major depressive disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China
Depression
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / epidemiology
Earthquakes*
Humans
Quality of Life
Surveys and Questionnaires
Survivors

Abstract

Publication types

MeSH terms

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