Confirmatory factor analysis of the Beck Depression Inventory-II in patients with advanced cancer: A theory-driven approach Journal Article


Authors: Tobias, K. G.; Lehrfeld, J.; Rosenfeld, B.; Pessin, H.; Breitbart, W.
Article Title: Confirmatory factor analysis of the Beck Depression Inventory-II in patients with advanced cancer: A theory-driven approach
Abstract: Objective: The diagnosis and treatment of depression are complicated by the presence of a serious medical illness, such as cancer. The role of inflammation in the pathophysiology of depression remains unknown; however, the symptom cluster of sickness behavior is more clearly related to inflammation. Symptom clusters may provide the specificity needed to improve treatment outcomes. The purpose of this study is to use confirmatory factor analysis to examine the construct of sickness behavior in patients with advanced cancer using the Beck Depression Inventory-II (BDI-II). Method: Patients (N = 167) were recruited from chemotherapy clinics and the Department of Psychiatry at Memorial Sloan Kettering Cancer Center. Symptoms were a priori delineated using the factor labels sickness behavior and negative affectivity (two-factor model), and affective, cognitive, and sickness behavior (three-factor model). These data were also fit for a more traditional model using affective, cognitive, and somatic factors. Results: The mean total BDI-II score was 14.74 (SD = 8.52; range = 1-46). Fit statistics for all models were good, but the novel three-factor model with sickness behavior provided the best fit: χ2(186) = 273.624; p < 0.001; root-mean-square error of approximation = 0.053; comparative fit index = 0.949. Significance of results: Both the two- and three-factor models provide support for the unique construct of sickness behavior in patients with advanced cancer. High factor correlations with the BDI-II and other measures of distress were observed, which raises questions about theoretically distinct, but related, constructs. Copyright © Cambridge University Press 2017.
Keywords: depression; cancer; sickness behavior; symptom clusters; beck depression inventory-ii
Journal Title: Palliative and Supportive Care
Volume: 15
Issue: 6
ISSN: 1478-9515
Publisher: Cambridge University Press  
Date Published: 2017-12-01
Start Page: 704
End Page: 709
Language: English
DOI: 10.1017/s1478951517000724
PROVIDER: scopus
PMCID: PMC5716931
PUBMED: 28835295
DOI/URL:
Notes: Article -- Export Date: 2 January 2018 -- Source: Scopus
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  1. William S Breitbart
    505 Breitbart
  2. Hayley Ann Pessin
    88 Pessin