Testing the Factor Structure and Measurement Invariance of the PHQ-9 Across Racially Diverse US College Students

Today's college students are at increased risk for depression. Therefore, accurate and sustainable assessment of depressive symptoms among college students has become an important issue. One promising instrument for depression screening in college settings is the Patient Health Questionnaire-9 (PHQ-9), a 9-item self-report measure developed in primary care and designed to assess the presence of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptom criteria for major depressive disorder. Although the PHQ-9 has been well validated in primary care settings, no studies have examined its factor structure for diverse college populations in the United States. This study used confirmatory factor analysis to test competing measurement models and the measurement invariance of the PHQ-9 across gender (men and women) and racial/ethnic groups (African American, Asian American, European American, Latino/a American) in a sample of 857 U.S. college students. Results supported a 1-factor model of the PHQ-9. Based on configural, metric, and scalar invariance test results, the PHQ-9 assesses depressive symptoms equivalently across gender and racial/ethnic groups. In support of validity evidence, PHQ-9 scores were positively associated with alcohol use and negatively associated with mental well-being. Implications for future research and assessment are discussed. Public Significance Statement The current study found that the PHQ-9 assesses depressive symptoms equivalently across diverse gender and racial/ethnic college student populations. The results support the promising utility of PHQ-9 as a brief depression assessment in college settings.