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Objectives The Japanese government partially enacted the “Work Style Reform Bill” in 2019. The National Center for Child Health and Development (NCCHD) introduced an Overnight Call Shift (OCS) system for pediatrician training. We conducted a follow‐up survey in 2019 to investigate the long‐term effectiveness of the OCS system to improve the pediatric residents' mental wellness at NCCHD. Methods We conducted a questionnaire‐based cross‐sectional survey for pediatric residents in 2019 to compare the data with those of the previous survey in 2012. The questionnaire includes demographic data, working conditions data, and mental wellness assessment by the Center for Epidemiologic Studies Depression scale (CES‐D) and the Maslach Burnout Inventory (MBI). Results The collection rate for the 2019 survey was 94.5% (37 participants/39 eligible). Compared to 2012, there were no significant changes in demographic data and working hours, a significant increase by about 30% in residents who took daytime off after night work, about 10% decrease in residents who scored 16 and above on the CES‐D, and a significant decrease in the mean score for depersonalization (DP) in the MBI. Multiple regression analyses showed that daytime off after night work was the decreasing factor for CES‐D and Emotional exhaustion (EE). Conclusions The overnight shiftwork system shortened the pediatric residents' duty hours somewhat, and imposed an impact on the pediatric residents' mental wellness.

Background The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has not been established in adolescents. This review aimed to investigate the factor structure of the CES-D in adolescents. Methods We searched Web of Science, PsychINFO and Scopus and included peer-reviewed, original studies assessing the factor structure of the 20-item CES-D in adolescents aged ≤18. Two independent researchers screened results and extracted data. Results Thirteen studies met the inclusion criteria and were primarily from school-based samples in the USA or Asia. Studies that conducted confirmatory factor analysis (CFA; n  = 9) reported a four-factor structure consistent with the original factor structure; these studies were primarily USA-based. Conversely, studies that conducted exploratory factor analysis (EFA) reported distinct two or three factor structures ( n  = 4) and were primarily based in Asia. Limitations Studies in a non-English language and those that included individuals aged > 18 years were excluded. Ethnic or cultural differences as well as different analytical methods impacted generalisability of results. The use of CFA as the primary analysis may have biased towards a four-factor structure. Conclusions A four-factor CES-D structure was an appropriate fit for adolescents in Western countries; further research is required to determine the fit in in Asian countries. This has important implications for clinical use of the scale. Future research should consider how cultural differences shape the experience of depression in adolescents.

Fifteen-year-old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the adolescents' infancy and preschool periods. Microarray technology applied to 28,000 cytosine—guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children's early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children's gender. To the authors' knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents' genomic DNA.

We examined differential item functioning (DIF) of the Center for Epidemiologic Studies Depression Scale (CES-D) items by country and statistically harmonized common cross-national factor scores for the CES-D to aid further cross-national research. Data were from Harmonized Cognitive Assessment Protocol (HCAP) studies in China (N = 9639), England (N = 1262), India (N = 4048), Mexico (N = 1918), South Africa (N = 631), and the United States (N = 3321). Multiple indicators, multiple causes models were estimated to test DIF in the CES-D items by country. DIF items were defined as having an odds ratio (OR) outside the range of 0.75–1.25 in multiple indicators, multiple causes models. We evaluated DIF impact and identified salient DIF by examining whether the difference between DIF-adjusted factor scores and non-DIF–adjusted factor scores exceeded a threshold of 0.30 standard deviation (SD) units. Confirmatory factor analysis was used to create DIF-adjusted, cross-nationally harmonized CES-D factor scores. Controlling for underlying depressive symptoms, HCAP participants in India had higher odds of reporting being not hopeful about future (OR = 1.38, 95% confidence interval [CI]: 1.34–1.42), not enjoying life (OR = 1.43, 95% CI: 1.38–1.48), and being unhappy (OR = 1.29, 95% CI: 1.25–1.34), compared to HCAP participants in the United States. These identified DIF items artificially increased mean harmonized CES-D factor scores by 0.48 SD units in the India HCAP, with over 50% of the factor scores increased by over 0.30 SD units, indicating salient DIF in the India HCAP. Our findings demonstrate cross-national heterogeneity in the expression of depressive symptoms. We provide DIF-adjusted CES-D factor scores to improve the quality of cross-national comparisons in aging research. •Inconsistent CES-D items challenge cross-national comparisons of depression.•We detected items with salient DIF in LASI-DAD, relative to other HCAP studies.•Items with DIF increased mean CES-D factor scores by 0.48 SD units in LASI-DAD.•DIF items in LASI-DAD should be adjusted for further cross-national comparisons.

Background Depression is an important public health problem and is closely associated with suicidal behavior in the population. Although the Center for Epidemiologic Studies Depression Scale (CES-D) is widely used for assessment of depression, the psychometric characteristics of this scale have not been explored in studies of suicide attempters and local residents in rural areas. Methods In this study, reliability and validity of CES-D were assessed in 409 suicide attempters and 409 comparison residents from rural China and through internal consistency analysis and confirmatory factor analysis (CFA). Results Cronbach’s alpha values of the CES-D were 0.940 and 0.895 in, respectively, suicide attempters and comparison residents. CES-D scores were significantly correlated with the scores of Trait Anxiety Inventory (TAI) and Beck Hopelessness Scale (BHS) in both the suicide attempters and the comparison residents. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) with 14 items (excluding items 9, 10, 13, 15, 17, and 19) had the best fit in these two populations. Conclusions The CES-D scale has satisfactory reliability and validity when used for assessing depression in suicide attempters and comparison residents in rural China.

The present study examined associations between the quality of teacher-child relationships and behavior problems among elementary school students using data from the NICHD Study of Early Child Care and Youth Development, a study of 1,364 children from birth through adolescence. There were two main findings. First, high-quality teacher-child relationships predicted low levels of externalizing behaviors. Second, high-quality relationships acted as protective factors, helping to prevent children with high levels of internalizing behaviors in early childhood from developing trajectories of long-term internalizing behavior problems. Teacher-child relationships may be proximal phenomena that can be targeted in interventions to help prevent behavior problems in middle childhood.

The Center for Epidemiologic Studies Depression Scale – Revised (CESD-R) is a popular self-report screening measure for depression. A 20-item questionnaire with scores ranging from 0 to 4 for each item, the CESD-R can produce total scores ranging from 0 to 80. However, the typical scoring protocol for the CESD-R restricts the range of possible scores to between 0 and 60 to retain the same range and clinical cutoff scores as the original CES-D. Despite the widespread adoption of this scoring approach, the psychometric impact has never been systematically examined. In an undergraduate and community adult sample (n = 869), item response theory analyses indicated that scoring the CESD-R with all 5 response options (CESD-R5opt) provided nearly twice as much information about a person’s latent depression for individuals with high levels of depression than did scoring the CESD-R with 4 response options per item (CESD-R4opt). The CESD-R5opt retained the strong reliability and factor structure of the CESD-R4opt and was more sensitive to individual differences for participants at high levels of depression compared to the CESD-R4opt. Results provide preliminary evidence that researchers and clinicians should score the CESD-R using the full 0-to-80 scale and a clinical cutoff score of 29.

Background Transcultural validation studies of depression scales are rare in Morocco. The Center for Epidemiologic Studies Depression Scale (CES-D) is commonly one of the most common and frequently used screening instruments for depressive symptoms, but the scale has not, up to date, been validated in dialect of Arabic in Moroccan contexts. Given the importance of assessing and preventing depressive symptoms in our Moroccan context, this study aims to validate the CES-D, translated, and adapted to the dialect of Arabic and Moroccan culture, in a sample with substance use disorder. Methods The data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample ( N  = 140). Then, this structure was confirmed in the validation sample ( N  = 205) using confirmatory factor analysis (CFA). Results Exploratory factor analysis extracted three factors different from the four factors in the original version. Confirmatory factor analysis confirmed the structure of three factors. The fit indices level showed acceptable to good performance of the measurement model. The instrument showed sufficient reliability and convergent validity, as demonstrated by acceptable values of composite reliability (CR = 0.89–0.93) and average variance extracted (AVE = 0.64–0.66), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio (HTMT) of correlations values was less than 0.85, indicating acceptable discriminant validity. Conclusions Overall reliability and both convergent and discriminant validity tests indicated that the Moroccan dialectal Arabic version of the CES-D had a good performance and may serve as a valid tool for measuring the severity of depression in people with substance use disorder.

Since the revision of the Center for Epidemiologic Studies Depression Scale (CESD-20-R), few studies have examined its validity and none yet its gender invariance. This study addressed these critical issues among 502 Nigerian university students (50.4% of females, Mage = 22.10 years). Confirmatory factor analyses (CFAs) demonstrated that a one-, two- and three-dimensional structures were tenable; however, the latter model appeared to be the best-fitting model to the data reflecting cognitive-affective, physical, and self-destructive components. The estimates of the internal consistency reliability of the CESD-20-R were significant (McDonald ω = 0.94, Greatest Lower Bound = 0.96). Multi-group CFAs provided support for full configural and weak factorial invariances but partial strong and strict invariances across gender. At strong factorial invariance level, two items (#13 “I felt fidgety” and #19 “trouble getting to sleep”) lacked invariance. Further, latent mean differences showed significantly higher scores among males than females on the self-destructive component reflecting suicidal ideation items (d = −0.238). Following CESD-20-R diagnostic criteria, 6.6% met criteria for major depression episode (MDE), 2.4% for probable MDE, and 5.6% for possible MDE. In sum, the CESD-20-R, which has been developed to be conformed to current depression diagnostic criteria, yielded a meaningful factorial structure and excellent internal consistency reliability. It can be used successfully by researchers and clinicians to establish gender comparisons of depressive symptoms in the context under consideration here. However, caution is required when interpreting some specific items. Moreover, in health programs for early prevention and intervention, careful attention needs to be paid to males who have shown more vulnerability to the suicidal ideation component of depressive symptoms than females.

This study considers how the psychological adjustment of ethnic minority college students may be linked to a sense of school belonging and ethnic identity, two constructs related to individuals feeling like they belong to a larger group. Using self-reports from 311 undergraduates from ethnic minority backgrounds, school belonging was found to be negatively associated with depressive symptoms, and positively associated with perceived self-worth, scholastic competence, and social acceptance, while ethnic identity was only found to be positively associated with self-worth. Furthermore, the interaction between ethnic identity and school belonging was significantly associated with self-worth, suggesting that in the absence of a sense of belonging at school, stronger ethnic identity was linked to higher self-worth. College students reported the lowest levels of self-worth when they were neither connected to their college nor connected to their ethnic group.