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Subconstructs of the Edinburgh Postnatal Depression Scale in a multi-ethnic inner-city population in the U.S.

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Abstract

The ten-item Edinburgh Postnatal Depression Scale (EPDS) is one of the most widely used self-report measures of postpartum depression. Although originally described as a one-dimensional measure, the recognition that depressive symptoms may be differentially experienced across cultural and racial/ethnic groups has led to studies examining structural equivalence of the EPDS in different populations. Variation of the factor structure remains understudied across racial/ethnic groups of US women. We examined the factor structure of the EPDS assessed 6 months postpartum in 515 women (29% black, 53% Hispanic, 18% white) enrolled in an urban Boston longitudinal birth cohort. Exploratory factor analysis (EFA) identified that a three-factor model, including depression, anxiety, and anhedonia subscales, was the most optimal fit in our sample as a whole and across race/ethnicity. Confirmatory factor analysis (CFA) was used to examine the fit of both the two- and three-factor models reported in prior research. CFA confirmed the best fit for a three-factor model, with minimal differences across race/ethnicity. “Things get on top of me” loaded on the anxiety factor among Hispanics, but loaded on the depression factor in whites and African Americans. These findings suggest that EPDS factor structure may need to be adjusted for diverse samples and warrants further study.

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Acknowledgements

The Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project has been funded by National Institutes of Health (NIH) grants R01 ES010932, U01 HL072494, and R01 HL080674 (PI: Wright RJ). Statistical support was funded by P30 ES023515. During preparation of this manuscript, Chiu YHM was supported by National Institute for Occupational Safety and Health (NIOSH) grant T42 OH008422, and Sheffield PE was supported by NIH grant K23 ES024127.

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Authors and Affiliations

  1. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Yueh-Hsiu Mathilda Chiu, Perry E. Sheffield, Hsiao-Hsien Leon Hsu, Paul C. Curtin & Rosalind J. Wright

  2. Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Yueh-Hsiu Mathilda Chiu, Perry E. Sheffield, Jonathan Goldstein & Rosalind J. Wright

  3. The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Rosalind J. Wright

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  1. Yueh-Hsiu Mathilda Chiu
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  2. Perry E. Sheffield
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  3. Hsiao-Hsien Leon Hsu
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Correspondence to Yueh-Hsiu Mathilda Chiu or Rosalind J. Wright.

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Procedures were approved by human studies committees at the BWH and BMC, and the written consents were obtained in participants’ primary language.

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The authors declare they have no competing interests.

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This article belongs to the Topical Collection: The EPDS: Thirty Years On

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Chiu, YH.M., Sheffield, P.E., Hsu, HH.L. et al. Subconstructs of the Edinburgh Postnatal Depression Scale in a multi-ethnic inner-city population in the U.S.. Arch Womens Ment Health 20, 803–810 (2017). https://doi.org/10.1007/s00737-017-0765-2

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