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Appears in Collections:Management, Work and Organisation Journal Articles
Peer Review Status: Refereed
Title: The Center for Epidemiologic Studies-Depression (CES-D) scale measures a continuum from well-being to depression: Testing two key predictions of positive clinical psychology
Author(s): Siddaway, Andrew
Wood, Alex M
Taylor, Peter J
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Keywords: recovery
Issue Date: 15-Apr-2017
Citation: Siddaway A, Wood AM & Taylor PJ (2017) The Center for Epidemiologic Studies-Depression (CES-D) scale measures a continuum from well-being to depression: Testing two key predictions of positive clinical psychology, Journal of Affective Disorders, 2013, pp. 180-186.
Abstract: Background: Two core but untested predictions of Positive Clinical Psychology (PCP) are that (1) Many psychiatric problems can be understood as one end of bipolar continua with well-being, and (2) that reducing psychiatric symptoms will provide an equal (near linear) decrease in risk for several other psychiatric variables, irrespective of position on continua.  Aims: We test these predictions in relation to a purported well-being/depression continuum, as measured by the Center for Epidemiologic Studies-Depression (CES-D), a popular measure of depressive experiences in research and clinical practice.  Method: A large (N = 4,138), diverse sample completed the CES-D, which contains a mixture of negatively worded and positively worded items (e.g., “I felt sad,” “I enjoyed life”). The latter are conventionally reverse scored to compute a total score. We first examined whether purportedly separate well-being and depression CES-D factors can be reconceptualised as a bipolar well-being/depression continuum. We then characterised the (linear or nonlinear) form of the relationship between this continuum and other psychiatric variables.  Results: Both predictions were supported. When controlling for shared method bias amongst positively worded items, a single factor well-being/depression continuum underlies the CES-D. Baseline levels on this continuum are found to have near linear relationships with changes in anxiety symptoms, aggression, and substance misuse over time, demonstrating that moving from depression to well-being on the CES-D provides an equal decrease in risk for several other psychological problems irrespective of position on the continuum.  Limitations: The CES-D does not measure well-being as comprehensively as established scales of well-being.  Conclusions: Results support calls for mental health services to jointly focus on increasing well-being and reducing distress, and point to the value of early intervention and instilling resilience in order to prevent people moving away from high levels of well-being.
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Rights: © 2017 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (

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