Depression Literacy and Misconceptions Scale (DepSter)

Abstract

The DepSter Scale, also known as Skala Przekonań na Temat Depresji, is a self-report instrument designed to measure multidimensional beliefs about depression, encompassing both depression literacy and misconceptions. Developed by Kulwicka and Gasiorowska (2023), this 14-item inventory was initially created in Polish, with statements derived from DSM-V and ICD-10 diagnostic criteria for major depressive episodes, current scientific knowledge on depression (Hammen, 2018), and insights from focus groups and online forums regarding stereotypes about depression. Through content validity assessments using interrater consistency and the CVR index, 15 items were initially selected, with one later removed due to a very low value, resulting in the final 14-item scale. The instrument was translated into English using a back-translation procedure. Data collection involved ten studies across Poland, the U.S., and the U.K. Confirmatory factor analysis supported a two-factor structure. The authors reported on the instrument’s reliability, validity, and measurement invariance, while acknowledging the limitation of a relatively low Cronbach’s alpha in some instances, potentially due to the limited number of items.

Keywords

Beliefs About Depression; Depression Literacy; Divergent Validity; External Validity; Internal Validity; Misconceptions About Depression; Social Perceptions

Authors

Katarzyna Kulwicka; Agata Gasiorowska

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Purpose

The DepSter Scale serves as a multidimensional measure of beliefs about depression, aiming to assess both individuals’ understanding of depression (depression literacy) and their misconceptions regarding the disorder.

Validity

Content Validity: The content validity of the DepSter scale was supported by a CVR index of 0.60 or higher, indicating strong agreement among experts regarding the relevance of the items.

Criterion Validity: Support for criterion validity was demonstrated by evaluating whether formal psychological education and prior exposure to depression were associated with higher levels of depression literacy and fewer misconceptions about the disorder.

Convergent Validity: Findings indicated that both a high level of depression literacy and a low level of misconceptions about depression were related to mental health literacy, depression literacy as measured by the Depression Literacy Questionnaire (D-Lit; Griffiths et al., 2004), personal experience with depression (either being diagnosed or having contact with a diagnosed individual), empathetic sensitivity, perspective-taking abilities, and emotional stability.

Divergent Validity: The results showed that while substantially correlated, the two dimensions of beliefs (depression literacy and misconceptions) possess distinct meanings, thus supporting divergent validity.

Reliability

Interrater Reliability: Interrater consistency for the DepSter scale was found to be satisfactory, with an ICC = 0.725 (95% CI[0.65, 0.79]).

Internal Consistency: Across several studies conducted with samples from Poland, the United States, and the United Kingdom, the Cronbach’s alpha values for the DepSter scale ranged from 0.49 to 0.93. The authors noted that the relatively low alpha values in some instances might be attributed to the limited number of items.

Test-Retest Reliability: The English version of the DepSter was re-administered after a three-week interval, yielding test-retest reliability values of α = 0.92 for misconceptions about depression and α = 0.65 for depression literacy. For the Polish version, administered three months later, the test-retest reliability was α = 0.76 for misconceptions about depression and α = 0.83 for depression literacy.

Factor Analysis

Confirmatory Factor Analysis (CFA): CFA results indicated a good fit for the two-factor model: χ²/df = 4.24, RMSEA = 0.075 (90% CI = [0.067, 0.084]), SRMR = 0.060, TLI = 0.85, CFI = 0.88.

Measurement Invariance: The measurement model demonstrated invariance across country groups with respect to configural and metric invariance. However, only partial scalar invariance was reported for the depression literacy subscale, and scalar invariance was lacking for the misconceptions about depression subscale.

Instrument

Test Type: Original Instrument Type: Inventory/Questionnaire

Format: Participants indicate their level of agreement with each statement using a Likert scale ranging from 1 = “strongly disagree” to 5 = “strongly agree.” The administration method is electronic.

Language Available: English; Polish

Population Group: Human; Male; Female

Age Group: Adulthood (18 yrs & older); Young Adulthood (18-29 yrs); Thirties (30-39 yrs); Middle Age (40-64 yrs); Aged (65 yrs & older)

Population Details: Respondents include adults recruited via Amazon Mechanical Turk and Prolific Academic Users from Poland, the United States, and the United Kingdom.

Test Methodology: The methodology involves Test Validity (Construct Validity, Content Validity, Convergent Validity, Criterion Validity, Discriminant Validity), Test Reliability (Internal Consistency, Interrater Reliability, Test-Retest Reliability), and Factor Analysis (Confirmatory Factor Analysis, Measurement Invariance).

Keywords

Beliefs About Depression; Depression Literacy; Divergent Validity; External Validity; Internal Validity; Misconceptions About Depression; Social Perceptions

Authors

Author ORCID Identifier:
Katarzyna Kulwicka: http://orcid.org/0000-0002-4731-1901

Affiliation:
Katarzyna Kulwicka: SWPS University of Social Sciences and Humanities Faculty of Psychology in Wroclaw
Agata Gasiorowska: SWPS University of Social Sciences and Humanities Faculty of Psychology in Wroclaw

Email addresses:
Katarzyna Kulwicka: [email protected]

Correspondence Address:
Katarzyna Kulwicka: [email protected]

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching.
Commercial Use: No
Fee: No
Test Year: 2023
Website for Permissions: creativecommons.org/licenses/by/4.0/

References

Kulwicka, K., & Gasiorowska, A. (2023). Depression literacy and misconceptions scale (DepSter): A new two-factorial tool for measuring beliefs about depression. BMC Psychiatry, 23(1), Article 300. https://doi.org/10.1186/s12888-023-04796-8

Items of the DepSter Scale

The DepSter scale is a 14-item measure. It consists of two factors: Depression Literacy (DL) and Misconceptions about Depression (MiscD). The specific items are available in the supplemental materials:

• 2023-70000-001, Supplemental Material 1, Pages 1-2

• 2023-70000-001, Supplemental Material 2, Pages 1-2

Instructions: Używając poniższej skali, zaznacz, do jakiego stopnia zgadzasz się z poniższymi twierdzeniami.

Response Scale:

1. Zdecydowanie się nie zgadzam

2. Nie zgadzam się

3. Ani się nie zgadzam, ani się zgadzam

4. Zgadzam się

5. Zdecydowanie się zgadzam

Items:

1. Depresja jest chorobą

2. Depresja to zwykła fanaberia

3. Depresja może dotknąć każdego

4. Depresja to tylko chwilowe pogorszenie samopoczucia

5. Depresja sprawia, że ludzie tracą zainteresowanie nawet tymi rzeczami, które kiedyś sprawiały im radość

6. Depresja dotyka tylko ludzi słabych, którzy nie radzą sobie z własnym życiem

7. Depresja sprawia, że ludzie nie mają siły do zrobienia czegokolwiek

8. Wystarczy silna wola, żeby pozbyć się depresji

9. Osoby, które mają depresję, często myślą o samobójstwie

10. Wystarczy wziąć się w garść, żeby pozbyć się depresji

11. Depresja wiąże się z ogromnym cierpieniem

12. Leki przeciwdepresyjne działają od razu po zażyciu

13. Depresja to użalanie się nad sobą

14. Osoby, które mają depresję, są słabe psychicznie

Klucz odpowiedzi:

• Depression Literacy (DL): Średnia z 1, 3, 5, 7, 9, 11

• Błędne przekonania na temat depresji (MiscD): Średnia z 2, 4, 6, 8, 10, 12, 13, 14

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Instructions: Please Indicate Your Agreement with The Following Statements Using the Scale Below.

Response Scale:

1. Strongly disagree

2. Disagree

3. Neither agree or disagree

4. Agree

5. Strongly agree

Items:

1. Depression is an illness

2. Depression is just a fad

3. Depression can affect anyone

4. Depression is just a temporary mood deterioration

5. Depression makes people lose interest even in the things they used to enjoy doing

6. Depression affects only the people who are weak and cannot cope with their life

7. Depression makes people lack the strength to do anything

8. To overcome depression, all you need is willpower

9. People with depression often think about suicide

10. To overcome depression, all you need is to get yourself together

11. Depression is associated with great suffering

12. Antidepressant medication start to work right after the intake

13. Depression is just a self-pity

14. People with depression are mentally weak

Scoring:

• Depression Literacy (DL): Average of 1, 3, 5, 7, 9, 11

• Misconceptions About Depression (MiscD): Average 2, 4, 6, 8, 10, 12, 13, 14