Web-based measure of life events using computerized life events and assessment record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression

Bifulco, Antonia ORCID: https://orcid.org/0000-0001-8316-9706, Spence, Ruth ORCID: https://orcid.org/0000-0002-6197-9975, Nunn, Stephen ORCID: https://orcid.org/0000-0002-2646-4968, Kagan, Lisa, Bailey-Rodriguez, Deborah ORCID: https://orcid.org/0000-0002-9931-563X, Hosang, Georgina M., Taylor, Matthew and Fisher, Helen L. (2019) Web-based measure of life events using computerized life events and assessment record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression. JMIR Mental Health, 6 (1) , e10675. ISSN 2368-7959 [Article] (doi:10.2196/10675)

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Abstract

Background: Given the criticisms of life event checklists and the costs associated with interviews, life event research requires a sophisticated but easy-to-use measure for research and clinical practice. Therefore, the Computerised Life Events and Assessment Record (CLEAR), based on the Life Events and Difficulties Schedule (LEDS), was developed.

Objectives: To test CLEAR’s reliability, validity, and association with depression.

Methods: CLEAR, the General Health Questionnaire, and the List of Threatening Experiences Questionnaire (LTE-Q) were completed by 328 participants (126 students; 202 matched midlife sample: 127 unaffected controls, 75 recurrent depression cases). Test-retest reliability over 3-4 weeks was examined, and validity determined by comparing CLEAR with LEDS and LTE-Q. Both CLEAR and LTE-Q were examined in relation to depression.

Results: CLEAR demonstrated good test-retest reliability for overall number of life events (.89) and severe life events (.60). Long-term problems showed similar findings. In terms of validity, CLEAR severe life events had moderate sensitivity (59.1%) and specificity (65.4%) when compared to LEDS. CLEAR demonstrated moderate sensitivity (43.1%) and specificity (78.6%) when compared to LTE-Q. CLEAR severe life events and long term problems were significantly associated with depression (OR = 3.50, 95% CI: 2.10-5.85, P < .001; OR = 3.38, 95% CI: 2.02-5.67, P < .001, respectively) whereas LTE-Q events were not (OR=1.06, 95% CI: .43-2.60, P =.90).

Conclusions: CLEAR has acceptable reliability and validity and predicts depression. It therefore has great potential for effective use in research and clinical practice identifying stress-related factors for the onset and maintenance of depression and related disorders.

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