Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis

Internalized oppression and deaf people's mental health

Deaf people experience ableism (able-bodied oppression), audism (hearing-ability oppression), and linguicism (sign language-use oppression) and this study investigated if internalizing these oppressive experiences predicts their mental health. Deaf participants (N = 134) completed a 54-item Deaf Oppression Scale, developed for this study with Ableism, Audism, and Linguicism Subtests, along with the Beck Depression Inventory-II and the State and Trait Anxiety Inventory. The Deaf Oppression Scale and its Ableism, Audism, and Linguicism Subscales carry good reliability and the model fit indices for a confirmatory factor analysis indicated a good fit. Sixteen (16%) percent (n = 22) of the sample had depression, 36% (n = 48) had state anxiety, and 64% (n = 86) had trait anxiety. Internalized ableism predicted greater characteristics and symptoms of depression, internalized ableism and linguicism predicted greater state anxiety, and internalized audism predicted greater trait anxiety. This is the first empirical evidence dissociating three types of oppression that deaf people experience and their separate and different effects on their psychological well-being.

Using the HBSC Symptom Checklist to measure junior secondary school students' psychosomatic complaints in the Chinese Mainland: Rasch-based validation, population-based norm, and norm-referenced scoring algorithm

BACKGROUND

The Symptom Checklist (SCL) developed by the Health Behaviour in School‑aged Children (HBSC) study is widely used to capture the psychosomatic complaints (PSC) of non-clinical children and adolescents. Although its psychometric properties have been well established internationally, the performance of the Mandarin Chinese version remains unclear. This study evaluates the Mandarin Chinese HBSC-SCL's psychometric properties, develops its norm, and creates the corresponding scoring algorithm.

METHODS

Data were collected from a two-wave cross-sectional survey conducted between June 20 and July 11, 2022, across eight Chinese Human Geography Regions (CHGRs). The sample included 3290 junior secondary school students, obtained through convenience sampling (first wave) and multistage, stratified, cluster sampling (second wave). The surveys were administered anonymously in the school setting, using a paper-and-pencil, self-administered questionnaire. The Mandarin Chinese HBSC-SCL's unidimensionality was verified using confirmatory factor analysis (CFA), and its psychometric properties were comprehensively evaluated using the partial credit model (PCM) of the Rasch measurement method. Based on the above scientific evidence, the population-based norm and norm-referenced scoring algorithm were developed and created.

RESULTS

The CFA confirmed that the HBSC-SCL can be considered unidimensional in the Chinese Mainland. Evidence-based on the six features of the Rasch model indicated that the Mandarin Chinese HBSC-SCL has satisfactory psychometric properties. All 5-category rating scales of eight items appropriately differentiated the students' PSC and demonstrated strong goodness-of-fit. This version also exhibited good unidimensionality and local independence. The Rasch model generated two kinds of reliability indicators, with the item indicators performing well. The person-item map demonstrated acceptable person and item matches, and provided new perspectives for future improvements. Additionally, no substantial uniform differential item functioning (UDIF) was detected across 13 groups (e.g., survey waves, gender, chronological age).

CONCLUSIONS

The Mandarin Chinese HBSC-SCL demonstrates satisfactory psychometric properties and performs well in the Chinese Mainland context. It provides concise self-reported PSC measures for junior secondary school students, potentially applicable to a broader Chinese-speaking population. Its ease of administration, scoring, and interpretation makes it suitable for routine school monitoring, large-scale population surveys, and clinical applications. Additionally, the population-based norm and norm-referenced scoring algorithm support the broader application of this version and offer new insights for interpreting PSC sum scores.

Different dorsolateral prefrontal activation during an emotionalautobiographical memory task between male and female depressed individuals: a fNIRS study

Depression in male and female are commonly associated with different prevalence, severity, and, in some cases, distinct syndromes or subtypes. However, only a small amount of research has been conducted to completely understand the underlying neuroanatomical mechanisms. The goal of the current study was to provide neural markers for specific depression therapies by demonstrating the differences in aberrant prefrontal activity between male and female depressed subjects during an emotional autobiographical memory test. The study included 127 young adults who were randomly assigned to one of two groups: male depression (62 participants) or female depression (65 participants). The average oxyhemoglobin levels in the dorsolateral prefrontal cortex throughout the emotional autobiographical memory task were assessed utilizing 53-channel functional near-infrared spectroscopy imaging equipment. The oxy-Hb activation in the left dorsolateral prefrontal cortex (lDLPFC) and right dorsolateral prefrontal cortex (rDLPFC) had no significant interaction between groups and emotional valences. A significant main effect was found between male and female, with female depression groups showing lower oxy-Hb activity in lDLPFC and rDLPFC than male depression groups. Male and female depression patients showed distinct brain activation in the DLPFC during an emotional autobiographical memory test, suggesting potential specific neurological indicators for varied somatic symptoms in male and female depression patients. These distinctions should be taken into account while creating preventive measures.

It isn't just Mom: Gendered provision of family and home responsibilities among emerging adults during COVID-19

Media and research reports have highlighted the disproportionate burden of home and family responsibilities shouldered by women and mothers due to COVID-19-related school/childcare shutdowns. This cross-sectional study extends this line of inquiry to emerging adults. Our study of 329 diverse emerging adults suggests that young women took on more home/family responsibilities than young men amidst the pandemic, and that these duties were associated with symptoms of depression. However, results also indicate that emerging adults who reported greater home/family responsibilities amidst the pandemic also experienced more quality family time, suggesting that pandemic-related challenges may have also been accompanied by opportunities for family connection. Contrary to previous research that has shown home/family responsibilities to be concentrated by SES and race/ethnicity, we found that participants uniformly endorsed COVID-19-related impacts on home/family responsibilities across these demographic distinctions. This could reflect the ubiquity of COVID-19's impact; across race/ethnicity and class-but differentially by gender-young adults faced significant challenges in taking on new home/family roles.

Internet addiction and depressive symptoms: a dose-response effect mediated by levels of physical activity

INTRODUCTION

There are several negative impacts on the physical and mental health of people presenting internet addiction, including development of mood disorders, such as depression.

OBJECTIVE

The aim of the study was to evaluate the association between internet addiction and depressive symptoms, as well as to test the mediating role of physical activity in this association.

METHODS

A cross-sectional study was conducted with undergraduate students from three universities (one private and two public institutions) in southern Brazil. Depressive symptoms were measured with the Beck Depression Inventory (BDI-21), internet addiction with the Internet Addiction Test (IAT-20), and physical activity with the International Physical Activity Questionnaire (IPAQ - short version). Poisson regression and the Karlson-Holm-Breen mediation method were used for statistical analyses.

RESULTS

We observed a dose-response relationship between internet addiction and depressive symptoms. Levels of physical activity mediated the association between moderate internet addiction and depressive symptoms, accounting for 10.7% of the effect observed.

CONCLUSION

Internet addiction can be detrimental to individuals' health, contributing to development of depressive symptoms. Along with psychological and pharmacological therapies, prescription of physical activities is recommended.

The impact of aging on morphometric changes in the cerebellum: A voxel-based morphometry study

Introduction

Aging influences the morphology of the central nervous system. While several previous studies focused on morphometric changes of the supratentorial parts, investigations on age-related cerebellar changes are rare. The literature concerning the morphological changes in the cerebellum is heterogenous depending (i) on the methods used (cerebellar analysis in the context of a whole brain analysis or specific methods for a cerebellar analysis), (ii) the life span that was investigated, and (iii) the analytic approach (i.e., using linear or non-linear methods).

Methods

We fill this research gap by investigating age-dependent cerebellar changes in the aging process occurring before the age of 70 in healthy participants, using non-linear methods and the spatially unbiased infratentorial template (SUIT) toolbox which is specifically developed to examine the cerebellum. Furthermore, to derive an overview of the possible behavioral correlates, we relate our findings to functional maps of the cerebellum. Twenty-four older participants (mean age 64.42 years, SD ± 4.8) and 25 younger participants (mean age 24.6 years, SD ± 2.14) were scanned using a 3 T-MRI, and the resulting data were processed using a SUIT.

Results

Gray matter (GM) volume loss was found in older participants in three clusters in the right cerebellar region, namely crus I/II and lobule VI related to the frontoparietal network, with crus I being functionally related to the default-mode network and lobule VI extending into vermis VIIa related to the ventral-attention-network.

Discussion

Our results underline an age-related decline in GM volume in the right cerebellar regions that are functionally predominantly related to non-motor networks and cognitive tasks regions of the cerebellum before the age of 70.

Evaluating the psychometric properties of the Chronic Time Pressure Inventory using Rasch analysis

Background

Chronic time pressure is a common source of everyday stress and anxiety. Noting this, the Chronic Time Pressure Inventory (CTPI) was designed to measure the construct within general samples. The CTPI was validated using procedures informed by classical test theory. This identified a bifactor solution, comprising a general factor encompassing two overlapping factors: Cognitive Awareness of Time Shortage and Feeling Harried. Furthermore, the CTPI demonstrated good psychometric integrity. Explicitly, internal consistency, satisfactory convergent validity with the Perceived Stress Scale, and measurement invariance. While these outcomes indicated that the CTPI was an effective measure of chronic time pressure, the scale was not subjected to analysis of item-person functioning (i.e., Rasch evaluation).

Methods

This study accordingly examined the psychometric properties of the CTPI using Rasch analysis. A general sample of 748 (595 females, 153 males) participants completed the measure online.

Results

Initial findings recommended modification of the response scale. Subsequent analyses revealed unidimensionality, adequate item/person reliability, and gender invariance. Overall, findings confirmed that the CTPI was a valid instrument for assessing perceptions of chronic time pressure within general population samples. Noting the lack of items aligning with higher ability levels, future work should develop the CTPI by adding more complex positively keyed items.

The Increased Alcohol and Marijuana Use Associated with the Quality of Life and Psychosocial Aspects: a Study During the Covid-19 Pandemic in a Brazilian University Community

The primary practice adopted to reduce Covid-19 contamination is social distancing (SD). SD had significant consequences on alcohol/drug use, quality of life, and psychosocial aspects. In the university community specifically, SD produces a collective traumatic event with changes in the work routine by the suspension of presence. This study aims to identify and analyze the associations of increased alcohol and marijuana consumption on the quality of life and psychosocial aspects of the university community (students, professors, and technical and administrative staff) at a Brazilian public university during SD due to Covid-19 pandemic. This descriptive and cross-sectional study used an online questionnaire to obtain information from 2790 university community participants. Data were analyzed using IBM SPSS Statistics version 22. The analysis included descriptive associations performed using Spearman's correlation coefficient and p < 0.05 was taken as statistically significant. The participants' majority was 62% female, 95.4% students, 73% were 17-25 years old, 33.4% had income between 1 and 3 minimum wage, and 48% of the university community "totally adhered to SD." The increased alcohol consumption during SD was associated with a worsening in quality of life (p = 0.001), health satisfaction (p = 0.015), the meaning of life (p = 0.040), ability to concentrate (p = 0.001), satisfaction with yourself (p = 0.029), and frequency of negative feelings (p = 0.001); in contrast, increased alcohol use improved satisfaction with peer support (p = 0.042), as well as increased marijuana use improved satisfaction with sex life (p < 0.001). The increased alcohol use was higher in women (30.5%) than in men (26.7%) and was negatively associated with more quality of life and psychosocial aspects among women than men. Students were the segment that presented the highest frequency of associations with increased alcohol and/or marijuana use in the three domains analyzed. This study innovated by associating increased alcohol and/or marijuana use with worsening quality of life and psychosocial aspects rather than evaluating them apart. Future studies must identify whether this association between increased alcohol use, mainly, and the worsening quality of life and psychosocial aspects during the SD period is maintained or improved with the return to face-to-face activities at the university, with particular attention to women and students. Psychologists and other mental health professionals should be called upon to develop interventions to meet emerging mental health needs.

Zur Messqualität des Beck-Depressionsinventars (BDI-II) in unterschiedlichen klinischen Stichproben

Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivität) hinweg und sind die Kategorien der Items jeweils aufsteigend geordnet? Methode: Anhand von sechs großen Datensätzen aus verschiedenen klinischen Bereichen wurden psychometrische Analysen mit dem Graded Response Model durchgeführt. Ergebnisse: In allen Stichproben fand sich eine hohe interne Konsistenz. Die Schwellenwerte waren mit Ausnahme von Item 6 („Bestrafungsgefühle“) geordnet. Gemäß Testinformationsfunktion misst das BDI-II im mittleren bis hohen Depressionsbereich sehr gut (Reliabilität > .90) und im unteren Bereich gut. Schlussfolgerung: Für das BDI-II ergibt sich eine hohe und relativ gleichbleibende Messpräzision über einen weiten Bereich des latenten Traits, weshalb es insbesondere im klinischen, aber auch im nicht klinisch relevanten Wertebereich zur Erhebung des Schweregrades einer Depression gut geeignet ist.

Comparison of unweighted and item response theory-based weighted sum scoring for the Nine-Questions Depression-Rating Scale in the Northern Thai Dialect

Background

The Nine-Questions Depression-Rating Scale (9Q) has been developed as an alternative assessment tool for assessing the severity of depressive symptoms in Thai adults. The traditional unweighted sum scoring approach does not account for differences in the loadings of the items on the actual severity. Therefore, we developed an Item Response Theory (IRT)-based weighted sum scoring approach to provide a scoring method that is more precise than the unweighted sum score.

Methods

Secondary data from a study on the criterion-related validity of the 9Q in the northern Thai dialect was used in this study. All participants were interviewed to obtain demographic data and screened/evaluated for major depressive disorder and the severity of the associated depressive symptoms, followed by diagnosis by a psychiatrist for major depressive disorder. IRT models were used to estimate the discrimination and threshold parameters. Differential item functioning (DIF) of responses to each item between males and females was compared using likelihood-ratio tests. The IRT-based weighed sum scores of the individual items are defined as the linear combination of individual response weighted with the discrimination and threshold parameters divided by the plausible maximum score based on the graded-response model (GRM) for the 9Q score (9Q-GRM) or the nominal-response model (NRM) for categorical combinations of the intensity and frequency of symptoms from the 9Q responses (9QSF-NRM). The performances of the two scoring procedures were compared using relative precision.

Results

Of the 1,355 participants, 1,000 and 355 participants were randomly selected for the developmental and validation group for the IRT-based weighted scoring, respectively. the gender-related DIF were presented for items 2 and 5 for the 9Q-GRM, while most items (except for items 3 and 6) for the 9QSF-NRM, which could be used to separately estimate the parameters between genders. The 9Q-GRM model accounting for DIF had a higher precision (16.7%) than the unweighted sum-score approach.

Discussion

Our findings suggest that weighted sum scoring with the IRT parameters can improve the scoring when using 9Q to measure the severity of the depressive symptoms in Thai adults. Accounting for DIF between the genders resulted in higher precision for IRT-based weighted scoring.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12874-022-01744-0.

Vitamin B6 Supplementation Reduces Symptoms of Depression in College Women Taking Oral Contraceptives: A Randomized, Double-Blind Crossover Trial

Oral contraceptive (OC) users have a heightened risk of low plasma concentrations of vitamin B6, a cofactor in the tryptophan-serotonin pathway critical to mood regulation. The purpose of this crossover study was to determine whether vitamin B6 supplementation reduced symptoms of depression and improved mood states in college women using OC. Participants were healthy (aged 18-25 yrs), did not take dietary supplements, and used OC (estrogen with progestin) consistently for at least 1 year. During the 12-week, randomized, double-blind crossover trial (4-week treatment periods [100 mg vitamin B6 daily or placebo] separated by a 4-week washout) participants (n = 8) maintained normal exercise and eating patterns and recorded tablet consumption daily. The Beck Depression Inventory-II (BDI-II) and Profile of Mood States (POMS) were used to assess mental health before and after each 4-week treatment period. Average dietary vitamin B6 intakes did not vary during the trial (1.2-1.4 mg/d), whereas vitamin B6 status rose significantly following the B6 supplementation period compared to the other three time points. BDI-II scores were reduced 20% by vitamin B6 supplementation in comparison to an 11% rise with placebo ingestion (p = 0.046). POMS scores were not significantly impacted by vitamin B6 supplementation. These preliminary data support a growing literature suggesting the benefits of B6 supplementation for reducing symptoms of depression in young women using OC.

Does medical school cause depression or do medical students already begin their studies depressed? A longitudinal study over the first semester about depression and influencing factors

OBJECTIVE

In the past, medical students have been found to be at increased risk for depressive symptoms compared to the general population. This study addresses the question, whether medical students already show these elevated depression scores at the beginning of medical school or whether it is the studies of medicine that leads to symptoms of depression.

METHODS

In the winter semester 2018/2019, 148 medical students at a middle-sized German university answered a questionnaire during the first (T0) and last week (T1) of their first semester that examined various risk and resilience factors for initial depressive symptoms and their course. The severity of symptoms was assessed with the Beck´s Depression Inventory II (BDI-II). A subscale of the NEO-FFI was used to investigate the personality factor neuroticism.

RESULTS

Over the study period, the percentage of students suffering from at least mild depressive symptoms increased from 16.3% in the first week of their studies (T0) to 21.4% at the end of the first semester (T1). The use of drugs or medication, loneliness, mental overload, performance pressure and financial burden show the strongest influence on the development of depressive symptoms. Concerning surveyed resilience factors, in particular emotional support, physical workout and sufficient time for social contact appear to be protective. The more risk factors are concentrated on an individual, the higher its increase of depressive symptoms. The opposite is prevailing for the investigated resilience factors. Except for the use of drugs or medication, no other criterion than the BDI-II value at T0 was able to predict the BDI-II score at T1. This underlines that especially the interplay of factors is decisive.

CONCLUSION

The findings of this study could indicate a worsening tendency of the BDI-II score in the further course of medical school. Ultimately, we emphasize the importance of offering preventive measures to medical students as early as possible.

COVID-19 and Depression: Prevalence and Risk Factors in Youth from Maharashtra, India

The COVID-19 pandemic and the ensuing lockdown have been a seismic shock for youth in India, elevating their risk of mental health problems like depression. This cross-sectional study sought to measure the point prevalence levels of depression in university students (ages 19–25 years) from Maharashtra, India, during the peak of the first wave of the pandemic and lockdown, through an online opt-in survey. The BDI-II was self-administered by 783 respondents (males = 243; females = 540). Results indicated overall mild levels of depression (mean BDI = 16.48) and high point prevalence, with 51.8% (n = 406) of the population being symptomatic, of which 16.3% had severe, 17.9% had moderate, and 17.8% had mild levels of depression. No association was found with age, gender, educational level of participants, period of hostel stay, education, and occupational level of parents. Overall percentages of symptomatic women were higher, suggesting the gendered effects of the pandemic. This study explored the symptomatology of depression wherein “sadness,” “changes in sleep patterns,” and “concentration difficulties” emerged as the most commonly experienced symptoms. Symptom expression was found to vary with intensity and gender. Symptomatic men experienced significantly more cognitive symptoms like self-criticalness, punishment feelings, thoughts about past failures, and changes in sleep patterns, while symptomatic women felt significantly high “loss of energy.” No significant gender differences were seen in the experience of cognitive-affective symptoms. Possible reasons are discussed. Further exploration of the experiences of youth is essential to understand the full gamut of the pandemic’s impact on them.

The Short- and Long-term Causal Relationships Between Self-compassion, Trait Mindfulness, Caregiver Stress, and Depressive Symptoms in Family Caregivers of Patients with Lung Cancer

Objectives

Using a prospective longitudinal design, this paper examines a serial mediation model of the associations between self-compassion, trait mindfulness, caregiver stress, and depressive symptoms among the family caregivers of patients with lung cancer.

Methods

A four-wave design was used, with initial assessment (T1) and three follow-ups, at the 2^nd month (T2), the 5^th month (T3), and the 8^th month (T4). A total of 123 family caregivers completed the baseline measurements, including caregiver stress, self-compassion, trait mindfulness, and depressive symptoms. Data were analyzed by serial mediation models to determine the causal ordering of these variables.

Results

Nearly one-quarter of the family caregivers suffered from clinically significant depressive symptoms and the severity of their depression remained unchanged throughout the 8-month follow-up period. Both cross-sectional and longitudinal path analyses revealed that the relationship between self-compassion and depressive symptoms was mediated sequentially by trait mindfulness and caregiver stress. The subscale analysis indicated that the association of higher compassionate action with fewer depressive symptoms was through chain-mediating effects of higher mindful awareness and lower caregiver stress.

Conclusions

Family caregivers who have higher levels of self-compassion tend to have more mindfulness; greater mindfulness leads to lower levels of perceived caregiving stress which, in turn, links to fewer symptoms of depression. Both self-compassion and mindfulness could be regarded as protective factors for caregivers to reduce caregiving stress and depression.

Prevalence of anxiety, depression and suicidal behaviors among Brazilian undergraduate students: A systematic review and meta-analysis

BACKGROUND

The university context can be an overwhelming background, being especially harmful to undergraduates' mental health. Considering that several studies have reported on the prevalence of psychological distress among Brazilian undergraduate students, this study aimed to conduct a systematic review and meta-analysis of the prevalence and associated factors of anxiety, depression and suicidal behavior in this population.

METHODS

Studies reporting on the prevalence of anxiety, depression and suicidal behavior and its associated factors among Brazilian undergraduate students were systematically searched in scientific electronic databases. Pooled prevalence was calculated using a random-effects meta-analysis. Individual associated factors were summarized, and study characteristics associated with outcome prevalence were tested through meta-regression analysis.

RESULTS

Forty-seven articles were included, of which 44 were meta-analyzed (37,486 undergraduates). The pooled prevalence estimates of anxiety, depression and suicidal behavior were 37.75%, 28.51%, and 9.10%, respectively. Meta-regression analysis showed that investigations with probabilistic samples presented a higher prevalence of anxiety and that studies conducted within public institutions and with samples of exclusively medical students presented higher frequencies of depression.

LIMITATIONS

Cross-sectional data do not allow the establishment of temporality and causal inference. Furthermore, the high heterogeneity of the included studies may also constitute a weakness of this review.

CONCLUSIONS

The prevalence of anxiety, depression and suicidal behavior among Brazilian undergraduates was high. These results have scientific and practical implications, the former regarding the need for the standardization of the methodology of studies and the latter regarding the need for comprehensive mental health care for Brazilian undergraduates.

Prevalence and its associated factors of depressive symptoms among Chinese college students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has caused a mental health crisis around the world. The psychological health of college students also faces great challenges. This study aimed to investigate the prevalence and the related factors of depressive symptoms among Chinese college students.

METHODS

This online cross-sectional survey was conducted via Wenjuanxing platform from March 3-15, 2020 and received 1681 effective questionnaires. Each questionnaire contains the Center for Epidemiologic Studies Depression scale, the Multi-Dimensional Scale of Perceived Social Support, the Herth Hope Index, and the self-designed items. Multivariable logistic regression was conducted to determine the significantly associated factors of depressive symptoms.

RESULTS

The prevalence of depressive symptoms among college students was 56.8%. Sleep problems (OR 2.678, 95%CI 2.094-3.424), family members' going out (OR 1.775, 95%CI 1.089-2.894), perceived more stress for online education (OR 1.642, 95%CI 1.191-2.263), fear of COVID-19 (OR 1.450, 95%CI 1.121-1.876), influence on social interaction (OR 1.354, 95%CI 1.053-1.741) and higher grade (OR 1.378, 95%CI 1.046-1.816) were considered as risk factors of depressive symptoms. Perceived social support (OR 0.354, 95%CI 0.259-0.484), hope (OR 0.052, 95%CI 0.034-0.080), female (OR:0.557, 95%CI 0.427-0.725) and higher monthly disposable income (OR 0.666, 95%CI 0.447-0.993) were identified as protective factors against depressive symptoms.

CONCLUSIONS

There was a high prevalence of depressive symptoms among Chinese college students during the COVID-19 pandemic. It is important to find ways to alleviate the pressure and fear of college students, to provide them with more social support, and to help them adapt to the changes in learning style and lifestyle.

Factor Structure and Measurement Invariance Across Gender of the Beck Depression Inventory-II in Adolescent Psychiatric Patients

The revised version of the Beck Depression Inventory (BDI-II) is one of the most frequently applied questionnaires not only in adults, but also in adolescents. To date, attempts to identify a replicable factor structure of the BDI-II have mainly been undertaken in adult populations. Moreover, most of the studies which included minors and were split by gender lacked confirmatory factor analyses and were generally conducted in healthy adolescents. The present study therefore aimed to determine the goodness of fit of various factor models proposed in the literature in an adolescent clinical sample, to evaluate alternative solutions for the factor structure and to explore potential gender differences in factor loadings. The focus was on testing bifactor models and subsequently on calculating bifactor statistical indices to help clarify whether a uni- or a multidimensional construct is more appropriate, and on testing the best-fitting factor model for measurement invariance according to gender. The sample comprised 835 adolescent girls and boys aged 13-18 years in out- and inpatient setting. Several factor models proposed in the literature provided a good fit when applied to the adolescent clinical sample, and differences in goodness of fit were small. Exploratory factor analyses were used to develop and test a bifactor model that consisted of a general factor and two specific factors, termed cognitive and somatic. The bifactor model confirmed the existence of a strong general factor on which all items load, and the bifactor statistical indices suggest that the BDI-II should be seen as a unidimensional scale. Concerning measurement invariance across gender, there were differences in loadings on item 21 (Loss of interest in sex) on the general factor and on items 1 (Sadness), 4 (Loss of pleasure), and 9 (Suicidal Thoughts) on the specific factors. Thus, partial measurement invariance can be assumed and differences are negligible. It can be concluded that the total score of the BDI-II can be used to measure depression severity in adolescent clinical samples.