Postpartum depressive symptoms across time and place: structural invariance of the Self-Reporting Questionnaire among women from the international, multi-site MAL-ED study

Laura L Pendergast, Rebecca J Scharf, Zeba A Rasmussen, Jessica C Seidman, Barbara A Schaefer, Erling Svensen, Fahmida Tofail, Beena Koshy, Margaret Kosek, Muneera A Rasheed, Reeba Roshan, Angelina Maphula, Rita Shrestha, Laura E Murray-Kolb, MAL-ED Network Investigators, Pascal Bessong, Angelina Mapula, Emanuel Nyathi, Cloupas Mahopo, Amidou Samie, Cebisa Nesamvuni, Erling Svensen, Estomih R Mduma, Crystal L Patil, Caroline Amour, Aldo A M Lima, Reinaldo B Oriá, Noélia L Lima, Alberto M Soares, Alexandre H Bindá, Ila F N Lima, Josiane S Quetz, Milena L Moraes, Bruna L L Maciel, Hilda Costa, Jose Quirino Filho, Álvaro J M Leite, Francisco B Mota, Alessandra F Di Moura, Maribel Paredes Olortegui, Cesar Banda Chavez, Dixner Rengifo Trigoso, Julian Torres Flores, Angel Orbe Vasquez, Silvia Rengifo Pinedo, Angel Mendez Acosta, Tahmeed Ahmed, Rashidul Haque, A M Shamsir Ahmed, Munirul Islam, Iqbal Hossain, Mustafa Mahfuz, Dinesh Mondol, Fahmida Tofail, Gagandeep Kang, Sushil John, Sudhir Babji, Mohan Venkata Raghava, Anuradha Rose, Beena Kurien, Anuradha Bose, Jayaprakash Muliyil, Anup Ramachandran, Carl J Mason, Prakash Sunder Shrestha, Sanjaya Kumar Shrestha, Ladaporn Bodhidatta, Ram Krishna Chandyo, Rita Shrestha, Binob Shrestha, Tor Strand, Manjeswori Ulak, Zulfiqar A Bhutta, Anita K M Zaidi, Sajid Soofi, Ali Turab, Didar Alam, Shahida Qureshi, Aisha K Yousafzai, Asad Ali, Imran Ahmed, Sajad Memon, Muneera Rasheed, Michael Gottlieb, Mark Miller, Karen H Tountas, Rebecca Blank, Dennis Lang, Stacey Knobler, Monica McGrath, Stephanie Richard, Jessica Seidman, Zeba Rasmussen, Ramya Ambikapathi, Benjamin McCormick, Stephanie Psaki, Vivek Charu, Jhanelle Graham, Gaurvika Nayyar, Viyada Doan, Leyfou Dabo, Danny Carreon, Archana Mohale, Christel Host, Dick Guerrant, Bill Petri, Eric Houpt, Jean Gratz, Leah Barrett, Rebecca Scharf, Laura Caulfield, William Checkley, Margaret Kosek, Pablo Penataro Yori, Gwenyth Lee, Ping Chen, Robert Black, Laura Murray-Kolb, Barbara Schaefer, William Pan, Laura L Pendergast, Rebecca J Scharf, Zeba A Rasmussen, Jessica C Seidman, Barbara A Schaefer, Erling Svensen, Fahmida Tofail, Beena Koshy, Margaret Kosek, Muneera A Rasheed, Reeba Roshan, Angelina Maphula, Rita Shrestha, Laura E Murray-Kolb, MAL-ED Network Investigators, Pascal Bessong, Angelina Mapula, Emanuel Nyathi, Cloupas Mahopo, Amidou Samie, Cebisa Nesamvuni, Erling Svensen, Estomih R Mduma, Crystal L Patil, Caroline Amour, Aldo A M Lima, Reinaldo B Oriá, Noélia L Lima, Alberto M Soares, Alexandre H Bindá, Ila F N Lima, Josiane S Quetz, Milena L Moraes, Bruna L L Maciel, Hilda Costa, Jose Quirino Filho, Álvaro J M Leite, Francisco B Mota, Alessandra F Di Moura, Maribel Paredes Olortegui, Cesar Banda Chavez, Dixner Rengifo Trigoso, Julian Torres Flores, Angel Orbe Vasquez, Silvia Rengifo Pinedo, Angel Mendez Acosta, Tahmeed Ahmed, Rashidul Haque, A M Shamsir Ahmed, Munirul Islam, Iqbal Hossain, Mustafa Mahfuz, Dinesh Mondol, Fahmida Tofail, Gagandeep Kang, Sushil John, Sudhir Babji, Mohan Venkata Raghava, Anuradha Rose, Beena Kurien, Anuradha Bose, Jayaprakash Muliyil, Anup Ramachandran, Carl J Mason, Prakash Sunder Shrestha, Sanjaya Kumar Shrestha, Ladaporn Bodhidatta, Ram Krishna Chandyo, Rita Shrestha, Binob Shrestha, Tor Strand, Manjeswori Ulak, Zulfiqar A Bhutta, Anita K M Zaidi, Sajid Soofi, Ali Turab, Didar Alam, Shahida Qureshi, Aisha K Yousafzai, Asad Ali, Imran Ahmed, Sajad Memon, Muneera Rasheed, Michael Gottlieb, Mark Miller, Karen H Tountas, Rebecca Blank, Dennis Lang, Stacey Knobler, Monica McGrath, Stephanie Richard, Jessica Seidman, Zeba Rasmussen, Ramya Ambikapathi, Benjamin McCormick, Stephanie Psaki, Vivek Charu, Jhanelle Graham, Gaurvika Nayyar, Viyada Doan, Leyfou Dabo, Danny Carreon, Archana Mohale, Christel Host, Dick Guerrant, Bill Petri, Eric Houpt, Jean Gratz, Leah Barrett, Rebecca Scharf, Laura Caulfield, William Checkley, Margaret Kosek, Pablo Penataro Yori, Gwenyth Lee, Ping Chen, Robert Black, Laura Murray-Kolb, Barbara Schaefer, William Pan

Abstract

Background: The Self-Reporting Questionnaire (SRQ) is a screening instrument that has been shown to be an effective measure of depression in postpartum women and is widely used in developing nations.

Methods: The SRQ was administered to 2028 mothers from eight nations at two time points: one and six months postpartum. All data were obtained from the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) study. The sample included women from MAL-ED sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. This study examined three aspects of validity of SRQ scores including (a) structural validity, (b) cross-cultural invariance, and (c) invariance over time.

Results: A 16-item, one-factor structure with items reflecting somatic symptoms removed was deemed to be superior to the original structure in this postpartum population. Although differential item functioning (DIF) across sites was evident the one-factor model was a good fit to the data from seven sites, and the structure was invariant across the one- and six-month time points.

Limitations: Findings are based on data from self-report scales. No information about the clinical status of the participants was available.

Conclusions: Overall, findings support the validity of a modified model of the SRQ among postpartum women. Somatic symptoms (e.g., headaches, not sleeping well) may not reflect internalizing problems in a postpartum population. Implications for researchers and practitioners are discussed.

Keywords: Low-and middle-income countries; MAL-ED; Postpartum depression; Self-Reporting Questionnaire; Validity.

Conflict of interest statement

Conflict of interest

The authors do not have any conflicts of interest.

Copyright © 2014 Elsevier B.V. All rights reserved.

Figures

Figure 1
Figure 1
MIMIC Model examining one-factor SRQ structure with MAL-ED study site as a covariate.

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