Abstract
Purpose: In a nationwide study, 44% of college students screened positive for depression, with 23% screening positive for a provisional diagnosis of major depression (Eisenberg et al., 2023). The American College Health Association [ACHA] (2024) reported significant mental health symptoms among undergraduates, with 78.8% reporting moderate to high levels of stress and 24.2% reporting a previous diagnosis of depression. Concerningly, 28.1% had a positive screening for suicide risk on the Suicide Behavior Questionnaire-Revised (ACHA, 2024). These statistics highlight the severe mental health crisis in this vulnerable population, offering a key opportunity to reach at-risk individuals during this transitional period. There is no population-specific instrument available that assesses risk of depression in college freshmen. The purpose of this presentation is to describe the development and psychometric properties of the College Assessment for Risk Evaluation of Depression (CAREd) screening instrument.
Methods: The CAREd instrument was developed following a grounded theory analysis (Charmaz, 2014) of interviews with 35 students who self-identified as having a history of depression. The initial 56 items were devised based on four categories representing the process of managing depression as a college freshman. A convenience sample of 328 undergraduate students was recruited. All items on the CAREd are measured on a four-point Likert scale, ranging from “not at all” to “always.” To measure criterion validity of the CAREd, the CES-D (Radloff, 1977) was administered concurrently.
Results: A total of 257 undergraduates completed the CAREd and the CES-D. Psychometric testing of the CAREd included item analysis, scale reliability, criterion validity, and exploratory factor analysis (Nunnally, 1978). Items exhibiting inter-item correlation scores below 0.3 and lacking thematic contribution to the CAREd were removed. These analyses resulted in a reduced 34-item instrument, of which the Cronbach’s alpha was r = 0.92. Scores ranged from 12 to 89 (M = 45.20, SD = 15.86). Criterion validity with the CES-D was r = 0.81.
Conclusions: The strong psychometric properties of the CAREd demonstrate support for a valid and reliable population-specific instrument to screen for risk of depression in college freshmen (Field, 2024). University healthcare providers can use the CAREd to screen first-year students for depression risk, enabling early interventions to prevent adverse outcomes.
Notes
References:
American College Health Association. (2024). American college health association-national college health assessment III: Undergraduate student reference group executive summary fall 2023. Silver Spring, MD.
Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Sage.
Eisenberg, D., Lipson, S. K., Heinze, J., & Zhou, S. (2023). The healthy minds study: 2021-2022 data report. https://healthymindsnetwork.org/wp-content/uploads/2023/08/HMSNational-Report-2021-22_full.pdf
Field, A. (2024). Discovering statistics using IBM SPSS statistics (6th ed.). Sage.
Nunnally, J. C. (1978). Psychometric theory (3rd ed.). McGraw-Hill.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
Sigma Membership
Zeta Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Grounded Theory
Research Approach
Qualitative Research
Keywords:
Instrument and Tool Development, College Students, Depression Risks
Recommended Citation
Gass, Grace; Brandy, Julie; and Kessler, Theresa A., "Psychometric Testing: College Assessment for Risk Evaluation of Depression (CAREd)" (2025). International Nursing Research Congress (INRC). 284.
https://www.sigmarepository.org/inrc/2025/presentations_2025/284
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Psychometric Testing: College Assessment for Risk Evaluation of Depression (CAREd)
Seattle, Washington, USA
Purpose: In a nationwide study, 44% of college students screened positive for depression, with 23% screening positive for a provisional diagnosis of major depression (Eisenberg et al., 2023). The American College Health Association [ACHA] (2024) reported significant mental health symptoms among undergraduates, with 78.8% reporting moderate to high levels of stress and 24.2% reporting a previous diagnosis of depression. Concerningly, 28.1% had a positive screening for suicide risk on the Suicide Behavior Questionnaire-Revised (ACHA, 2024). These statistics highlight the severe mental health crisis in this vulnerable population, offering a key opportunity to reach at-risk individuals during this transitional period. There is no population-specific instrument available that assesses risk of depression in college freshmen. The purpose of this presentation is to describe the development and psychometric properties of the College Assessment for Risk Evaluation of Depression (CAREd) screening instrument.
Methods: The CAREd instrument was developed following a grounded theory analysis (Charmaz, 2014) of interviews with 35 students who self-identified as having a history of depression. The initial 56 items were devised based on four categories representing the process of managing depression as a college freshman. A convenience sample of 328 undergraduate students was recruited. All items on the CAREd are measured on a four-point Likert scale, ranging from “not at all” to “always.” To measure criterion validity of the CAREd, the CES-D (Radloff, 1977) was administered concurrently.
Results: A total of 257 undergraduates completed the CAREd and the CES-D. Psychometric testing of the CAREd included item analysis, scale reliability, criterion validity, and exploratory factor analysis (Nunnally, 1978). Items exhibiting inter-item correlation scores below 0.3 and lacking thematic contribution to the CAREd were removed. These analyses resulted in a reduced 34-item instrument, of which the Cronbach’s alpha was r = 0.92. Scores ranged from 12 to 89 (M = 45.20, SD = 15.86). Criterion validity with the CES-D was r = 0.81.
Conclusions: The strong psychometric properties of the CAREd demonstrate support for a valid and reliable population-specific instrument to screen for risk of depression in college freshmen (Field, 2024). University healthcare providers can use the CAREd to screen first-year students for depression risk, enabling early interventions to prevent adverse outcomes.
Description
This session will explore the development and psychometric testing of the College Assessment for Risk Evaluation of Depression (CAREd) instrument, designed to screen college freshmen for risk of depression. The practical applications of the CAREd instrument will be discussed, offering valuable insights for supporting the mental health of students.