Afghanistan National Depression Screening (ANDs) scale: development and psychometric testing

Abstract

Background Depression is a complex mental health disorder marked by persistent sadness, hopelessness, and reduced interest in daily activities. The present study developed the Afghanistan National Depression Screening (ANDs) scale and examined its psychometric properties within the Afghan population. Methods The study enrolled 1245 Afghan individuals as participants. The items within the ANDs scale were developed through a thorough examination of pre-existing depression scales, expert assessments, and participant interviews. Multiple psychometric evaluations were administered to ensure the reliability and validity of the scale. Results After review and corrected item-total correlation testing, 15-items exhibiting acceptable corrected item-total correlation coefficients (ranging from 0.315 to 0.647) were retained and further validated through significant factor loadings (ranging from 0.358 to 0.725). Additionally, various properties assessed through classical test theory demonstrated satisfactory results on the 15-item scale. Specifically, measures of reliability such as internal consistency (α = 0.846) and Spearman-Brown coefficient (0.975) were deemed acceptable. Convergent validity was evidenced by strong correlations with established scales, including the DASS-21 (depression subscale, r = 0.854), GHQ-28 (depression subscale, r = 0.693), CES-D 20 (r = 0.922), and PHQ-9 (r = 0.758). Conclusion The 15-item ANDs scale is developed to assess depression in Afghan populations, showing promise in correlation with established measures like PHQ-9, DASS-21, CESD-20, and GHQ-28. Its potential for identifying depression symptoms warrants further investigation in epidemiological studies and clinical settings, though replication across diverse samples is necessary for generalizability.